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Regarding syndrome of inappropriate antidiuretic hormone (SIADH), which is true?
- A. Hyponatremia is dilutional
- B. Urine is relatively hypertonic to plasma
- C. ADH-mediated water reabsorption does not occur
- D. Renal function is jeopardized
Correct Answer: A
Rationale: In the syndrome of inappropriate antidiuretic hormone (SIADH), there is excessive secretion of antidiuretic hormone (ADH) leading to increased water reabsorption in the kidney tubules. This results in dilutional hyponatremia because the amount of water reabsorbed is greater than the electrolytes, such as sodium, leading to a relative decrease in their concentration in the blood. As a result, hyponatremia occurs in SIADH, contributing to symptoms such as nausea, confusion, and seizures due to the imbalance in electrolytes.
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Prolonged ingestion of iodine can produce goiter, and is known as:
- A. Jod-Basedow effect
- B. Sick euthyroid syndrome
- C. Wolf-Chaikoff effect
- D. Thyrotoxicosis factitia
Correct Answer: C
Rationale: The prolonged ingestion of iodine causing goiter is known as the Wolf-Chaikoff effect. This phenomenon occurs when high levels of iodine cause a temporary inhibition of thyroid hormone synthesis, resulting in a decrease in thyroid hormone production. In some individuals, this can lead to the development of a goiter due to the lack of thyroid hormone feedback regulation. It is important to note that the Wolf-Chaikoff effect typically resolves on its own as the thyroid gland adapts to the increased iodine levels over time.
What is Addison's disease?
- A. Addison's disease is a long-term endocrine disorder in which the adrenal glands do not produce enough steroid hormones.
- B. Addison's disease involves the overproduction of cortisol and aldosterone by the adrenal cortex.
- C. Addison's disease involves the overproduction of androgens by the adrenal medulla.
- D. Addison's disease involves the underproduction of androgens by the adrenal medulla.
Correct Answer: A
Rationale: Addison's disease, also known as primary adrenal insufficiency, is a condition where the adrenal glands do not produce enough steroid hormones, mainly cortisol and sometimes aldosterone. This deficiency in steroid hormone production is typically caused by autoimmune destruction of the adrenal cortex. Without enough cortisol and aldosterone, various symptoms may arise, such as fatigue, weight loss, low blood pressure, and skin discoloration. Therefore, option A accurately describes the nature of Addison's disease.
Anti-diuretic hormone secretion is:
- A. increased during stress.
- B. reduced during hemorrhage.
- C. reduced by increased blood osmolality.
- D. increased by alcohol.
Correct Answer: B
Rationale: Anti-diuretic hormone (ADH), also known as vasopressin, is a hormone released by the pituitary gland in response to changes in blood osmolality, blood volume, and blood pressure. During hemorrhage (significant blood loss), the body experiences a decrease in blood volume and blood pressure. In response to this decrease in blood volume, ADH secretion is increased to help the body retain water and maintain blood pressure levels. Therefore, it is incorrect to say that ADH secretion is reduced during hemorrhage.
Which of the following lung cancers is most commonly associated with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH)?
- A. Squamous cell carcinoma
- B. Small cell (oat cell) carcinoma
- C. Large cell carcinoma
- D. Adenocarcinoma
Correct Answer: B
Rationale: Small cell (oat cell) carcinoma of the lung is most commonly associated with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). This paraneoplastic syndrome occurs in patients with small cell lung cancer due to the production of antidiuretic hormone (ADH) by the tumor cells. The excessive release of ADH leads to water retention and dilutional hyponatremia, causing symptoms such as nausea, confusion, seizures, and potentially life-threatening complications. Other types of lung cancer, such as squamous cell carcinoma, large cell carcinoma, and adenocarcinoma, are less commonly associated with SIADH.
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.