All of the following are consistent with non-proliferative diabetic retinopathy except:

Correct Answer: C

Rationale: The correct answer is C: Neovascularization. Non-proliferative diabetic retinopathy is characterized by early changes such as retinal vascular microaneurysms, blot hemorrhages, and cotton-wool spots. Neovascularization is a feature of proliferative diabetic retinopathy, not non-proliferative. Neovascularization refers to the growth of abnormal new blood vessels in the retina, which can lead to severe vision loss if not treated promptly. In summary, neovascularization is not consistent with non-proliferative diabetic retinopathy, as it is a hallmark of the proliferative stage.

Correct Answer: A

Rationale: The correct answer is A: Adrenaline. In injury to the adrenal cortex, adrenaline is least affected because it is primarily synthesized and secreted by the adrenal medulla, not the adrenal cortex. Cortisol, aldosterone, and androstenedione are hormones produced by the adrenal cortex. In adrenal cortex injury, the secretion of cortisol, aldosterone, and androstenedione would be significantly affected due to the damage to the adrenal cortex, leading to hormonal imbalance and related symptoms. Therefore, option A is the correct answer as it is not primarily secreted by the adrenal cortex and would be least affected in this scenario.

Correct Answer: A

Rationale: Rationale: A: Correct. Cushing's disease is caused by a pituitary adenoma secreting excess ACTH, stimulating adrenal cortex to produce excess cortisol. B: Incorrect. Cushing's disease does not result from excess cortisol secretion by the pituitary adenoma. C: Incorrect. Cushing's disease is not caused by an adrenal adenoma secreting excess ACTH. D: Incorrect. Cushing's disease is not caused by an adrenal adenoma secreting excess cortisol. Summary: The correct answer is A because it accurately describes the pathophysiology of Cushing's disease, where a pituitary adenoma secretes excess ACTH leading to increased cortisol production. Choices B, C, and D are incorrect as they misinterpret the primary source of hormone overproduction in Cushing's disease.

Correct Answer: C

Rationale: Increased parathyroid hormone (PTH) concentration is associated with tetany because PTH helps regulate calcium levels in the blood. When calcium levels are low, PTH is released to stimulate the release of calcium from bones and increase calcium absorption from the intestines. Tetany is characterized by muscle cramps and spasms due to low calcium levels, which can occur when PTH levels are elevated. A: Vitamin D toxicity is associated with high levels of calcium in the blood, not low calcium levels as seen in tetany. B: Rickets is a condition caused by vitamin D deficiency, leading to impaired bone growth and development, not directly related to elevated PTH levels. D: Reduced excretion of phosphate is not directly linked to elevated PTH levels, as PTH primarily regulates calcium levels.

Correct Answer: C

Rationale: The correct answer is C: Neovascularization. Non-proliferative diabetic retinopathy is characterized by early changes such as retinal vascular microaneurysms, blot hemorrhages, and cotton-wool spots. Neovascularization is a feature of proliferative diabetic retinopathy, not non-proliferative. Neovascularization refers to the growth of abnormal new blood vessels in the retina, which can lead to severe vision loss if not treated promptly. In summary, neovascularization is not consistent with non-proliferative diabetic retinopathy, as it is a hallmark of the proliferative stage.

Correct Answer: C

Rationale: The correct answer is C: Stress. Stress triggers the release of growth hormone through the activation of the hypothalamic-pituitary-adrenal axis. When the body is under stress, the hypothalamus signals the pituitary gland to release growth hormone. This hormone then stimulates growth and cell reproduction. Glucocorticoids (A) and somatostatin (B) actually inhibit the release of growth hormone. Obesity (D) can lead to decreased growth hormone release due to disrupted hormonal regulation. In summary, stress is the correct answer as it directly stimulates the release of growth hormone, while the other choices inhibit or have a negative impact on growth hormone release.

Correct Answer: C

Rationale: Diabetes insipidus is a condition where the kidneys are unable to conserve water, leading to the excretion of large volumes of dilute urine. This is due to either a lack of antidiuretic hormone (ADH) production (central DI) or the kidneys' insensitivity to ADH (nephrogenic DI). Choice A is incorrect as the urine is dilute, not concentrated. Choice B is incorrect as diabetes insipidus results in large, not small, urine volumes. Choice D is incorrect as the urine is dilute, not concentrated. Therefore, choice C accurately describes diabetes insipidus.

Correct Answer: C

Rationale: The correct answer is C: SIADH. Secondary hyperaldosteronism is characterized by increased aldosterone production due to factors outside of the adrenal glands, such as increased renin-angiotensin-aldosterone system activation. SIADH does not involve aldosterone, but rather involves inappropriate secretion of antidiuretic hormone leading to hyponatremia. In contrast, congestive cardiac failure, nephrotic syndrome, and cirrhosis of the liver can all lead to secondary hyperaldosteronism due to mechanisms such as decreased effective circulating volume, renal hypoperfusion, and increased angiotensin II levels, respectively.

Correct Answer: D

Rationale: The correct answer is D: second messengers. Protein hormones typically bind to cell surface receptors, activating second messenger systems to relay the signal inside the cell. This mechanism allows for rapid and amplified cellular responses. Choices A and B (cytoplasmic and nuclear receptors) are more commonly associated with steroid hormones, not protein hormones. Choice C (cyclic ribosomal adenosine phosphate) is not a known mechanism of hormone action. Thus, the correct answer is D, as second messengers are the primary mediators of protein hormone actions.