Which is not a part of multiple endocrine neoplasia type I (Wermers syndrome)?

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: 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.

Correct Answer: C

Rationale: Erythropoietin is primarily secreted from the kidney, specifically by the Juxtaglomerular cells in the kidney's cortex. These cells are responsible for sensing oxygen levels and regulating erythropoietin production accordingly. Mesenchymal tumors, cerebellar haemangioblastoma, and lymphoma are not associated with erythropoietin secretion, making them incorrect choices. Mesenchymal tumors originate from connective tissues, cerebellar haemangioblastoma is a type of brain tumor, and lymphoma is a cancer of the lymphatic system. Only the Juxtaglomerular cells in the kidney have the physiological role of secreting erythropoietin in response to hypoxia.

Correct Answer: C

Rationale: The correct answer is C: Neovascularization. Non-proliferative diabetic retinopathy is characterized by early changes such as retinal vascular microaneurysms, blot hemorrhages, and cotton-wool spots. Neovascularization is a feature of proliferative diabetic retinopathy, not non-proliferative. Neovascularization refers to the growth of abnormal new blood vessels in the retina, which can lead to severe vision loss if not treated promptly. In summary, neovascularization is not consistent with non-proliferative diabetic retinopathy, as it is a hallmark of the proliferative stage.