All the following are effects of hypercalcemia except

Correct Answer: C

Rationale: Hypercalcemia refers to elevated levels of calcium in the blood. The effects of hypercalcemia include increased urinary frequency (polyuria), gastrointestinal symptoms such as constipation rather than diarrhea, kidney stones (nephrolithiasis), and various cardiac abnormalities. One key cardiac abnormality associated with hypercalcemia is a prolonged QT interval rather than a shortened QT interval. Prolongation of the QT interval can predispose individuals to arrhythmias, particularly Torsades de pointes. Therefore, the correct answer is C, as a shortened QT interval is not a typical effect of hypercalcemia.

Correct Answer: A

Rationale: Phaeochromocytoma may be associated with Medullary carcinoma of thyroid, Hyperparathyroidism, and Addison's disease as part of MEN Syndrome (Multiple Endocrine Neoplasia) Type 2. However, it is not typically associated with Neurofibromatosis. Neurofibromatosis is associated with the development of benign tumors of nerve tissue and is not directly linked to the presence of Phaeochromocytoma.

Correct Answer: A

Rationale: C-21 hydroxylase deficiency is the most common enzymatic defect leading to the development of congenital adrenal hyperplasia (CAH). This enzyme is necessary for the synthesis of cortisol and aldosterone in the adrenal glands. When there is a deficiency in C-21 hydroxylase, the pathway is shifted towards the production of androgens instead of cortisol and aldosterone, leading to excess androgen production. This results in the characteristic features of CAH, such as ambiguous genitalia in females and virilization in both males and females. Other enzyme deficiencies listed in the choices can also lead to different types of CAH but are less common compared to C-21 hydroxylase deficiency.

Correct Answer: B

Rationale: Conn's syndrome, also known as primary hyperaldosteronism, is characterized by excess production of aldosterone by the adrenal glands. This leads to increased sodium retention and potassium excretion in the kidneys. As a result, patients with Conn's syndrome typically present with hypokalemia (low potassium levels), not hyperkalemia (high potassium levels). The other features of Conn's syndrome include alkalosis (metabolic), muscle cramps, and severe systemic hypertension.

Correct Answer: D

Rationale: Vanillylmandelic acid (VMA) is a metabolite of catecholamines, such as epinephrine and norepinephrine. Phaeochromocytoma is a catecholamine-secreting tumor that arises from the chromaffin cells in the adrenal medulla or sympathetic ganglia. As a result of the increased production of catecholamines in patients with phaeochromocytoma, there is an increase in VMA excretion in the urine. This increase in VMA excretion is a significant diagnostic feature of phaeochromocytoma and helps in its detection through urine testing. Therefore, the correct choice is D. Phaeochromocytoma.