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: Chronic pancreatitis. Hypoglycemia is not typically associated with chronic pancreatitis as it is more related to pancreatic insufficiency and impaired glucose regulation. A: Glycogen storage disease can lead to hypoglycemia due to the inability to properly release stored glucose. C: Galactosaemia can cause hypoglycemia due to the impaired breakdown of galactose into glucose. D: Post-gastrectomy can lead to hypoglycemia due to rapid glucose absorption and altered hormonal responses.

Correct Answer: C

Rationale: The correct answer is C: Bi-temporal hemianopia. Pituitary adenoma compressing the optic chiasm typically leads to bi-temporal hemianopia due to compression of the crossing fibers from the nasal visual fields. This results in loss of peripheral vision in both temporal visual fields. A: Bilateral inferior visual field deficits and B: Bilateral superior visual field deficits are less likely as they are not typical patterns associated with optic chiasm compression. D: Right homonymous hemianopia is incorrect as it is not associated with compression of the optic chiasm by a pituitary adenoma.

Correct Answer: B

Rationale: Correct Answer: B (Rheumatic carditis) Rationale: 1. Rheumatic carditis is a heart condition, which may lead to a decreased cardiac output and subsequently a lower pulse rate during sleep. 2. Anxiety neurosis can lead to increased sympathetic activity, causing an elevated pulse rate during sleep. 3. Pulmonary tuberculosis can cause systemic inflammation and increased metabolic demand, resulting in an elevated pulse rate during sleep. 4. Atropine, a parasympatholytic drug, inhibits the action of the parasympathetic nervous system, leading to an increased pulse rate.

Correct Answer: B

Rationale: The correct answer is B: Bitemporal Hemianopsia. Pituitary adenomas can compress the optic chiasm, leading to bitemporal hemianopsia. This occurs due to the loss of peripheral vision on both sides. Carpo-pedal spasm (A) is associated with hypocalcemia, Chvostek's sign (C) is a facial spasm seen in hypocalcemia, and tremor (D) can be seen in conditions such as Parkinson's disease, but they are not specific to pituitary adenoma. Bitemporal hemianopsia is a classic sign of pituitary adenoma due to its location near the optic chiasm.