Nokea
The triad of hyponatraemia, haemodilution and urine hypertonic to plasma suggest diagnosis of:
- A. Nephrotic syndrome
- B. SIADH
- C. Nephrogenic diabetes insipidus
- D. Addison's disease
Correct Answer: B
Rationale: The triad of hyponatremia (low sodium levels in the blood), haemodilution (increased plasma volume), and urine hypertonic to plasma (high urine osmolality compared to blood osmolality) is characteristic of Syndrome of Inappropriate Antidiuretic Hormone (SIADH). In SIADH, there is excessive release of antidiuretic hormone (ADH), also known as vasopressin, leading to water retention by the kidneys and dilutional hyponatremia. This condition results in the body holding onto water, causing hyponatremia and dilution of the blood. The urine being hypertonic compared to plasma indicates that the kidneys are reabsorbing water effectively and concentrating the urine.
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Postmenopausal estrogen therapy has been shown to increase a female's risk of all the following clinical outcomes except:
- A. Breast cancer
- B. Hip fracture
- C. Myocardial infarction
- D. Venous thromboembolism Endocrine Answers 1 C 26 B 51 D 76 B 2 C 27 A 52 A 77 C 3 B 28 C 53 B 78 D 4 B 29 D 54 B 79 D 5 C 30 B 55 C 80 C 6 A 31 B 56 C 81 C 7 A 32 D 57 B 82 A 8 B 33 D 58 C 83 C 9 C 34 C 59 A 84 B 10 C 35 C 60 A 85 A 11 B 36 A 61 B 86 B 12 A 37 D 62 A 87 D 13 B 38 B 63 A 88 A 14 C 39 D 64 B 89 C 15 D 40 A 65 B 90 A 16 D 41 D 66 D 91 D 17 A 42 D 67 A 92 B 18 C 43 D 68 C 93 A 19 A 44 B 69 A 94 A 20 B 45 B 70 A 95 A 21 A 46 A 71 A 96 D 22 B 47 C 72 B 97 D 23 B 48 A 73 D 98 B 24 B 49 D 74 B 99 D 25 B 50 C 75 D 100 B
Correct Answer: B
Rationale: Postmenopausal estrogen therapy has been shown to have a protective effect on bone density and reduce the risk of osteoporosis-related fractures, including hip fractures. Estrogen therapy helps to maintain bone strength and reduce the chances of fractures in postmenopausal women. Therefore, estrogen therapy does not increase the risk of hip fractures; in fact, it may decrease the risk of hip fractures in this population.
Which one of the following statements best describes an Addisonian crisis?
- A. Severe adrenal insufficiency resulting in dangerously low serum testosterone levels
- B. Dangerously high levels of testosterone
- C. Dangerously high serum cortisol levels
- D. Severe adrenal insufficiency resulting in dangerously low serum cortisol levels
Correct Answer: D
Rationale: An Addisonian crisis, also known as an acute adrenal crisis, is a life-threatening medical emergency that occurs due to severe adrenal insufficiency, leading to a sudden drop in cortisol levels. Cortisol is a vital hormone produced by the adrenal glands, and its deficiency can result in serious symptoms such as hypotension, dehydration, electrolyte imbalances, and shock. If left untreated, an Addisonian crisis can be fatal. Therefore, the correct description of an Addisonian crisis is severe adrenal insufficiency resulting in dangerously low serum cortisol levels.
Which of the following is not a symptom of Cushing's syndrome?
- A. Easy bruising
- B. Weight gain
- C. Acne
- D. Weight loss
Correct Answer: D
Rationale: Weight gain is a common symptom of Cushing's syndrome due to the excessive production of cortisol, a hormone that regulates metabolism and fat storage. The other symptoms listed, such as easy bruising, acne, and stretch marks, are also characteristic features of Cushing's syndrome. However, weight loss is typically not associated with this condition. In fact, individuals with Cushing's syndrome often experience unexplained and rapid weight gain, especially in the face, abdomen, and upper back (resulting in a characteristic "buffalo hump" appearance), rather than weight loss.
ADH is secreted by the
- A. Hypothalamus
- B. Posterior lobe of the pituitary
- C. Intermediate Lobe of the pituitary
- D. Anterior lobe of the pituitary
Correct Answer: B
Rationale: ADH (antidiuretic hormone), also known as vasopressin, is secreted by the posterior lobe of the pituitary gland. ADH plays a key role in regulating water balance in the body by controlling the reabsorption of water in the kidneys. When the body senses a decrease in blood volume or an increase in blood osmolarity, ADH is released to signal the kidneys to conserve water, leading to concentrated urine production and water retention in the body.
Earliest changes observed by ophthalmoscope in background retinopathy of diabetes is:
- A. Venous dilatation
- B. Microaneurysms
- C. Increased capillary permeability
- D. Arteriovenous shunts
Correct Answer: B
Rationale: The earliest changes observed by ophthalmoscope in background retinopathy of diabetes is typically the presence of microaneurysms. These are small dilations of retinal capillaries due to weakening of the vessel walls caused by diabetes-induced damage. Microaneurysms are a hallmark sign of diabetic retinopathy and are often the first visible sign on retinal examination. Other changes in diabetic retinopathy, such as venous dilatation, increased capillary permeability, and arteriovenous shunts, may develop later in the disease process as it progresses.