Nokea
Which cranial nerve is not involved in acromegaly?
- A. VIII
- B. III, IV, VI
- C. V
- D. Il
Correct Answer: A
Rationale: Acromegaly is a disorder caused by the overproduction of growth hormone in adulthood, usually due to a pituitary tumor. The cranial nerves that may be affected in acromegaly are Cranial Nerves III, IV, VI (oculomotor, trochlear, abducens) due to compression of the optic chiasm by the expanding tumor. Cranial Nerve V (trigeminal nerve) may also be affected given its close proximity to the pituitary gland. However, Cranial Nerve VIII (vestibulocochlear nerve) is not typically involved in acromegaly.
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Sheehan's syndrome presents with:
- A. Cardiac failure
- B. Persistent lactation
- C. Fever
- D. Striking cachexia
Correct Answer: B
Rationale: Sheehan's syndrome, also known as postpartum hypopituitarism, is a condition characterized by pituitary gland dysfunction due to severe blood loss during childbirth, resulting in ischemic necrosis of the pituitary gland. As a consequence of pituitary hormone deficiency, one of the hallmark manifestations of Sheehan's syndrome is persistent lactation despite stopping breastfeeding. This occurs due to inadequate prolactin inhibition, leading to continuous milk production. Other common symptoms of Sheehan's syndrome include fatigue, weight loss, menstrual irregularities, hypothyroidism, adrenal insufficiency, and other pituitary hormone deficiencies. Cardiac failure, fever, and striking cachexia are not typical presentations associated with Sheehan's syndrome.
All of the following develop into dwarfism except:
- A. Congenital adrenal hyperplasia
- B. Hypopituitarism
- C. Homocystinuria
- D. Pseudohypoparathyroidism
Correct Answer: A
Rationale: Congenital adrenal hyperplasia does not lead to dwarfism. It is a group of genetic disorders that affect the adrenal glands and can cause various symptoms related to hormone imbalances. In contrast, the other conditions listed - hypopituitarism, homocystinuria, and pseudohypoparathyroidism - can all lead to dwarfism through different mechanisms. Hypopituitarism is characterized by a deficiency of pituitary hormones, including growth hormone, which can result in stunted growth and dwarfism. Homocystinuria is a metabolic disorder that can affect bone growth and lead to skeletal abnormalities resulting in dwarfism. Pseudohypoparathyroidism is a rare genetic disorder that can manifest with short stature or dwarfism due to skeletal abnormalities caused by altered bone metabolism.
All of the following would be expected to increase prolactin levels except:
- A. Chest wall trauma
- B. Hyperthyroidism
- C. Pregnancy
- D. Renal failure
Correct Answer: B
Rationale: Prolactin levels can be increased by various factors, including chest wall trauma, pregnancy, and renal failure. However, hyperthyroidism is not typically associated with elevated prolactin levels. In fact, hyperthyroidism is more commonly associated with decreased levels of prolactin due to the inhibitory effect of thyroid hormones on prolactin secretion. Therefore, all of the options except for hyperthyroidism would be expected to increase prolactin levels.
Thyrotoxicosis may be featured by all except:
- A. Myopathy
- B. Pretibial myxoedema
- C. Hypernatraemia
- D. Atrial fibrillation
Correct Answer: A
Rationale: Thyrotoxicosis, also known as hyperthyroidism, is a condition characterized by excessive thyroid hormone production by the thyroid gland. Symptoms of thyrotoxicosis can include weight loss, heat intolerance, tremors, hyperactivity, and fatigue. While musculoskeletal symptoms such as weakness and tremors are common in thyrotoxicosis, true myopathy (muscle disease) is not a typical feature of the condition. Therefore, myopathy is the correct choice among the given options.
Which test is used to evaluate blood glucose levels over the previous 2 months?
- A. Methemoglobin
- B. Hemoglobin A1c
- C. Fasting blood sugar
- D. C peptide protein
Correct Answer: B
Rationale: Hemoglobin A1c, also known as HbA1c or glycated hemoglobin, is a blood test that measures the average blood glucose level over the previous 2 to 3 months. This test is useful in monitoring long-term blood glucose control in individuals with diabetes. Hemoglobin A1c provides an indication of how well blood glucose levels have been controlled over time, reflecting the average blood sugar levels during the lifespan of red blood cells, which is typically around 2 to 3 months. A higher Hemoglobin A1c level indicates poorer blood glucose control and an increased risk of diabetes complications.