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: A

Rationale: The correct answer is A: Phaeochromocytoma. Multiple Endocrine Neoplasia Type I (MEN I) is characterized by tumors in the pituitary, pancreas, and parathyroid glands. Phaeochromocytoma is not typically associated with MEN I. Phaeochromocytoma is commonly seen in MEN II syndrome. Therefore, A is the correct answer. Choice B, C, and D are incorrect as they are all associated with MEN I based on the characteristic tumor involvement in the pituitary, pancreas, and parathyroid glands, respectively.

Correct Answer: B

Rationale: Step-by-step rationale for why answer B is correct: 1. Cushing's syndrome is characterized by excess cortisol production. 2. Women are more likely to develop Cushing's syndrome due to hormonal differences. 3. Women have higher cortisol levels naturally, making them more susceptible. 4. Men can still develop Cushing's syndrome but at a lower rate compared to women. Summary: A: Incorrect, as women are more likely to develop Cushing's syndrome. C: Incorrect, as the incidence is higher in women due to hormonal factors. D: Incorrect, as it refers to thyroid hormones, not cortisol in Cushing's syndrome.

Correct Answer: A

Rationale: The correct answer is A: Cirrhosis. In cirrhosis, there is a decrease in the binding proteins for T4, leading to decreased total T4 levels in the plasma. Pregnancy, euthyroid sick syndrome, and familial excess thyroid binding globulin are all conditions associated with increased total T4 levels due to various physiological changes. In pregnancy, there is an increase in thyroid hormone production to support fetal development. Euthyroid sick syndrome is a condition where there is a decrease in binding proteins, leading to an increase in free T4 levels but normal total T4 levels. Familial excess thyroid binding globulin causes an increase in total T4 levels due to excessive binding proteins.

Correct Answer: C

Rationale: Rationale for choice C (FSH) being correct: 1. FSH stimulates Sertoli cells in the testes. 2. Sertoli cells produce androgen binding globulin (ABG). 3. ABG binds to testosterone, regulating its availability. 4. FSH indirectly influences testosterone levels via ABG production. Summary of incorrect choices: A. LH stimulates Leydig cells to produce testosterone, not Sertoli cells. B. GnRH regulates the release of FSH and LH but does not directly stimulate ABG production. D. Oxytocin is not involved in the regulation of Sertoli cells or ABG production in males.

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: Cortisol. The adrenal cortex produces cortisol, a steroid hormone involved in stress response and metabolism. Norepinephrine (A) is produced by the adrenal medulla. 5-DHEA (C) is a precursor to sex hormones and not directly produced by the adrenal cortex. Aldosterone (D) is produced by the adrenal cortex but is involved in regulating salt and water balance, not directly related to cortisol production.

Correct Answer: C

Rationale: The correct answer is C: SIADH. Secondary hyperaldosteronism is characterized by increased aldosterone production due to factors outside of the adrenal glands, such as increased renin-angiotensin-aldosterone system activation. SIADH does not involve aldosterone, but rather involves inappropriate secretion of antidiuretic hormone leading to hyponatremia. In contrast, congestive cardiac failure, nephrotic syndrome, and cirrhosis of the liver can all lead to secondary hyperaldosteronism due to mechanisms such as decreased effective circulating volume, renal hypoperfusion, and increased angiotensin II levels, respectively.

Correct Answer: A

Rationale: The correct answer is A: Adrenaline. In injury to the adrenal cortex, adrenaline is least affected because it is primarily synthesized and secreted by the adrenal medulla, not the adrenal cortex. Cortisol, aldosterone, and androstenedione are hormones produced by the adrenal cortex. In adrenal cortex injury, the secretion of cortisol, aldosterone, and androstenedione would be significantly affected due to the damage to the adrenal cortex, leading to hormonal imbalance and related symptoms. Therefore, option A is the correct answer as it is not primarily secreted by the adrenal cortex and would be least affected in this scenario.