Which of the following investigations is the gold standard for diagnosing acromegaly?

Correct Answer: C

Rationale: The gold standard for diagnosing acromegaly is the oral glucose tolerance test (OGTT) along with growth hormone (GH) measurement. During this test, the patient is given a glucose solution to drink, and then blood samples are taken to measure GH levels at specific time intervals. In a person without acromegaly, glucose ingestion would typically suppress GH levels. However, in individuals with acromegaly, GH levels remain elevated even after glucose administration due to the inability of glucose to inhibit GH release from the tumor.

Correct Answer: A

Rationale: Phaeochromocytoma may be associated with Medullary carcinoma of thyroid, Hyperparathyroidism, and Addison's disease as part of MEN Syndrome (Multiple Endocrine Neoplasia) Type 2. However, it is not typically associated with Neurofibromatosis. Neurofibromatosis is associated with the development of benign tumors of nerve tissue and is not directly linked to the presence of 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: D

Rationale: Addison's disease, also known as primary adrenal insufficiency, is mainly caused by the autoimmune destruction of the adrenal cortex. This results in the inadequate production of hormones such as cortisol and aldosterone by the adrenal glands. While other conditions such as Adrenoleukodystrophy, Pyelonephritis, and Tuberculosis can also affect the adrenal glands, they are not known to be direct causes of Addison's disease.

Correct Answer: C

Rationale: Autonomic neuropathy in diabetes can manifest with various symptoms, such as retrograde ejaculation (A), gustatory sweating (B), and hypoglycemic unresponsiveness (D). Mononeuritis multiplex (C) is not typically associated with autonomic neuropathy in diabetes. Mononeuritis multiplex is a condition characterized by damage to at least two separate nerve areas resulting in weakness, pain, and sensory loss. Autonomic neuropathy in diabetes tends to affect the autonomic nerves that control involuntary bodily functions, leading to symptoms such as gastrointestinal issues, cardiovascular abnormalities, and sexual dysfunction, but mononeuritis multiplex is not a common feature of this condition.

Correct Answer: B

Rationale: Conn's syndrome, also known as primary hyperaldosteronism, is characterized by excess production of aldosterone by the adrenal glands. This leads to increased sodium retention and potassium excretion in the kidneys. As a result, patients with Conn's syndrome typically present with hypokalemia (low potassium levels), not hyperkalemia (high potassium levels). The other features of Conn's syndrome include alkalosis (metabolic), muscle cramps, and severe systemic hypertension.

Correct Answer: A

Rationale: Centripetal obesity, acne, and hirsutism are classic features of Cushing's syndrome. Cushing's syndrome results from prolonged exposure to high levels of cortisol, which can be due to various causes such as adrenal tumors, pituitary adenomas, or exogenous glucocorticoid use. Centripetal obesity refers to the characteristic fat distribution pattern seen in Cushing's syndrome, where fat accumulates mainly in the face, neck, and trunk while sparing the limbs. Acne and hirsutism are also commonly seen in Cushing's syndrome due to the hormonal imbalances caused by excess cortisol. Testing for serum cortisol levels, dexamethasone suppression tests, and imaging studies can help confirm the diagnosis of Cushing's syndrome in a patient presenting with these symptoms.

Correct Answer: C

Rationale: Hormones are chemical messengers that are produced by various glands in the body and released into the bloodstream to signal and regulate the activity of specific target cells. Unlike energy sources that can be metabolized for energy production (like carbohydrates and fats), hormones are not typically used as an energy source themselves (Choice B). Hormones are typically not biologically inert by themselves (Choice A), as they have specific functions in regulating various physiological processes in the body. While some hormones may be stored in secretory granules before release, not all hormones are stored in this manner (Choice D). Additionally, hormones are not always released by exocytosis (Choice E), as some hormones can also be released through other mechanisms such as diffusion. The correct choice, therefore, is C: hormones are incorporated as a structural moiety into another molecule, as they bind to specific receptors on target cells to elicit a cellular response and regulate physiological functions.

Correct Answer: D

Rationale: Increased serum aldosterone level is typically associated with conditions such as Conn's syndrome or primary hyperaldosteronism. These conditions lead to an excess of aldosterone, which results in increased sodium resorption and potassium excretion by the kidneys. This imbalance can lead to hypertension (Choice A), hypernatraernia (elevated sodium level) (Choice B), and hypokalaemia (low potassium level) (Choice C). However, metabolic acidosis (Choice D) is not directly associated with increased aldosterone levels. Instead, metabolic acidosis may be seen in conditions like renal tubular acidosis or diabetic ketoacidosis.