What is the most common cause of hyperthyroidism?
- A. Thyroiditis
- B. Toxic thyroid adenoma
- C. Toxic multinodular goitre
- D. Grave's disease
Correct Answer: D
Rationale: Grave's disease is the most common cause of hyperthyroidism. It is an autoimmune disorder where the body's immune system mistakenly attacks the thyroid gland, leading to overproduction of thyroid hormones. This results in symptoms such as weight loss, rapid heartbeat, heat intolerance, and tremors. While toxic thyroid adenoma, toxic multinodular goitre, and thyroiditis are also potential causes of hyperthyroidism, Grave's disease is the most prevalent among them.
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All of the following are featured by dermal hyperpigmentation except:
- A. Conn's syndrome
- B. Bronchogenic carcinoma
- C. Addison's disease
- D. Haemochromatosis
Correct Answer: A
Rationale: Dermal hyperpigmentation, also known as hyperpigmentation of the skin, is commonly associated with conditions such as Addison's disease, hemochromatosis, and bronchogenic carcinoma. In Addison's disease, there is increased production of melanin due to elevated levels of adrenocorticotropic hormone (ACTH) which stimulates melanocytes. Hemochromatosis can cause hyperpigmentation due to excess iron deposits in the skin. Bronchogenic carcinoma can lead to a condition known as acanthosis nigricans, characterized by dark, velvety discoloration of the skin primarily around the neck and armpits. However, Conn's syndrome, which is a primary aldosteronism resulting from an adrenal adenoma or hyperplasia, is not typically associated with dermal hyperpigmentation.
Which of the following is false regarding medullary carcinoma of thyroid?
- A. Cervical Iymphadenopathy
- B. High serum calcitonin
- C. Carcinoid syndrome may be associated with
- D. Psychosis
Correct Answer: D
Rationale: Medullary carcinoma of the thyroid typically presents with symptoms related to the thyroid gland itself, neck mass or swelling, and sometimes cervical lymphadenopathy. It is characterized by the production of calcitonin, leading to high serum calcitonin levels. Carcinoid syndrome, which includes symptoms such as flushing, diarrhea, and wheezing, is more commonly associated with neuroendocrine tumors, rather than medullary carcinoma of the thyroid. Psychosis is not a typical feature or manifestation of medullary carcinoma of the thyroid.
Which of the following is the most potent stimulus for hypothalamic production of arginine vasopressin?
- A. Hypertonicity
- B. Hyperkalemia
- C. Hypokalemia
- D. Hypotonicity
Correct Answer: A
Rationale: Hypertonicity (increased osmolarity or high concentration of solutes in the blood) is the most potent stimulus for the hypothalamic production of arginine vasopressin (also known as antidiuretic hormone or ADH). When the body senses increased plasma osmolality, the osmoreceptors in the hypothalamus stimulate the release of vasopressin from the posterior pituitary gland. Vasopressin acts on the kidneys to increase water reabsorption and decrease urine output, helping to restore normal osmolarity. This mechanism helps to conserve water and maintain body fluid balance in response to dehydration or increased solute concentration in the blood.
Which of the following is not a recognized feature of myxoedema?
- A. Ascites
- B. Cerebellar ataxia
- C. Increased incidence of pernicious anaemia
- D. Thyroid acropachy
Correct Answer: D
Rationale: Myxoedema is a severe form of hypothyroidism characterized by a range of symptoms and signs. Ascites, cerebellar ataxia, and increased incidence of pernicious anaemia are recognized features of myxoedema. However, thyroid acropachy is not a recognized feature of myxoedema. Thyroid acropachy is a condition characterized by clubbing of the fingers and toes, swelling of the hands and feet, and periosteal new bone formation, typically seen in patients with Graves' disease, which is a form of hyperthyroidism.
Which of the following are not causes of neurogenic diabetes insipidus?
- A. Sheehan's syndrome
- B. Mutations in the vasopressin (ADH) receptor gene
- C. Meningitis
- D. Mutations in the vasopressin gene
Correct Answer: D
Rationale: Neurogenic diabetes insipidus is due to a deficiency in vasopressin (antidiuretic hormone, ADH) production in the hypothalamus or a failure of proper vasopressin release from the posterior pituitary. Causes of neurogenic DI typically involve factors affecting vasopressin synthesis, storage, or release. However, mutations in the vasopressin gene itself would be a cause of genetic forms of diabetes insipidus, not neurogenic diabetes insipidus. Common causes of neurogenic diabetes insipidus include traumatic brain injury, brain tumors, pituitary adenomas, meningitis, and Sheehan's syndrome.