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.
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Thyroid-stimulating hormone (TSH):
- A. is synthesized in parafollicular cells
- B. is a template for thyroid hormone biosynthesis.
- C. is derived from iodinated tyrosine residues.
- D. secretion is inhibited by TRH from the hypothalamus.
Correct Answer: D
Rationale: Thyroid-stimulating hormone (TSH) is a hormone produced by the anterior pituitary gland. It stimulates the thyroid gland to produce and release thyroid hormones, specifically thyroxine (T4) and triiodothyronine (T3). TSH secretion is regulated by the hypothalamus via the release of thyrotropin-releasing hormone (TRH). TRH acts on the anterior pituitary gland to stimulate the production and release of TSH. Therefore, TSH secretion is indeed inhibited by TRH, not stimulated as in the other options.
Blood calcium is elevated:
- A. in rickets.
- B. in pseudohypoparathyroidism.
- C. by calcitonin.
- D. by Vitamin D3
Correct Answer: D
Rationale: Blood calcium levels are primarily regulated by the actions of parathyroid hormone (PTH) and Vitamin D. Vitamin D plays a crucial role in maintaining calcium balance in the body by promoting the absorption of calcium from the intestines. When blood calcium levels are low, Vitamin D works to increase absorption of calcium to raise the levels back to normal. Therefore, elevated blood calcium levels are commonly associated with excess Vitamin D intake or conditions that increase Vitamin D levels, such as hypervitaminosis D.
Which of the following is the underlying problem in neurogenic diabetes insipidus?
- A. Overproduction of vasopressin (antidiuretic hormone)
- B. Lack of oxytocin
- C. Overproduction of oxytocin
- D. Overproduction of prolactin
Correct Answer: E
Rationale: Neurogenic diabetes insipidus is a condition characterized by a deficiency of vasopressin (antidiuretic hormone). Vasopressin is responsible for regulating the body's water balance by controlling the reabsorption of water in the kidneys. In neurogenic diabetes insipidus, there is a problem with either the production, release, or action of vasopressin, leading to excessive urination and thirst. This condition can be caused by damage to the hypothalamus or pituitary gland, which are involved in producing and releasing vasopressin. Symptoms of neurogenic diabetes insipidus include frequent urination, excessive thirst, and dehydration.
Which of the following is not a neuromuscular feature of thyrotoxicosis?
- A. Myasthenic syndrome
- B. Brisk knee jerk
- C. Hypokalaemic periodic paralysis
- D. Hyperkinesia
Correct Answer: A
Rationale: Thyrotoxicosis typically presents with hypermetabolism and various neuromuscular manifestations. Myasthenic syndrome, which involves muscle weakness and fatigability, is not a common neuromuscular feature of thyrotoxicosis. Instead, manifestations such as brisk knee jerk reflexes, hypokalaemic periodic paralysis (due to shifts in potassium levels), and hyperkinesia (excessive movement) are more commonly observed in patients with thyrotoxicosis. Myasthenic syndrome is more commonly associated with autoimmune disorders affecting the neuromuscular junction, such as myasthenia gravis.
Oxytocin:
- A. is not produced in males.
- B. inhibits lactation.
- C. stimulates smooth muscle contraction.
- D. is produced primarily in the SON in the hypothalamus.
Correct Answer: C
Rationale: Oxytocin is a hormone that is produced in both males and females. In females, oxytocin plays a crucial role in various physiological processes, notably during labor and childbirth. Oxytocin acts on the smooth muscles of the uterus, causing them to contract during labor (parturition) and helps in the ejection of milk during breastfeeding. This hormone is primarily synthesized in the paraventricular nucleus (PVN) and the supraoptic nucleus (SON) of the hypothalamus and stored in the posterior pituitary gland before being released into the bloodstream. Overall, oxytocin's main function is to stimulate smooth muscle contraction in the uterus and the mammary glands.
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