Nokea
Thyroid hormones (T3 and T4):
- A. increase metabolic rate.
- B. are hydrophilic as they are made from amino acids.
- C. contain iron atoms in ferrous form.
- D. stimulate the secretion of thyroid-stimulating hormone (TSH; thyrotropin).
Correct Answer: A
Rationale: Thyroid hormones, T3 (triiodothyronine) and T4 (thyroxine), play a crucial role in regulating metabolism in the body. They are responsible for increasing the metabolic rate of cells by influencing the production of proteins and controlling how the body uses energy. This increase in metabolic rate results in processes such as increased heart rate, enhanced nutrient breakdown, and higher body temperature. Thus, option A, "increase metabolic rate," is the correct statement regarding thyroid hormones (T3 and T4).
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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.
Upper segment > lower segment of body is found in all (in dwarfism) except:
- A. Pituitary dwarf
- B. Cretinism
- C. Achondroplasia
- D. Juvenile myxedema
Correct Answer: D
Rationale: In dwarfism conditions, the upper body segment being greater than the lower body segment is a characteristic feature seen in Achondroplasia. This condition results in a disproportionately short stature with short limbs but a trunk of normal length.
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.
Commonest enzymatic defect for development of congenital adrenal hyperplasia is:
- A. C-21 hydroxylase deficiency
- B. 3b dehydrogenase deficiency
- C. C-11 hydroxylase deficiency
- D. C-17 hydroxylase deficiency
Correct Answer: A
Rationale: C-21 hydroxylase deficiency is the most common enzymatic defect leading to the development of congenital adrenal hyperplasia (CAH). This enzyme is necessary for the synthesis of cortisol and aldosterone in the adrenal glands. When there is a deficiency in C-21 hydroxylase, the pathway is shifted towards the production of androgens instead of cortisol and aldosterone, leading to excess androgen production. This results in the characteristic features of CAH, such as ambiguous genitalia in females and virilization in both males and females. Other enzyme deficiencies listed in the choices can also lead to different types of CAH but are less common compared to C-21 hydroxylase deficiency.
What is the most common cause of Cushing's syndrome?
- A. Ectopic ACTH production
- B. Adrenal adenoma
- C. Glucocorticoid treatment (iatrogenic)
- D. Pituitary adenoma
Correct Answer: D
Rationale: The most common cause of Cushing's syndrome is a pituitary adenoma, specifically a corticotroph adenoma. This adenoma leads to excessive secretion of adrenocorticotropic hormone (ACTH) by the pituitary gland, which in turn stimulates the adrenal glands to produce high levels of cortisol. This results in the symptoms and signs characteristic of Cushing's syndrome. Pituitary adenomas are responsible for around 70-80% of cases of Cushing's syndrome, making it the most common cause.