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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.
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Pseudohypoparathyroidism is not associated with:
- A. Cataract
- B. Raised level of plasma PIH
- C. Mental retardation
- D. Reduced level of plasma phosphate
Correct Answer: B
Rationale: Pseudohypoparathyroidism is a rare genetic disorder that mimics the symptoms of hypoparathyroidism, despite normal or elevated levels of parathyroid hormone (PTH). The condition is characterized by hypocalcemia, hyperphosphatemia, and normal or elevated PTH levels. However, it is not associated with a raised level of plasma PIH (Parathyroid Inhibiting Hormone). In pseudohypoparathyroidism, the body's tissues are resistant to the action of PTH, leading to impaired calcium regulation. Other common features of pseudohypoparathyroidism may include cataract formation, mental retardation, and reduced levels of plasma phosphate.
Which of the following is the most common cause of hypothyroidism worldwide?
- A. Graves' disease
- B. Hashimoto's thyroiditis
- C. Iatrogenic hypothyroidism
- D. Iodine deficiency
Correct Answer: D
Rationale: Iodine deficiency is the most common cause of hypothyroidism worldwide. Iodine is an essential mineral required for the production of thyroid hormones. Without sufficient iodine, the thyroid gland is unable to produce an adequate amount of thyroid hormones, leading to hypothyroidism. Areas with low iodine levels in the soil or water are more prone to iodine deficiency, which can result in a range of thyroid disorders, including hypothyroidism. Efforts to prevent iodine deficiency include iodized salt programs and dietary interventions to ensure an adequate intake of iodine.
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.
Which of the following statements best describes Hashimoto's thyroiditis?
- A. Inflammation of the thyroid gland as the result of a virus. The disease is often preceded by an upper respiratory tract infection.
- B. A destructive autoimmune disease caused by auto-reactive antibodies against thyroglobulin.
- C. Iodine deficiency
- D. thyroid gland
Correct Answer: B
Rationale: Hashimoto's thyroiditis is an autoimmune disease where the immune system mistakenly attacks the thyroid gland. The antibodies produced by the immune system target the thyroglobulin in the thyroid gland, leading to its destruction over time. This results in decreased thyroid hormone production, leading to hypothyroidism. Therefore, choice B, "A destructive autoimmune disease caused by auto-reactive antibodies against thyroglobulin," best describes Hashimoto's thyroiditis.
Vanillylmandelic acid (VMA) excretion is increased in urine in:
- A. Conn's syndrome
- B. Congenital adrenal hyperplasia
- C. Testicular feminization syndrome
- D. Phaeochromocytoma
Correct Answer: D
Rationale: Vanillylmandelic acid (VMA) is a metabolite of catecholamines, such as epinephrine and norepinephrine. Phaeochromocytoma is a catecholamine-secreting tumor that arises from the chromaffin cells in the adrenal medulla or sympathetic ganglia. As a result of the increased production of catecholamines in patients with phaeochromocytoma, there is an increase in VMA excretion in the urine. This increase in VMA excretion is a significant diagnostic feature of phaeochromocytoma and helps in its detection through urine testing. Therefore, the correct choice is D. Phaeochromocytoma.