Nokea
Which one of the following statements best describes an Addisonian crisis?
- A. Severe adrenal insufficiency resulting in dangerously low serum testosterone levels
- B. Dangerously high levels of testosterone
- C. Dangerously high serum cortisol levels
- D. Severe adrenal insufficiency resulting in dangerously low serum cortisol levels
Correct Answer: D
Rationale: An Addisonian crisis, also known as an acute adrenal crisis, is a life-threatening medical emergency that occurs due to severe adrenal insufficiency, leading to a sudden drop in cortisol levels. Cortisol is a vital hormone produced by the adrenal glands, and its deficiency can result in serious symptoms such as hypotension, dehydration, electrolyte imbalances, and shock. If left untreated, an Addisonian crisis can be fatal. Therefore, the correct description of an Addisonian crisis is severe adrenal insufficiency resulting in dangerously low serum cortisol levels.
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Which one of the following statements describes the underlying pathology of Grave's disease?
- A. An autoimmune disease directed against thyroid stimulating hormone (TSH) receptors. The autoantibodies stimulate the TSH receptors causing increased T3 and T4 production.
- B. Inflammation of the thyroid gland due to lymphocytic infiltration causes the stored thyroid hormones to be released into the circulation leading to hyperthyroidism.
- C. Consumption of ground beef which has been contaminated with thyroid tissue. The thyroid tissue contains metabolically active thyroid hormones which causes hyperthyroidism.
- D. A benign tumour of the thyroid gland which produces excessive amounts of thyroid hormones.
Correct Answer: A
Rationale: Graves' disease is an autoimmune disorder where autoantibodies, known as thyroid-stimulating immunoglobulins (TSIs) or thyroid-stimulating antibodies (TSAs), bind to and stimulate the thyroid-stimulating hormone (TSH) receptors on thyroid follicular cells. This leads to increased production and secretion of thyroid hormones T3 (triiodothyronine) and T4 (thyroxine), causing hyperthyroidism. The autoantibodies essentially mimic the action of TSH, resulting in excess thyroid hormone release and manifestation of hyperthyroid symptoms. This underlying pathology of Graves' disease is distinct from other causes of hyperthyroidism, making choice A the correct statement.
Which of the following is a complication of diabetes mellitus?
- A. Gastroparesis
- B. Exophthalmos
- C. Hirsutism
- D. Moon facies
Correct Answer: A
Rationale: Gastroparesis is a complication of diabetes mellitus. It is a condition that affects the normal spontaneous movement of the muscles in the stomach, causing delayed emptying of food from the stomach into the small intestine. This can lead to symptoms such as nausea, vomiting, bloating, and poor appetite. Diabetes can damage the nerves that control the stomach muscles, resulting in gastroparesis. Managing blood sugar levels and following a proper diet can help in controlling the symptoms of gastroparesis in individuals with diabetes. Exophthalmos, hirsutism, and moon facies are not typically associated with complications of diabetes mellitus.
Cushing's syndrome does not give rise to:
- A. Hirsutism
- B. Peripheral neuropathy
- C. Purple striae
- D. Acne
Correct Answer: B
Rationale: Cushing's syndrome is a disorder caused by prolonged exposure to high levels of cortisol hormone. While Cushing's syndrome can manifest with a variety of symptoms, peripheral neuropathy is not a typical feature of this condition. Cushing's syndrome is commonly associated with symptoms such as hirsutism (excessive hair growth), purple striae (skin stretch marks that are purple in color), and acne due to the hormonal imbalances it creates. Peripheral neuropathy, which involves damage to the peripheral nerves leading to symptoms like numbness, tingling, and weakness in the extremities, is not a characteristic symptom of Cushing's syndrome.
All of the following would be expected to increase prolactin levels except:
- A. Chest wall trauma
- B. Hyperthyroidism
- C. Pregnancy
- D. Renal failure
Correct Answer: B
Rationale: Prolactin levels can be increased by various factors, including chest wall trauma, pregnancy, and renal failure. However, hyperthyroidism is not typically associated with elevated prolactin levels. In fact, hyperthyroidism is more commonly associated with decreased levels of prolactin due to the inhibitory effect of thyroid hormones on prolactin secretion. Therefore, all of the options except for hyperthyroidism would be expected to increase prolactin levels.
Which of the following is false regarding medullary carcinoma of thyroid?
- A. Cervical Iymphadenopathy
- B. High serum calcitonin
- C. Carcinoid syndrome may be associated with
- D. Psychosis
Correct Answer: D
Rationale: Medullary carcinoma of the thyroid typically presents with symptoms related to the thyroid gland itself, neck mass or swelling, and sometimes cervical lymphadenopathy. It is characterized by the production of calcitonin, leading to high serum calcitonin levels. Carcinoid syndrome, which includes symptoms such as flushing, diarrhea, and wheezing, is more commonly associated with neuroendocrine tumors, rather than medullary carcinoma of the thyroid. Psychosis is not a typical feature or manifestation of medullary carcinoma of the thyroid.