Nokea
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.
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Excess prolactin causes:
- A. Acromegaly
- B. Gynecomastia
- C. Dwarfism
- D. Early Menopause
Correct Answer: B
Rationale: Excess prolactin typically causes gynecomastia in men. Prolactin is a hormone primarily responsible for milk production in women. However, in men, elevated levels of prolactin can lead to various symptoms, with gynecomastia being one of the most common. Gynecomastia is the development of breast tissue in males, which can result in swelling and tenderness of the breasts. It is important to investigate the underlying cause of elevated prolactin levels as it could be due to various conditions such as pituitary tumors, certain medications, or thyroid disorders.
Which age group does acromegaly most commonly affect?
- A. 30-50 years
- B. 10-25 years
- C. 55-70 years
- D. 25-40 years
Correct Answer: A
Rationale: Acromegaly most commonly affects individuals in the age group of 30-50 years. This condition is typically diagnosed in adults between these ages. Acromegaly is often caused by the overproduction of growth hormone in adults, which leads to excessive bone growth and tissue expansion. While acromegaly can develop at any age, it is more commonly seen in adults within the 30-50 age range.
Tetany is characterized by all of the following signs except:
- A. Trousseau's sign
- B. Tinel's sign
- C. Erb's sign
- D. Peroneal sign
Correct Answer: C
Rationale: Tetany is a condition characterized by involuntary muscle spasms and contractions due to low levels of calcium in the blood. The signs associated with tetany include Trousseau's sign, which is the carpal spasm elicited by inflating a blood pressure cuff above systolic pressure, and Chvostek's sign, which is the facial muscle spasm elicited by tapping on the facial nerve. Peroneal sign is not specifically associated with tetany but can be seen in conditions like peroneal nerve injury. Erb's sign, on the other hand, is not a recognized sign of tetany. It is associated with Erb's palsy, a condition resulting from injury to the brachial plexus nerves, typically during childbirth. Tinel's sign, which is a tingling sensation elicited by tapping over a compressed nerve, is also not a characteristic sign of tetany.
Tall stature is not characteristic of:
- A. Klinefelter's syndrome
- B. Homocystinuria
- C. Marfan's syndrome
- D. Turner's syndrome
Correct Answer: D
Rationale: Turner's syndrome is a genetic condition that affects females and is characterized by short stature and other physical abnormalities due to the absence of part or all of one of the X chromosomes. Therefore, tall stature is not characteristic of Turner's syndrome.
What is the most common cause of Cushing's syndrome?
- A. Ectopic ACTH production
- B. Adrenal adenoma
- C. Glucocorticoid treatment (iatrogenic)
- D. Pituitary adenoma
Correct Answer: D
Rationale: The most common cause of Cushing's syndrome is a pituitary adenoma, specifically a corticotroph adenoma. This adenoma leads to excessive secretion of adrenocorticotropic hormone (ACTH) by the pituitary gland, which in turn stimulates the adrenal glands to produce high levels of cortisol. This results in the symptoms and signs characteristic of Cushing's syndrome. Pituitary adenomas are responsible for around 70-80% of cases of Cushing's syndrome, making it the most common cause.