synthesis:

Correct Answer: D

Rationale: The correct answer is D because synthesis of thyroid hormones (T3 and T4) occurs by the coupling of iodinated tyrosine residues on thyroglobulin within thyroid follicles. Thyroglobulin acts as a precursor for thyroid hormone synthesis. Choices A, B, and C are incorrect because thyroid hormone synthesis does not occur in parafollicular cells, extracellularly in plasma, or require cholesterol for the coupling of iodinated tyrosine residues on thyroglobulin.

Correct Answer: C

Rationale: Increased parathyroid hormone (PTH) concentration is associated with tetany because PTH helps regulate calcium levels in the blood. When calcium levels are low, PTH is released to stimulate the release of calcium from bones and increase calcium absorption from the intestines. Tetany is characterized by muscle cramps and spasms due to low calcium levels, which can occur when PTH levels are elevated. A: Vitamin D toxicity is associated with high levels of calcium in the blood, not low calcium levels as seen in tetany. B: Rickets is a condition caused by vitamin D deficiency, leading to impaired bone growth and development, not directly related to elevated PTH levels. D: Reduced excretion of phosphate is not directly linked to elevated PTH levels, as PTH primarily regulates calcium levels.

Correct Answer: C

Rationale: The correct answer is C: Oxytocin. The anterior pituitary gland produces several hormones, including adrenocorticotropic hormone (A), growth hormone (B), and thyroid-stimulating hormone (D). Oxytocin is actually produced by the posterior pituitary gland, not the anterior pituitary. Oxytocin is responsible for uterine contractions during childbirth and milk ejection during breastfeeding. Therefore, C is the correct answer as it is not produced by the anterior pituitary unlike the other hormones mentioned.

Correct Answer: C

Rationale: The correct answer is C: Ischaemic heart disease. Metabolic syndrome X consists of a cluster of conditions, including hyperlipidemia, obesity, hypertension, and insulin resistance. Ischaemic heart disease, while commonly associated with metabolic syndrome X due to the increased risk factors, is not a direct component of the syndrome itself. Therefore, it is not considered a part of metabolic syndrome X. Hyperlipidemia (A), obesity (B), and hypertension (D) are all key components of metabolic syndrome X due to their association with insulin resistance and increased risk of cardiovascular disease.

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.