All of the following are actions of parathyroid hormone except

Correct Answer: A

Rationale: The correct answer is A because parathyroid hormone does not directly stimulate osteoblasts to increase bone formation. Instead, it indirectly increases bone resorption by stimulating osteoclasts. Parathyroid hormone also increases calcium reabsorption from the distal tubule of the kidney (choice C) and inhibits phosphate reabsorption in the proximal tubule of the kidney (choice D). By understanding the physiological actions of parathyroid hormone, we can deduce that direct stimulation of osteoblasts is not one of its functions.

Correct Answer: C

Rationale: The correct answer is C: Purple skin striae. This is the most common sign of Cushing's syndrome due to the excessive production of cortisol leading to thinning of the skin and formation of purple stretch marks. Hirsutism (A) is excessive hair growth, not specific to Cushing's. Obesity (B) can be a symptom, but it is not the most common. Skin hyperpigmentation (D) is seen in Addison's disease, not Cushing's.

Correct Answer: C

Rationale: Step-by-step rationale: 1. Tertiary hyperparathyroidism occurs due to prolonged secondary hyperparathyroidism in response to chronic renal failure. 2. In chronic renal failure, impaired kidney function leads to reduced activation of vitamin D and impaired calcium regulation. 3. Persistent hypocalcemia triggers the parathyroid glands to overproduce parathyroid hormone, leading to tertiary hyperparathyroidism. 4. Rickets (choice A) is associated with vitamin D deficiency, pseudohypoparathyroidism (choice B) is a genetic disorder, and malabsorption syndrome (choice D) affects nutrient absorption, but they are not commonly linked to tertiary hyperparathyroidism.

Correct Answer: C

Rationale: The correct answer is C: Glucose-6-phosphatase deficiency. This enzyme is essential for gluconeogenesis and glycogenolysis, so its deficiency leads to fasting hypoglycemia. Galactosaemia (A) can cause hypoglycemia due to impaired galactose metabolism. Insulinoma (B) results in excess insulin production causing hypoglycemia. Systemic carnitine deficiency (D) can lead to hypoglycemia by impairing fatty acid oxidation, but it does not directly cause fasting hypoglycemia as seen in Glucose-6-phosphatase deficiency.

Correct Answer: C

Rationale: Erythropoietin is primarily secreted from the kidney, specifically by the Juxtaglomerular cells in the kidney's cortex. These cells are responsible for sensing oxygen levels and regulating erythropoietin production accordingly. Mesenchymal tumors, cerebellar haemangioblastoma, and lymphoma are not associated with erythropoietin secretion, making them incorrect choices. Mesenchymal tumors originate from connective tissues, cerebellar haemangioblastoma is a type of brain tumor, and lymphoma is a cancer of the lymphatic system. Only the Juxtaglomerular cells in the kidney have the physiological role of secreting erythropoietin in response to hypoxia.