Which of the following is not a symptom of Cushing's syndrome?

Correct Answer: D

Rationale: Weight gain is a common symptom of Cushing's syndrome due to the excessive production of cortisol, a hormone that regulates metabolism and fat storage. The other symptoms listed, such as easy bruising, acne, and stretch marks, are also characteristic features of Cushing's syndrome. However, weight loss is typically not associated with this condition. In fact, individuals with Cushing's syndrome often experience unexplained and rapid weight gain, especially in the face, abdomen, and upper back (resulting in a characteristic "buffalo hump" appearance), rather than weight loss.

Correct Answer: D

Rationale: Persistent muscular weakness is characteristic of myxoedema, which is severe hypothyroidism. Myxoedema can lead to general weakness and fatigue, as thyroid hormones play a crucial role in controlling metabolism and energy production in the body. Other symptoms of myxoedema include cold intolerance, weight gain, dry skin, and hair loss. Conn's syndrome (hyperaldosteronism) is characterized by hypertension and low potassium levels, not persistent muscular weakness. Acromegaly is a condition resulting from excess growth hormone production, leading to enlarged body parts and metabolic changes but not specifically muscular weakness. Hyperparathyroidism is associated with high levels of parathyroid hormone, which can lead to bone weakening and calcium imbalance, but it is not typically a primary cause of muscular weakness.

Correct Answer: D

Rationale: Oxytocin and antidiuretic hormone (ADH; vasopressin) are both synthesized in the hypothalamus, specifically in the supraoptic and paraventricular nuclei. After synthesis, they are transported along axons to the posterior pituitary where they are stored until they are released into the bloodstream when needed. This is why they are released from the posterior pituitary, not the anterior pituitary. These hormones have different functions in the body, with oxytocin being involved in labor and breastfeeding, while ADH plays a role in regulating water balance and blood pressure.

Correct Answer: D

Rationale: Binding proteins are essential in transporting hormones through the bloodstream and protecting them from rapid degradation by enzymes. These proteins do not actually mediate the hormonal effects themselves. Hormonal effects are typically mediated by the hormone-receptor interactions at target cells. Binding proteins primarily serve as carriers for hormones and maintain their stability and availability in the circulation.

Correct Answer: D

Rationale: Medullary carcinoma of the thyroid typically presents with symptoms related to the thyroid gland itself, neck mass or swelling, and sometimes cervical lymphadenopathy. It is characterized by the production of calcitonin, leading to high serum calcitonin levels. Carcinoid syndrome, which includes symptoms such as flushing, diarrhea, and wheezing, is more commonly associated with neuroendocrine tumors, rather than medullary carcinoma of the thyroid. Psychosis is not a typical feature or manifestation of medullary carcinoma of the thyroid.

Correct Answer: B

Rationale: In males, Leydig cells in the testes are stimulated to produce testosterone by luteinizing hormone (LH). LH is produced by the anterior pituitary gland and acts on the Leydig cells to promote the synthesis and release of testosterone. This hormone plays a crucial role in male reproductive function and the development of masculine characteristics. Follicle stimulating hormone (FSH) plays a role in spermatogenesis in males but does not directly stimulate Leydig cells to produce testosterone.

Correct Answer: A

Rationale: Gastroparesis is a complication of diabetes mellitus. It is a condition that affects the normal spontaneous movement of the muscles in the stomach, causing delayed emptying of food from the stomach into the small intestine. This can lead to symptoms such as nausea, vomiting, bloating, and poor appetite. Diabetes can damage the nerves that control the stomach muscles, resulting in gastroparesis. Managing blood sugar levels and following a proper diet can help in controlling the symptoms of gastroparesis in individuals with diabetes. Exophthalmos, hirsutism, and moon facies are not typically associated with complications of diabetes mellitus.

Correct Answer: D

Rationale: Hypoglycemia is characterized by a low blood sugar level, which can lead to various symptoms. The features of hypoglycemia typically include drenching sweat, tachycardia (increased heart rate), and tachypnea (rapid breathing). A brisk jerk, on the other hand, is not a typical feature of hypoglycemia. Symptoms such as confusion, dizziness, shakiness, hunger, weakness, and irritability are more commonly associated with hypoglycemia than a brisk jerk.

Correct Answer: A

Rationale: Phaeochromocytoma is a neuroendocrine tumor that arises from the chromaffin cells of the adrenal medulla. It is the most common cause of a catecholamine-secreting tumor in adults. While it can also rarely occur outside the adrenal gland (referred to as extra-adrenal or paraganglioma), the majority of cases originate within the adrenal medulla. Symptoms of phaeochromocytoma are due to the excessive release of catecholamines (epinephrine and norepinephrine), leading to a characteristic triad of headaches, sweating, and palpitations. Therefore, the commonest cause of phaeochromocytoma is a tumor of the adrenal medulla.