The triad of hyponatraemia, haemodilution and urine hypertonic to plasma suggest diagnosis of:

Correct Answer: B

Rationale: The triad of hyponatremia (low sodium levels in the blood), haemodilution (increased plasma volume), and urine hypertonic to plasma (high urine osmolality compared to blood osmolality) is characteristic of Syndrome of Inappropriate Antidiuretic Hormone (SIADH). In SIADH, there is excessive release of antidiuretic hormone (ADH), also known as vasopressin, leading to water retention by the kidneys and dilutional hyponatremia. This condition results in the body holding onto water, causing hyponatremia and dilution of the blood. The urine being hypertonic compared to plasma indicates that the kidneys are reabsorbing water effectively and concentrating the urine.

Correct Answer: D

Rationale: The overnight 1-mg dexamethasone suppression test is commonly used as an initial screening test for Cushing's syndrome. In this test, a patient takes 1 mg of dexamethasone orally at 11 p.m., and their serum cortisol level is measured the next morning. In patients with Cushing's syndrome, the cortisol levels will not be suppressed by the dexamethasone due to the presence of excessive cortisol production.

Correct Answer: A

Rationale: The most common cause of Cushing's disease is an ACTH-producing pituitary adenoma. In this condition, the pituitary gland produces excessive amounts of adrenocorticotropic hormone (ACTH), which stimulates the adrenal glands to produce high levels of cortisol. This leads to the signs and symptoms of Cushing's disease, such as weight gain, high blood pressure, and muscle weakness. Adrenocortical adenoma refers to a benign tumor of the adrenal cortex that can also cause Cushing's syndrome, but it is not as common as an ACTH-producing pituitary adenoma. Ectopic ACTH secretion occurs when a non-pituitary tumor produces ACTH, leading to Cushing's syndrome. McCune-Albright syndrome is a rare genetic disorder that can cause various endocrine abnormalities, but it is not a common cause of Cushing's disease.

Correct Answer: D

Rationale: Neuropathic pain due to diabetes can present with a variety of symptoms, including burning pain, electric shock quality, and tingling sensation. These symptoms are commonly reported by individuals with diabetic neuropathy, which is the most common form of neuropathic pain associated with diabetes. The combination of these sensations can significantly impact the quality of life for those living with diabetes and neuropathic pain. Therefore, all of the above options are consistent with neuropathic pain due to diabetes.

Correct Answer: B

Rationale: Hemoglobin A1c, also known as HbA1c or glycated hemoglobin, is a blood test that measures the average blood glucose level over the previous 2 to 3 months. This test is useful in monitoring long-term blood glucose control in individuals with diabetes. Hemoglobin A1c provides an indication of how well blood glucose levels have been controlled over time, reflecting the average blood sugar levels during the lifespan of red blood cells, which is typically around 2 to 3 months. A higher Hemoglobin A1c level indicates poorer blood glucose control and an increased risk of diabetes complications.