Which of the following is not a part of metabolic 'syndrome X'?

Correct Answer: C

Rationale: The correct answer is C: Ischaemic heart disease. Metabolic syndrome X consists of a cluster of conditions, including hyperlipidemia, obesity, hypertension, and insulin resistance. Ischaemic heart disease, while commonly associated with metabolic syndrome X due to the increased risk factors, is not a direct component of the syndrome itself. Therefore, it is not considered a part of metabolic syndrome X. Hyperlipidemia (A), obesity (B), and hypertension (D) are all key components of metabolic syndrome X due to their association with insulin resistance and increased risk of cardiovascular disease.

Correct Answer: B

Rationale: The correct answer is B: Kidney disease. Oral contraceptive pills are contraindicated in patients with kidney disease due to the risk of impaired drug clearance and potential adverse effects on renal function. Breast cancer (A), liver disease (C), and prior history of deep venous thrombosis (D) are all contraindications to the use of oral contraceptives due to increased risks of complications such as thrombosis or exacerbation of underlying conditions.

Correct Answer: C

Rationale: Elevated glucose levels in obese individuals are often due to insulin resistance. Insulin resistance occurs when the body's cells do not respond effectively to insulin, leading to decreased glucose uptake. This results in elevated blood glucose levels. Diabetic acidosis (choice A) is a complication of uncontrolled diabetes characterized by high blood ketone levels, not directly related to obesity. Glucose intolerance (choice B) refers to the body's inability to regulate blood glucose levels efficiently but is not specific to obesity. Insulin deficiency (choice D) is characteristic of type 1 diabetes, where the body does not produce enough insulin, which is distinct from insulin resistance seen in obesity.

Correct Answer: D

Rationale: Step-by-step rationale: 1. Gynaecomastia is a known side effect of spironolactone, digitalis, and cimetidine. 2. Rifampicin is not associated with gynaecomastia. 3. Rifampicin is an antibiotic used to treat tuberculosis and other infections. 4. The mechanism of action of rifampicin does not involve hormonal changes that could lead to gynaecomastia. Summary of incorrect choices: - A: Spironolactone is a potassium-sparing diuretic that can cause gynaecomastia. - B: Digitalis (digoxin) can lead to gynaecomastia as a side effect. - C: Cimetidine, an H2 receptor antagonist, is also known to cause gynaecomastia.

Correct Answer: A

Rationale: Rationale: A: Correct. Cushing's disease is caused by a pituitary adenoma secreting excess ACTH, stimulating adrenal cortex to produce excess cortisol. B: Incorrect. Cushing's disease does not result from excess cortisol secretion by the pituitary adenoma. C: Incorrect. Cushing's disease is not caused by an adrenal adenoma secreting excess ACTH. D: Incorrect. Cushing's disease is not caused by an adrenal adenoma secreting excess cortisol. Summary: The correct answer is A because it accurately describes the pathophysiology of Cushing's disease, where a pituitary adenoma secretes excess ACTH leading to increased cortisol production. Choices B, C, and D are incorrect as they misinterpret the primary source of hormone overproduction in Cushing's disease.

Correct Answer: C

Rationale: The correct answer is C: Stress. Stress triggers the release of growth hormone through the activation of the hypothalamic-pituitary-adrenal axis. When the body is under stress, the hypothalamus signals the pituitary gland to release growth hormone. This hormone then stimulates growth and cell reproduction. Glucocorticoids (A) and somatostatin (B) actually inhibit the release of growth hormone. Obesity (D) can lead to decreased growth hormone release due to disrupted hormonal regulation. In summary, stress is the correct answer as it directly stimulates the release of growth hormone, while the other choices inhibit or have a negative impact on growth hormone release.

Correct Answer: A

Rationale: The correct answer is A: Acute pancreatitis. Hyperparathyroidism is not typically associated with acute pancreatitis. Hyperparathyroidism is characterized by excessive production of parathyroid hormone, leading to increased calcium levels in the blood. Nephrocalcinosis, palpable neck swelling, and pseudogout are commonly seen in hyperparathyroidism due to the effects of elevated calcium levels on the kidneys, parathyroid glands, and joints, respectively. Acute pancreatitis, on the other hand, is more commonly associated with gallstones, alcohol consumption, or certain medications, rather than hyperparathyroidism.

Correct Answer: A

Rationale: Aldosterone increases potassium excretion by promoting the reabsorption of sodium and water in the kidneys, leading to potassium excretion. This helps maintain electrolyte balance. Other choices are incorrect because aldosterone does not directly increase water loss, is released in response to low blood volume, and is deficient in Addison's disease.

Correct Answer: D

Rationale: The correct answer is D: Fine hairs. In secondary hypothyroidism, the pituitary gland fails to produce enough thyroid-stimulating hormone (TSH), resulting in low thyroid hormone levels. Fine hairs (or hair thinning) is a symptom of hyperthyroidism, not hypothyroidism. Normal cholesterol levels (Choice A) are seen in secondary hypothyroidism due to decreased metabolic rate. Menorrhagia (Choice B) can occur due to hormonal imbalances caused by untreated hypothyroidism. Low TSH levels (Choice C) are a characteristic feature of secondary hypothyroidism as the pituitary gland is not producing enough TSH to stimulate the thyroid gland.