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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Increased muscle mass with slowness of activity (Hoffman syndrome) is seen in:
- A. Acromegaly
- B. Myxoedema
- C. Pseudohypoparathyroidism
- D. Myotonia dystrophica
Correct Answer: A
Rationale: Acromegaly is a disorder caused by excessive growth hormone production by the pituitary gland in adults, leading to an increase in muscle mass (hypertrophy). Hoffman syndrome, characterized by increased muscle mass with slowness of activity, is a clinical feature often seen in individuals with acromegaly. The excessive growth hormone levels in acromegaly can cause acral growth, soft tissue swelling, and muscle hypertrophy, contributing to the characteristic features of the condition, including Hoffman syndrome. Therefore, the correct answer is Acromegaly.
Anti-diuretic hormone secretion is:
- A. increased during stress.
- B. reduced during hemorrhage.
- C. reduced by increased blood osmolality.
- D. increased by alcohol.
Correct Answer: B
Rationale: Anti-diuretic hormone (ADH), also known as vasopressin, is a hormone released by the pituitary gland in response to changes in blood osmolality, blood volume, and blood pressure. During hemorrhage (significant blood loss), the body experiences a decrease in blood volume and blood pressure. In response to this decrease in blood volume, ADH secretion is increased to help the body retain water and maintain blood pressure levels. Therefore, it is incorrect to say that ADH secretion is reduced during hemorrhage.
Hormones are:
- A. biologically inert by themselves.
- B. used as an energy source
- C. incorporated as a structural moiety into another molecule
- D. always stored in secretory granules
Correct Answer: C
Rationale: Hormones are chemical messengers that are produced by various glands in the body and released into the bloodstream to signal and regulate the activity of specific target cells. Unlike energy sources that can be metabolized for energy production (like carbohydrates and fats), hormones are not typically used as an energy source themselves (Choice B). Hormones are typically not biologically inert by themselves (Choice A), as they have specific functions in regulating various physiological processes in the body. While some hormones may be stored in secretory granules before release, not all hormones are stored in this manner (Choice D). Additionally, hormones are not always released by exocytosis (Choice E), as some hormones can also be released through other mechanisms such as diffusion. The correct choice, therefore, is C: hormones are incorporated as a structural moiety into another molecule, as they bind to specific receptors on target cells to elicit a cellular response and regulate physiological functions.
Commonest cause of Addison's disease is:
- A. Granuloma
- B. Idiopathic atrophy
- C. Inflammatory necrosis
- D. Malignancy
Correct Answer: A
Rationale: The most common cause of Addison's disease is autoimmune adrenalitis, also known as autoimmune adrenal insufficiency. In autoimmune adrenalitis, the adrenal glands are damaged by immune system-mediated processes, leading to their dysfunction. This autoimmune destruction typically presents as bilateral adrenal cortex atrophy due to the formation of granulomas. Therefore, the commonest cause of Addison's disease is the presence of granulomas in the adrenal glands, making option A, Granuloma, the correct choice.
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.