Nokea
Which of the following lung cancers is most commonly associated with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH)?
- A. Squamous cell carcinoma
- B. Small cell (oat cell) carcinoma
- C. Large cell carcinoma
- D. Adenocarcinoma
Correct Answer: B
Rationale: Small cell (oat cell) carcinoma of the lung is most commonly associated with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). This paraneoplastic syndrome occurs in patients with small cell lung cancer due to the production of antidiuretic hormone (ADH) by the tumor cells. The excessive release of ADH leads to water retention and dilutional hyponatremia, causing symptoms such as nausea, confusion, seizures, and potentially life-threatening complications. Other types of lung cancer, such as squamous cell carcinoma, large cell carcinoma, and adenocarcinoma, are less commonly associated with SIADH.
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Which of the following is not a feature of autonomic neuropathy in diabetes?
- A. Retrograde ejaculation
- B. Gustatory sweating
- C. Mononeuritis multiplex
- D. Hypoglycemic unresponsiveness
Correct Answer: C
Rationale: Autonomic neuropathy in diabetes can manifest with various symptoms, such as retrograde ejaculation (A), gustatory sweating (B), and hypoglycemic unresponsiveness (D). Mononeuritis multiplex (C) is not typically associated with autonomic neuropathy in diabetes. Mononeuritis multiplex is a condition characterized by damage to at least two separate nerve areas resulting in weakness, pain, and sensory loss. Autonomic neuropathy in diabetes tends to affect the autonomic nerves that control involuntary bodily functions, leading to symptoms such as gastrointestinal issues, cardiovascular abnormalities, and sexual dysfunction, but mononeuritis multiplex is not a common feature of this condition.
Pseudohypoparathyroidism is not associated with:
- A. Cataract
- B. Raised level of plasma PIH
- C. Mental retardation
- D. Reduced level of plasma phosphate
Correct Answer: B
Rationale: Pseudohypoparathyroidism is a rare genetic disorder that mimics the symptoms of hypoparathyroidism, despite normal or elevated levels of parathyroid hormone (PTH). The condition is characterized by hypocalcemia, hyperphosphatemia, and normal or elevated PTH levels. However, it is not associated with a raised level of plasma PIH (Parathyroid Inhibiting Hormone). In pseudohypoparathyroidism, the body's tissues are resistant to the action of PTH, leading to impaired calcium regulation. Other common features of pseudohypoparathyroidism may include cataract formation, mental retardation, and reduced levels of plasma phosphate.
Which of the following are causes of Addison's disease?
- A. Adrenoleukodystrophy
- B. Pyelonephritis
- C. Tuberculosis
- D. Autoimmune destruction of the adrenal cortex
Correct Answer: D
Rationale: Addison's disease, also known as primary adrenal insufficiency, is mainly caused by the autoimmune destruction of the adrenal cortex. This results in the inadequate production of hormones such as cortisol and aldosterone by the adrenal glands. While other conditions such as Adrenoleukodystrophy, Pyelonephritis, and Tuberculosis can also affect the adrenal glands, they are not known to be direct causes of Addison's disease.
Which of the following investigations is the gold standard for diagnosing acromegaly?
- A. Serum IGF1 measurement
- B. Growth hormone releasing hormone measurement
- C. Oral glucose tolerance test + Growth hormone measurement
- D. Growth hormone measurement
Correct Answer: C
Rationale: The gold standard for diagnosing acromegaly is the oral glucose tolerance test (OGTT) along with growth hormone (GH) measurement. During this test, the patient is given a glucose solution to drink, and then blood samples are taken to measure GH levels at specific time intervals. In a person without acromegaly, glucose ingestion would typically suppress GH levels. However, in individuals with acromegaly, GH levels remain elevated even after glucose administration due to the inability of glucose to inhibit GH release from the tumor.
Which one of the following is acromegaly caused by?
- A. Overproduction of adrenocorticotropic hormone (ACTH)
- B. Overproduction of gonadotrophin releasing hormone (GnRH)
- C. Overproduction of growth hormone (GH)
- D. Overproduction of vasopressin (antidiuretic hormone)
Correct Answer: C
Rationale: Acromegaly is a disorder that is characterized by the overproduction of growth hormone (GH) by the pituitary gland in adults. This results in the abnormal growth of bones and tissues, leading to enlarged hands, feet, and facial features. The excess GH is usually caused by a pituitary tumor known as a somatotroph adenoma. This tumor causes the pituitary gland to produce excessive amounts of GH, which in turn leads to the symptoms associated with acromegaly. Treatment for acromegaly often involves surgical removal or reduction of the pituitary tumor, as well as medication to normalize GH levels.