Nokea
Neurological features of myxoedema include all of the following except:
- A. Delayed relaxation of ankle jerk
- B. Cerebellar ataxia
- C. Hypertonia
- D. Bradylalia
Correct Answer: B
Rationale: Myxoedema refers to severe hypothyroidism which can lead to neurological manifestations. The correct features associated with myxoedema include delayed relaxation of ankle jerk (Choice A), hypertonia (Choice C), and bradylalia (Choice D). Cerebellar ataxia, which involves incoordination and balance issues due to dysfunction of the cerebellum, is not a typical neurological feature seen in myxoedema.
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Which of the following investigations is the gold standard for diagnosing acromegaly?
- A. Serum IGF1 measurement
- B. Growth hormone releasing hormone measurement
- C. Oral glucose tolerance test + Growth hormone measurement
- D. Growth hormone measurement
Correct Answer: C
Rationale: The gold standard for diagnosing acromegaly is the oral glucose tolerance test (OGTT) along with growth hormone (GH) measurement. During this test, the patient is given a glucose solution to drink, and then blood samples are taken to measure GH levels at specific time intervals. In a person without acromegaly, glucose ingestion would typically suppress GH levels. However, in individuals with acromegaly, GH levels remain elevated even after glucose administration due to the inability of glucose to inhibit GH release from the tumor.
"Pseudo-Cushing's syndrome' may be found in all except:
- A. Myxoedema
- B. Chronic alcoholism
- C. Obesity
- D. Depression
Correct Answer: A
Rationale: Pseudo-Cushing's syndrome is a condition that mimics the symptoms of Cushing's syndrome but is not actually caused by excess cortisol production by the adrenal glands. It can be caused by various conditions such as chronic alcoholism, obesity, depression, and certain medications. However, myxoedema (also known as severe hypothyroidism) is not typically associated with pseudo-Cushing's syndrome. Myxoedema is characterized by low thyroid hormone levels, which would not lead to the symptoms of pseudo-Cushing's syndrome.
Thyroid-stimulating hormone (TSH):
- A. is a glycoprotein hormone.
- B. is synthesized in the follicular cells of the thyroid gland.
- C. has gonadotropic activity.
- D. stimulates the activity of parafollicular thyroid cells.
Correct Answer: A
Rationale: Thyroid-stimulating hormone (TSH) is a glycoprotein hormone that is produced and secreted by the anterior pituitary gland. It acts on the thyroid gland to stimulate the production and release of thyroid hormones, T3 (triiodothyronine) and T4 (thyroxine). TSH plays a crucial role in regulating the function of the thyroid gland and maintaining overall thyroid hormone levels in the body.
Increased muscle mass with slowness of activity (Hoffman syndrome) is seen in:
- A. Acromegaly
- B. Myxoedema
- C. Pseudohypoparathyroidism
- D. Myotonia dystrophica
Correct Answer: A
Rationale: Acromegaly is a disorder caused by excessive growth hormone production by the pituitary gland in adults, leading to an increase in muscle mass (hypertrophy). Hoffman syndrome, characterized by increased muscle mass with slowness of activity, is a clinical feature often seen in individuals with acromegaly. The excessive growth hormone levels in acromegaly can cause acral growth, soft tissue swelling, and muscle hypertrophy, contributing to the characteristic features of the condition, including Hoffman syndrome. Therefore, the correct answer is Acromegaly.
Obesity is associated with an increased incidence of all the following except
- A. Diabetes mellitus
- B. Cancer
- C. Hypertension
- D. Chronic obstructive lung disease
Correct Answer: D
Rationale: Obesity is associated with an increased risk of developing various health conditions, including diabetes mellitus, cancer, and hypertension. However, chronic obstructive lung disease (COPD) is not directly linked to obesity. COPD is primarily caused by exposure to harmful particles or gases, most commonly from cigarette smoke. While obesity can impact lung function and worsen symptoms in individuals with COPD, it is not a direct cause of the condition. Therefore, the correct answer is D, chronic obstructive lung disease.