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.
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Which of the following is not a symptom of Cushing's syndrome?
- A. Easy bruising
- B. Weight gain
- C. Acne
- D. Weight loss
Correct Answer: D
Rationale: Weight gain is a common symptom of Cushing's syndrome due to the excessive production of cortisol, a hormone that regulates metabolism and fat storage. The other symptoms listed, such as easy bruising, acne, and stretch marks, are also characteristic features of Cushing's syndrome. However, weight loss is typically not associated with this condition. In fact, individuals with Cushing's syndrome often experience unexplained and rapid weight gain, especially in the face, abdomen, and upper back (resulting in a characteristic "buffalo hump" appearance), rather than weight loss.
Thyrotoxicosis may be featured by all except:
- A. Myopathy
- B. Pretibial myxoedema
- C. Hypernatraemia
- D. Atrial fibrillation
Correct Answer: A
Rationale: Thyrotoxicosis, also known as hyperthyroidism, is a condition characterized by excessive thyroid hormone production by the thyroid gland. Symptoms of thyrotoxicosis can include weight loss, heat intolerance, tremors, hyperactivity, and fatigue. While musculoskeletal symptoms such as weakness and tremors are common in thyrotoxicosis, true myopathy (muscle disease) is not a typical feature of the condition. Therefore, myopathy is the correct choice among the given options.
All of the following are noted in Cushing's syndrome except:
- A. Psychosis
- B. Systemic hypertension
- C. Sexual precocity
- D. Osteoporosis
Correct Answer: C
Rationale: Cushing's syndrome is a collection of signs and symptoms caused by prolonged exposure to high levels of cortisol. Common features of Cushing's syndrome include weight gain, central obesity, moon face, buffalo hump, easy bruising, muscle weakness, and menstrual irregularities in women.
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.
Oxytocin and antidiuretic hormone (ADH; vasopressin) are:
- A. complex steroids.
- B. synthesized and stored in the posterior pituitary.
- C. released from the anterior pituitary where blood is hypotonic.
- D. synthesized in the hypothalamus and released from the posterior pituitary.
Correct Answer: D
Rationale: Oxytocin and antidiuretic hormone (ADH; vasopressin) are both synthesized in the hypothalamus, specifically in the supraoptic and paraventricular nuclei. After synthesis, they are transported along axons to the posterior pituitary where they are stored until they are released into the bloodstream when needed. This is why they are released from the posterior pituitary, not the anterior pituitary. These hormones have different functions in the body, with oxytocin being involved in labor and breastfeeding, while ADH plays a role in regulating water balance and blood pressure.
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