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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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All of the following are features of Conn's syndrome except:
- A. Alkalosis
- B. Hyperkalemia
- C. Muscle cramps
- D. Severe systemic hypertension
Correct Answer: B
Rationale: Conn's syndrome, also known as primary hyperaldosteronism, is characterized by excess production of aldosterone by the adrenal glands. This leads to increased sodium retention and potassium excretion in the kidneys. As a result, patients with Conn's syndrome typically present with hypokalemia (low potassium levels), not hyperkalemia (high potassium levels). The other features of Conn's syndrome include alkalosis (metabolic), muscle cramps, and severe systemic hypertension.
Phaeochromocytoma is not associated with:
- A. Weight gain
- B. Fear of death (angor animi)
- C. Paroxysmal hypertension
- D. Constipation
Correct Answer: A
Rationale: Phaeochromocytoma is a rare neuroendocrine tumor that usually originates from the adrenal glands and produces excess catecholamines. The characteristic symptoms of phaeochromocytoma include paroxysmal (sudden and severe) hypertension, fear of impending death (angor animi), and episodic symptoms like palpitations, headache, and diaphoresis. However, weight gain is not a typical manifestation associated with phaeochromocytoma. In fact, patients with this condition may experience unintentional weight loss due to the effects of excess catecholamines on metabolism and appetite suppression. Therefore, weight gain is not a significant feature observed in individuals with phaeochromocytoma.
Vanillylmandelic acid (VMA) excretion is increased in urine in:
- A. Conn's syndrome
- B. Congenital adrenal hyperplasia
- C. Testicular feminization syndrome
- D. Phaeochromocytoma
Correct Answer: D
Rationale: Vanillylmandelic acid (VMA) is a metabolite of catecholamines, such as epinephrine and norepinephrine. Phaeochromocytoma is a catecholamine-secreting tumor that arises from the chromaffin cells in the adrenal medulla or sympathetic ganglia. As a result of the increased production of catecholamines in patients with phaeochromocytoma, there is an increase in VMA excretion in the urine. This increase in VMA excretion is a significant diagnostic feature of phaeochromocytoma and helps in its detection through urine testing. Therefore, the correct choice is D. Phaeochromocytoma.
Which of the following are causes of nephrogenic diabetes insipidus?
- A. Sheehan's syndrome
- B. Lithium
- C. Mutations in the vasopressin (ADH) receptor gene
- D. Mutations in vasopressin gene
Correct Answer: B
Rationale: Nephrogenic diabetes insipidus (NDI) is a condition where the kidneys are unable to respond to antidiuretic hormone (ADH) as they should, leading to excessive urination and extreme thirst. One of the main causes of nephrogenic diabetes insipidus is the use of certain medications, with lithium being the most common culprit. Lithium can interfere with the kidney's response to ADH, resulting in decreased water reabsorption and the characteristic symptoms of diabetes insipidus. Other causes of NDI can include genetic mutations affecting the vasopressin receptor gene or other underlying conditions such as hypercalcemia, hypokalemia, or obstructive uropathy.
The receptors for non-steroid peptide hormones are found on the ______.
- A. plasma membrane
- B. nuclear envelope
- C. mitochondria
- D. lysosomes
Correct Answer: A
Rationale: The receptors for non-steroid peptide hormones are typically found on the plasma membrane of target cells. These hormones are large or polar molecules that cannot easily diffuse through the cell membrane. Instead, they bind to specific receptors on the cell surface, initiating signaling pathways that eventually lead to changes within the cell. Once the peptide hormone binds to its receptor on the plasma membrane, secondary messenger systems are activated to relay the signal into the cell and initiate the appropriate cellular response. This distinct mechanism of action highlights the importance of the plasma membrane as the location of receptors for non-steroid peptide hormones.