Nokea
Primary hyperaldosteronism is not featured by:
- A. Diastolic hypertension
- B. Paraesthesia
- C. Alkalosis
- D. Oedema
Correct Answer: B
Rationale: Primary hyperaldosteronism, also known as Conn's syndrome, is characterized by excessive production of aldosterone by the adrenal glands, leading to increased sodium reabsorption and potassium excretion in the kidneys. The typical features of primary hyperaldosteronism include hypertension (often systolic), hypokalemia, metabolic alkalosis, and oedema due to sodium retention. Paraesthesia, which refers to abnormal sensations such as tingling or numbness, is not a common feature associated with primary hyperaldosteronism.
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Which of the following are signs of acromegaly?
- A. Increased jaw prominence
- B. Enlargement of feet
- C. Enlargement of the hands and fingers
- D. Decrease in tongue size (microglossia)
Correct Answer: A
Rationale: Acromegaly is a disorder characterized by excess growth hormone production, usually due to a pituitary adenoma. Signs and symptoms of acromegaly arise gradually over time due to excess growth hormone leading to tissue overgrowth.
Increased serum aldosterone level is not associated with:
- A. Hypertension
- B. Hypernatraernia
- C. Hypokalaemia
- D. Metabolic acidosis
Correct Answer: D
Rationale: Increased serum aldosterone level is typically associated with conditions such as Conn's syndrome or primary hyperaldosteronism. These conditions lead to an excess of aldosterone, which results in increased sodium resorption and potassium excretion by the kidneys. This imbalance can lead to hypertension (Choice A), hypernatraernia (elevated sodium level) (Choice B), and hypokalaemia (low potassium level) (Choice C). However, metabolic acidosis (Choice D) is not directly associated with increased aldosterone levels. Instead, metabolic acidosis may be seen in conditions like renal tubular acidosis or diabetic ketoacidosis.
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.
Excess prolactin causes:
- A. Acromegaly
- B. Gynecomastia
- C. Dwarfism
- D. Early Menopause
Correct Answer: B
Rationale: Excess prolactin typically causes gynecomastia in men. Prolactin is a hormone primarily responsible for milk production in women. However, in men, elevated levels of prolactin can lead to various symptoms, with gynecomastia being one of the most common. Gynecomastia is the development of breast tissue in males, which can result in swelling and tenderness of the breasts. It is important to investigate the underlying cause of elevated prolactin levels as it could be due to various conditions such as pituitary tumors, certain medications, or thyroid disorders.
Effect of diabetes on foetus includes all except:
- A. Microsomia
- B. Hyperbilirubinaemia
- C. Stillbirth
- D. Open neural tube defect
Correct Answer: B
Rationale: Hyperbilirubinemia is not a common effect of diabetes on the fetus. The correct effects of diabetes on the fetus include: