Nokea
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.
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All the following are risk factors for the development of osteoporotic fractures except
- A. African race
- B. Current cigarette smoking
- C. Female sex
- D. Physical inactivity
Correct Answer: A
Rationale: While African race is considered a protective factor against the development of osteoporosis due to higher peak bone mass and lower fracture rates compared to other races, the other factors listed (current cigarette smoking, female sex, and physical inactivity) are all established risk factors for the development of osteoporotic fractures. African-American individuals, in general, have a lower risk of osteoporosis and fractures compared to Caucasians and Asians.
Which of the followings is consistent with neuropathic pain due to diabetes:
- A. Burning pain
- B. Electric shock quality
- C. Tingling
- D. All of the above
Correct Answer: D
Rationale: Neuropathic pain due to diabetes can present with a variety of symptoms, including burning pain, electric shock quality, and tingling sensation. These symptoms are commonly reported by individuals with diabetic neuropathy, which is the most common form of neuropathic pain associated with diabetes. The combination of these sensations can significantly impact the quality of life for those living with diabetes and neuropathic pain. Therefore, all of the above options are consistent with neuropathic pain due to diabetes.
Which of the following is not a recognized feature of myxoedema?
- A. Ascites
- B. Cerebellar ataxia
- C. Increased incidence of pernicious anaemia
- D. Thyroid acropachy
Correct Answer: D
Rationale: Myxoedema is a severe form of hypothyroidism characterized by a range of symptoms and signs. Ascites, cerebellar ataxia, and increased incidence of pernicious anaemia are recognized features of myxoedema. However, thyroid acropachy is not a recognized feature of myxoedema. Thyroid acropachy is a condition characterized by clubbing of the fingers and toes, swelling of the hands and feet, and periosteal new bone formation, typically seen in patients with Graves' disease, which is a form of hyperthyroidism.
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.
Which one of the following statements is true regarding the prevalence of acromegaly?
- A. Acromegaly affects a similar number of men and women
- B. Acromegaly affects twice as many women than men
- C. Acromegaly affects twice as many men than it does women
Correct Answer: C
Rationale: Acromegaly is a rare hormonal disorder where excess growth hormone is produced, leading to the enlargement of bones and tissues. The prevalence of acromegaly is higher in men compared to women, with a ratio of about two men affected for every woman. This gender difference is believed to be due to the impact of sex hormones on the development and progression of the condition. While acromegaly can affect both men and women, men are more commonly diagnosed with the disorder.