Which of the following is not a feature of autonomic neuropathy in diabetes?

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: 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: 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: C

Rationale: The phrase "Cushing's disease" specifically refers to the cause of Cushing's syndrome that is due to an ACTH-secreting pituitary adenoma. In this specific case, the excess production of ACTH leads to bilateral adrenal hyperplasia and oversecretion of cortisol. It is important to differentiate between Cushing's syndrome caused by a pituitary adenoma (Cushing's disease) and other causes such as adrenal adenomas, ectopic ACTH production, or iatrogenic sources.

Correct Answer: D

Rationale: The most common cause of Cushing's syndrome is a pituitary adenoma, specifically a corticotroph adenoma. This adenoma leads to excessive secretion of adrenocorticotropic hormone (ACTH) by the pituitary gland, which in turn stimulates the adrenal glands to produce high levels of cortisol. This results in the symptoms and signs characteristic of Cushing's syndrome. Pituitary adenomas are responsible for around 70-80% of cases of Cushing's syndrome, making it the most common cause.

Correct Answer: B

Rationale: Small cell (oat cell) carcinoma of the lung is most commonly associated with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). This paraneoplastic syndrome occurs in patients with small cell lung cancer due to the production of antidiuretic hormone (ADH) by the tumor cells. The excessive release of ADH leads to water retention and dilutional hyponatremia, causing symptoms such as nausea, confusion, seizures, and potentially life-threatening complications. Other types of lung cancer, such as squamous cell carcinoma, large cell carcinoma, and adenocarcinoma, are less commonly associated with SIADH.

Correct Answer: B

Rationale: Hashimoto's thyroiditis is an autoimmune disease where the immune system mistakenly attacks the thyroid gland. The antibodies produced by the immune system target the thyroglobulin in the thyroid gland, leading to its destruction over time. This results in decreased thyroid hormone production, leading to hypothyroidism. Therefore, choice B, "A destructive autoimmune disease caused by auto-reactive antibodies against thyroglobulin," best describes Hashimoto's thyroiditis.

Correct Answer: B

Rationale: Myxoedema refers to severe hypothyroidism which can lead to neurological manifestations. The correct features associated with myxoedema include delayed relaxation of ankle jerk (Choice A), hypertonia (Choice C), and bradylalia (Choice D). Cerebellar ataxia, which involves incoordination and balance issues due to dysfunction of the cerebellum, is not a typical neurological feature seen in myxoedema.

Correct Answer: A

Rationale: Acromegaly is a disorder characterized by excess growth hormone production, usually due to a pituitary adenoma. Signs and symptoms of acromegaly arise gradually over time due to excess growth hormone leading to tissue overgrowth.