Secondary hyperaldosteronism is associated with all except:

Correct Answer: C

Rationale: The correct answer is C: SIADH. Secondary hyperaldosteronism is characterized by increased aldosterone production due to factors outside of the adrenal glands, such as increased renin-angiotensin-aldosterone system activation. SIADH does not involve aldosterone, but rather involves inappropriate secretion of antidiuretic hormone leading to hyponatremia. In contrast, congestive cardiac failure, nephrotic syndrome, and cirrhosis of the liver can all lead to secondary hyperaldosteronism due to mechanisms such as decreased effective circulating volume, renal hypoperfusion, and increased angiotensin II levels, respectively.

Correct Answer: A

Rationale: The correct answer is A: Phaeochromocytoma. Multiple Endocrine Neoplasia Type I (MEN I) is characterized by tumors in the pituitary, pancreas, and parathyroid glands. Phaeochromocytoma is not typically associated with MEN I. Phaeochromocytoma is commonly seen in MEN II syndrome. Therefore, A is the correct answer. Choice B, C, and D are incorrect as they are all associated with MEN I based on the characteristic tumor involvement in the pituitary, pancreas, and parathyroid glands, respectively.

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: Step-by-step rationale: 1. Tertiary hyperparathyroidism occurs due to prolonged secondary hyperparathyroidism in response to chronic renal failure. 2. In chronic renal failure, impaired kidney function leads to reduced activation of vitamin D and impaired calcium regulation. 3. Persistent hypocalcemia triggers the parathyroid glands to overproduce parathyroid hormone, leading to tertiary hyperparathyroidism. 4. Rickets (choice A) is associated with vitamin D deficiency, pseudohypoparathyroidism (choice B) is a genetic disorder, and malabsorption syndrome (choice D) affects nutrient absorption, but they are not commonly linked to tertiary hyperparathyroidism.

Correct Answer: C

Rationale: The correct answer is C: Glucose-6-phosphatase deficiency. This enzyme is essential for gluconeogenesis and glycogenolysis, so its deficiency leads to fasting hypoglycemia. Galactosaemia (A) can cause hypoglycemia due to impaired galactose metabolism. Insulinoma (B) results in excess insulin production causing hypoglycemia. Systemic carnitine deficiency (D) can lead to hypoglycemia by impairing fatty acid oxidation, but it does not directly cause fasting hypoglycemia as seen in Glucose-6-phosphatase deficiency.