Nokea
Which of the following is a complication of diabetes mellitus?
- A. Gastroparesis
- B. Exophthalmos
- C. Hirsutism
- D. Moon facies
Correct Answer: A
Rationale: Gastroparesis is a complication of diabetes mellitus. It is a condition that affects the normal spontaneous movement of the muscles in the stomach, causing delayed emptying of food from the stomach into the small intestine. This can lead to symptoms such as nausea, vomiting, bloating, and poor appetite. Diabetes can damage the nerves that control the stomach muscles, resulting in gastroparesis. Managing blood sugar levels and following a proper diet can help in controlling the symptoms of gastroparesis in individuals with diabetes. Exophthalmos, hirsutism, and moon facies are not typically associated with complications of diabetes mellitus.
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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.
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.
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 of the following is the most common cause of Cushing's disease?
- A. ACTH-producing pituitary adenoma
- B. Adrenocortical adenoma
- C. Ectopic ACTH secretion
- D. McCune-Albright syndrome
Correct Answer: A
Rationale: The most common cause of Cushing's disease is an ACTH-producing pituitary adenoma. In this condition, the pituitary gland produces excessive amounts of adrenocorticotropic hormone (ACTH), which stimulates the adrenal glands to produce high levels of cortisol. This leads to the signs and symptoms of Cushing's disease, such as weight gain, high blood pressure, and muscle weakness. Adrenocortical adenoma refers to a benign tumor of the adrenal cortex that can also cause Cushing's syndrome, but it is not as common as an ACTH-producing pituitary adenoma. Ectopic ACTH secretion occurs when a non-pituitary tumor produces ACTH, leading to Cushing's syndrome. McCune-Albright syndrome is a rare genetic disorder that can cause various endocrine abnormalities, but it is not a common cause of Cushing's disease.
Which one of the following statements describes the underlying pathology of Grave's disease?
- A. An autoimmune disease directed against thyroid stimulating hormone (TSH) receptors. The autoantibodies stimulate the TSH receptors causing increased T3 and T4 production.
- B. Inflammation of the thyroid gland due to lymphocytic infiltration causes the stored thyroid hormones to be released into the circulation leading to hyperthyroidism.
- C. Consumption of ground beef which has been contaminated with thyroid tissue. The thyroid tissue contains metabolically active thyroid hormones which causes hyperthyroidism.
- D. A benign tumour of the thyroid gland which produces excessive amounts of thyroid hormones.
Correct Answer: A
Rationale: Graves' disease is an autoimmune disorder where autoantibodies, known as thyroid-stimulating immunoglobulins (TSIs) or thyroid-stimulating antibodies (TSAs), bind to and stimulate the thyroid-stimulating hormone (TSH) receptors on thyroid follicular cells. This leads to increased production and secretion of thyroid hormones T3 (triiodothyronine) and T4 (thyroxine), causing hyperthyroidism. The autoantibodies essentially mimic the action of TSH, resulting in excess thyroid hormone release and manifestation of hyperthyroid symptoms. This underlying pathology of Graves' disease is distinct from other causes of hyperthyroidism, making choice A the correct statement.