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: D

Rationale: In dwarfism conditions, the upper body segment being greater than the lower body segment is a characteristic feature seen in Achondroplasia. This condition results in a disproportionately short stature with short limbs but a trunk of normal length.

Correct Answer: B

Rationale: Small cell (oat cell) carcinoma of the lung is most commonly associated with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). This paraneoplastic syndrome occurs in patients with small cell lung cancer due to the production of antidiuretic hormone (ADH) by the tumor cells. The excessive release of ADH leads to water retention and dilutional hyponatremia, causing symptoms such as nausea, confusion, seizures, and potentially life-threatening complications. Other types of lung cancer, such as squamous cell carcinoma, large cell carcinoma, and adenocarcinoma, are less commonly associated with SIADH.

Correct Answer: B

Rationale: Myxoedema coma is a severe form of hypothyroidism that can lead to the slowing down of various body functions, including reduced heart rate (bradycardia). As the condition progresses and the body's metabolism becomes more depressed, one of the compensatory mechanisms is an increase in heart rate (tachycardia) to try to maintain adequate tissue perfusion. Therefore, tachycardia is a characteristic feature of myxoedema coma, rather than hypertension or euthermia which are not typically associated with this condition. Hypoventilation is also a common feature of myxoedema coma due to the decreased metabolic rate and respiratory drive.

Correct Answer: D

Rationale: Charcot joint, also known as neuropathic arthropathy, is a serious complication of diabetes mellitus that affects the joints. It commonly affects the foot, especially the midfoot and hindfoot. The condition is characterized by joint deformities, fractures, and dislocations due to nerve damage and loss of sensation in the foot. The repetitive stress on the foot from walking or weight-bearing activities can lead to progressive joint destruction and deformity. It is important for individuals with diabetes to monitor their foot health closely and seek prompt medical attention if they notice any changes or deformities in their feet.