Primary hyperaldosteronism is not featured by:

Correct Answer: B

Rationale: Primary hyperaldosteronism, also known as Conn's syndrome, is characterized by excessive production of aldosterone by the adrenal glands, leading to increased sodium reabsorption and potassium excretion in the kidneys. The typical features of primary hyperaldosteronism include hypertension (often systolic), hypokalemia, metabolic alkalosis, and oedema due to sodium retention. Paraesthesia, which refers to abnormal sensations such as tingling or numbness, is not a common feature associated with primary hyperaldosteronism.

Correct Answer: A

Rationale: Phaeochromocytoma is a rare neuroendocrine tumor that usually originates from the adrenal glands and produces excess catecholamines. The characteristic symptoms of phaeochromocytoma include paroxysmal (sudden and severe) hypertension, fear of impending death (angor animi), and episodic symptoms like palpitations, headache, and diaphoresis. However, weight gain is not a typical manifestation associated with phaeochromocytoma. In fact, patients with this condition may experience unintentional weight loss due to the effects of excess catecholamines on metabolism and appetite suppression. Therefore, weight gain is not a significant feature observed in individuals with phaeochromocytoma.

Correct Answer: B

Rationale: Pseudohypoparathyroidism is a rare genetic disorder that mimics the symptoms of hypoparathyroidism, despite normal or elevated levels of parathyroid hormone (PTH). The condition is characterized by hypocalcemia, hyperphosphatemia, and normal or elevated PTH levels. However, it is not associated with a raised level of plasma PIH (Parathyroid Inhibiting Hormone). In pseudohypoparathyroidism, the body's tissues are resistant to the action of PTH, leading to impaired calcium regulation. Other common features of pseudohypoparathyroidism may include cataract formation, mental retardation, and reduced levels of plasma phosphate.

Correct Answer: A

Rationale: The most common cause of Addison's disease is autoimmune adrenalitis, also known as autoimmune adrenal insufficiency. In autoimmune adrenalitis, the adrenal glands are damaged by immune system-mediated processes, leading to their dysfunction. This autoimmune destruction typically presents as bilateral adrenal cortex atrophy due to the formation of granulomas. Therefore, the commonest cause of Addison's disease is the presence of granulomas in the adrenal glands, making option A, Granuloma, the correct choice.

Correct Answer: A

Rationale: Acromegaly is a disorder caused by excessive growth hormone production by the pituitary gland in adults, leading to an increase in muscle mass (hypertrophy). Hoffman syndrome, characterized by increased muscle mass with slowness of activity, is a clinical feature often seen in individuals with acromegaly. The excessive growth hormone levels in acromegaly can cause acral growth, soft tissue swelling, and muscle hypertrophy, contributing to the characteristic features of the condition, including Hoffman syndrome. Therefore, the correct answer is Acromegaly.