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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.
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All of the following are potential signs or symptoms of growth hormone deficiency except:
- A. Abnormal lipid profile
- B. Atherosclerosis
- C. Increased bone mineral density
- D. Left ventricular dysfunction
Correct Answer: C
Rationale: Growth hormone deficiency (GHD) is commonly associated with decreased bone mineral density, leading to an increased risk of fractures and osteoporosis. Therefore, increased bone mineral density would not typically be a sign or symptom of GHD. On the other hand, abnormal lipid profile, atherosclerosis, and left ventricular dysfunction are all potential signs or symptoms of GHD. Abnormal lipid profile can manifest as increased levels of LDL cholesterol and decreased levels of HDL cholesterol. Atherosclerosis, the buildup of plaque in the arteries, can occur in individuals with GHD due to the impact on lipid metabolism. Left ventricular dysfunction may also be seen in individuals with GHD due to the role of growth hormone in cardiac function and structure.
Features of hypoglycaemia do not include:
- A. Drenching sweat
- B. Tachycardia
- C. Tachypnoea
- D. Brisk jerk
Correct Answer: D
Rationale: Hypoglycemia is characterized by a low blood sugar level, which can lead to various symptoms. The features of hypoglycemia typically include drenching sweat, tachycardia (increased heart rate), and tachypnea (rapid breathing). A brisk jerk, on the other hand, is not a typical feature of hypoglycemia. Symptoms such as confusion, dizziness, shakiness, hunger, weakness, and irritability are more commonly associated with hypoglycemia than a brisk jerk.
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.
Which of the following tests should be used to make the diagnosis of Cushing's syndrome?
- A. 24-hour urine free cortisol
- B. Corticotropin-releasing hormone (CRH) level at 8 a.m.
- C. Inferior petrosal venous sampling
- D. Overnight 1-mg dexamethasone suppression test
Correct Answer: D
Rationale: The overnight 1-mg dexamethasone suppression test is commonly used as an initial screening test for Cushing's syndrome. In this test, a patient takes 1 mg of dexamethasone orally at 11 p.m., and their serum cortisol level is measured the next morning. In patients with Cushing's syndrome, the cortisol levels will not be suppressed by the dexamethasone due to the presence of excessive cortisol production.
All of the following are associated with hyperuricemia except:
- A. Cardiovascular disease
- B. Gouty arthritis
- C. Nephrolithiasis
- D. Peripheral neuropathy
Correct Answer: D
Rationale: Hyperuricemia is a medical condition characterized by elevated levels of uric acid in the blood. This can lead to the formation of urate crystals, which are responsible for various health problems. The three main conditions associated with hyperuricemia are cardiovascular disease (A), gouty arthritis (B), and nephrolithiasis (C).