In a patient with diabetes insipidus:

Correct Answer: B

Rationale: The correct answer is B: Intranasal vasopressin may be helpful. In diabetes insipidus, there is a deficiency of vasopressin leading to excessive urination and thirst. Administering vasopressin intranasally can help replace the deficient hormone, reducing urine output and thirst. Hypernatremia (choice A) can occur due to excessive water loss, but it is not always present. There is no osmolar gap (choice C) in diabetes insipidus. Urine specific gravity (choice D) is typically low in diabetes insipidus due to the dilute urine produced.

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: Rationale: 1. GnRH directly binds to pituitary receptors. 2. GnRH specifically targets gonadotroph cells to release LH and FSH. 3. CRH and ACTH are related to stress and adrenal function, not reproductive hormones. 4. Tremor is unrelated to pituitary hormone regulation. Summary: Gonadotrophin releasing hormone (GnRH) is the correct answer as it directly stimulates the release of LH and FSH from the pituitary gland. Other choices are incorrect as they are not involved in the regulation of reproductive hormones.

Correct Answer: D

Rationale: Step-by-step rationale: 1. Gynaecomastia is a known side effect of spironolactone, digitalis, and cimetidine. 2. Rifampicin is not associated with gynaecomastia. 3. Rifampicin is an antibiotic used to treat tuberculosis and other infections. 4. The mechanism of action of rifampicin does not involve hormonal changes that could lead to gynaecomastia. Summary of incorrect choices: - A: Spironolactone is a potassium-sparing diuretic that can cause gynaecomastia. - B: Digitalis (digoxin) can lead to gynaecomastia as a side effect. - C: Cimetidine, an H2 receptor antagonist, is also known to cause gynaecomastia.

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: C

Rationale: The correct answer is C: Myxoedema. Myxoedema is associated with hypothyroidism, not SIADH. Guillain-Barre syndrome, subacute bacterial endocarditis, and bronchogenic carcinoma are all conditions that can lead to SIADH due to various mechanisms. Guillain-Barre syndrome can cause SIADH through autonomic dysfunction, endocarditis through the release of inflammatory cytokines, and bronchogenic carcinoma through production of ectopic ADH. Therefore, myxoedema is the only incorrect choice as it does not typically lead to SIADH.

Correct Answer: D

Rationale: Step 1: Toxic thyroid adenoma is characterized by a benign tumor in the thyroid gland. Step 2: This tumor produces excessive amounts of thyroid hormones, particularly T3 and T4. Step 3: The tumor arises from the follicular cells of the thyroid gland. Step 4: Choice D accurately describes a toxic thyroid adenoma as a benign tumor producing excessive thyroid hormones from follicular cells. Summary: Choice A is incorrect because it describes autoimmune thyroid disease, not a toxic adenoma. Choice B is incorrect as it describes a malignant tumor, not a benign one. Choice C is incorrect as it describes thyroiditis, not a toxic adenoma.

Correct Answer: B

Rationale: The correct answer is B: ductless. Endocrine glands release hormones directly into the bloodstream without the use of ducts. This allows hormones to reach target organs throughout the body. Choice A (vascular) is incorrect because it refers to the presence of blood vessels, which is common in all glands, not just endocrine glands. Choice C (square) is irrelevant as the shape of glands does not determine their function. Choice D (autonomous) is incorrect as it does not accurately describe endocrine glands; while they function independently, the term "autonomous" does not specifically apply to them.

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.