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: 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.

Correct Answer: B

Rationale: Karyotype 47, XYY refers to the presence of an extra Y chromosome in males. This condition is known as XYY syndrome, also called Jacob's syndrome. Individuals with XYY syndrome are typically phenotypically male but may have some associated physical and behavioral characteristics. These individuals are often referred to as "supermales" due to the presence of the extra Y chromosome. This is different from true hermaphroditism, Klinefelter's syndrome, and gonadal dysgenesis, which have distinct chromosomal patterns and manifestations.

Correct Answer: A

Rationale: Addison's disease, also known as primary adrenal insufficiency, is a condition where the adrenal glands do not produce enough steroid hormones, mainly cortisol and sometimes aldosterone. This deficiency in steroid hormone production is typically caused by autoimmune destruction of the adrenal cortex. Without enough cortisol and aldosterone, various symptoms may arise, such as fatigue, weight loss, low blood pressure, and skin discoloration. Therefore, option A accurately describes the nature of Addison's disease.

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: A

Rationale: Phaeochromocytoma is a rare neuroendocrine tumor that usually originates from the adrenal glands and produces excess catecholamines. The characteristic symptoms of phaeochromocytoma include paroxysmal (sudden and severe) hypertension, fear of impending death (angor animi), and episodic symptoms like palpitations, headache, and diaphoresis. However, weight gain is not a typical manifestation associated with phaeochromocytoma. In fact, patients with this condition may experience unintentional weight loss due to the effects of excess catecholamines on metabolism and appetite suppression. Therefore, weight gain is not a significant feature observed in individuals with phaeochromocytoma.

Correct Answer: B

Rationale: Excess prolactin typically causes gynecomastia in men. Prolactin is a hormone primarily responsible for milk production in women. However, in men, elevated levels of prolactin can lead to various symptoms, with gynecomastia being one of the most common. Gynecomastia is the development of breast tissue in males, which can result in swelling and tenderness of the breasts. It is important to investigate the underlying cause of elevated prolactin levels as it could be due to various conditions such as pituitary tumors, certain medications, or thyroid disorders.

Correct Answer: D

Rationale: Obesity is associated with an increased risk of developing various health conditions, including diabetes mellitus, cancer, and hypertension. However, chronic obstructive lung disease (COPD) is not directly linked to obesity. COPD is primarily caused by exposure to harmful particles or gases, most commonly from cigarette smoke. While obesity can impact lung function and worsen symptoms in individuals with COPD, it is not a direct cause of the condition. Therefore, the correct answer is D, chronic obstructive lung disease.