Which of the following is the most common cause of hypothyroidism worldwide?

Correct Answer: D

Rationale: Iodine deficiency is the most common cause of hypothyroidism worldwide. Iodine is an essential mineral required for the production of thyroid hormones. Without sufficient iodine, the thyroid gland is unable to produce an adequate amount of thyroid hormones, leading to hypothyroidism. Areas with low iodine levels in the soil or water are more prone to iodine deficiency, which can result in a range of thyroid disorders, including hypothyroidism. Efforts to prevent iodine deficiency include iodized salt programs and dietary interventions to ensure an adequate intake of iodine.

Correct Answer: C

Rationale: Tetany is a condition characterized by involuntary muscle spasms and contractions due to low levels of calcium in the blood. The signs associated with tetany include Trousseau's sign, which is the carpal spasm elicited by inflating a blood pressure cuff above systolic pressure, and Chvostek's sign, which is the facial muscle spasm elicited by tapping on the facial nerve. Peroneal sign is not specifically associated with tetany but can be seen in conditions like peroneal nerve injury. Erb's sign, on the other hand, is not a recognized sign of tetany. It is associated with Erb's palsy, a condition resulting from injury to the brachial plexus nerves, typically during childbirth. Tinel's sign, which is a tingling sensation elicited by tapping over a compressed nerve, is also not a characteristic sign of tetany.

Correct Answer: A

Rationale: Phaeochromocytoma is a rare neuroendocrine tumor that usually originates from the adrenal glands and produces excess catecholamines. The characteristic symptoms of phaeochromocytoma include paroxysmal (sudden and severe) hypertension, fear of impending death (angor animi), and episodic symptoms like palpitations, headache, and diaphoresis. However, weight gain is not a typical manifestation associated with phaeochromocytoma. In fact, patients with this condition may experience unintentional weight loss due to the effects of excess catecholamines on metabolism and appetite suppression. Therefore, weight gain is not a significant feature observed in individuals with phaeochromocytoma.

Correct Answer: B

Rationale: Pseudohypoparathyroidism is a rare genetic disorder that mimics the symptoms of hypoparathyroidism, despite normal or elevated levels of parathyroid hormone (PTH). The condition is characterized by hypocalcemia, hyperphosphatemia, and normal or elevated PTH levels. However, it is not associated with a raised level of plasma PIH (Parathyroid Inhibiting Hormone). In pseudohypoparathyroidism, the body's tissues are resistant to the action of PTH, leading to impaired calcium regulation. Other common features of pseudohypoparathyroidism may include cataract formation, mental retardation, and reduced levels of plasma phosphate.

Correct Answer: A

Rationale: The most common cause of Addison's disease is autoimmune adrenalitis, also known as autoimmune adrenal insufficiency. In autoimmune adrenalitis, the adrenal glands are damaged by immune system-mediated processes, leading to their dysfunction. This autoimmune destruction typically presents as bilateral adrenal cortex atrophy due to the formation of granulomas. Therefore, the commonest cause of Addison's disease is the presence of granulomas in the adrenal glands, making option A, Granuloma, the correct choice.