Blood calcium is elevated:

Correct Answer: D

Rationale: Blood calcium levels are primarily regulated by the actions of parathyroid hormone (PTH) and Vitamin D. Vitamin D plays a crucial role in maintaining calcium balance in the body by promoting the absorption of calcium from the intestines. When blood calcium levels are low, Vitamin D works to increase absorption of calcium to raise the levels back to normal. Therefore, elevated blood calcium levels are commonly associated with excess Vitamin D intake or conditions that increase Vitamin D levels, such as hypervitaminosis D.

Correct Answer: B

Rationale: The earliest changes observed by ophthalmoscope in background retinopathy of diabetes is typically the presence of microaneurysms. These are small dilations of retinal capillaries due to weakening of the vessel walls caused by diabetes-induced damage. Microaneurysms are a hallmark sign of diabetic retinopathy and are often the first visible sign on retinal examination. Other changes in diabetic retinopathy, such as venous dilatation, increased capillary permeability, and arteriovenous shunts, may develop later in the disease process as it progresses.

Correct Answer: A

Rationale: Hyperthermia is not a typical feature of diabetic ketoacidosis (DKA). DKA is typically characterized by high blood sugar levels, ketone accumulation, metabolic acidosis, dehydration, drowsiness, and, in severe cases, unconsciousness. Common symptoms include drowsiness, dehydration, and air hunger (deep and rapid breathing). However, hyperthermia, which refers to an elevated body temperature, is not a characteristic typically associated with DKA. It is important to monitor and manage DKA promptly as it is a serious complication of diabetes that requires immediate medical attention.

Correct Answer: C

Rationale: Growth hormone deficiency (GHD) is commonly associated with decreased bone mineral density, leading to an increased risk of fractures and osteoporosis. Therefore, increased bone mineral density would not typically be a sign or symptom of GHD. On the other hand, abnormal lipid profile, atherosclerosis, and left ventricular dysfunction are all potential signs or symptoms of GHD. Abnormal lipid profile can manifest as increased levels of LDL cholesterol and decreased levels of HDL cholesterol. Atherosclerosis, the buildup of plaque in the arteries, can occur in individuals with GHD due to the impact on lipid metabolism. Left ventricular dysfunction may also be seen in individuals with GHD due to the role of growth hormone in cardiac function and structure.

Correct Answer: A

Rationale: Thyrotoxicosis typically presents with hypermetabolism and various neuromuscular manifestations. Myasthenic syndrome, which involves muscle weakness and fatigability, is not a common neuromuscular feature of thyrotoxicosis. Instead, manifestations such as brisk knee jerk reflexes, hypokalaemic periodic paralysis (due to shifts in potassium levels), and hyperkinesia (excessive movement) are more commonly observed in patients with thyrotoxicosis. Myasthenic syndrome is more commonly associated with autoimmune disorders affecting the neuromuscular junction, such as myasthenia gravis.