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: A

Rationale: Pseudo-Cushing's syndrome is a condition that mimics the symptoms of Cushing's syndrome but is not actually caused by excess cortisol production by the adrenal glands. It can be caused by various conditions such as chronic alcoholism, obesity, depression, and certain medications. However, myxoedema (also known as severe hypothyroidism) is not typically associated with pseudo-Cushing's syndrome. Myxoedema is characterized by low thyroid hormone levels, which would not lead to the symptoms of pseudo-Cushing's syndrome.

Correct Answer: A

Rationale: Phaeochromocytoma may be associated with Medullary carcinoma of thyroid, Hyperparathyroidism, and Addison's disease as part of MEN Syndrome (Multiple Endocrine Neoplasia) Type 2. However, it is not typically associated with Neurofibromatosis. Neurofibromatosis is associated with the development of benign tumors of nerve tissue and is not directly linked to the presence of Phaeochromocytoma.

Correct Answer: C

Rationale: Autonomic neuropathy in diabetes can manifest with various symptoms, such as retrograde ejaculation (A), gustatory sweating (B), and hypoglycemic unresponsiveness (D). Mononeuritis multiplex (C) is not typically associated with autonomic neuropathy in diabetes. Mononeuritis multiplex is a condition characterized by damage to at least two separate nerve areas resulting in weakness, pain, and sensory loss. Autonomic neuropathy in diabetes tends to affect the autonomic nerves that control involuntary bodily functions, leading to symptoms such as gastrointestinal issues, cardiovascular abnormalities, and sexual dysfunction, but mononeuritis multiplex is not a common feature of this condition.

Correct Answer: A

Rationale: In the syndrome of inappropriate antidiuretic hormone (SIADH), there is excessive secretion of antidiuretic hormone (ADH) leading to increased water reabsorption in the kidney tubules. This results in dilutional hyponatremia because the amount of water reabsorbed is greater than the electrolytes, such as sodium, leading to a relative decrease in their concentration in the blood. As a result, hyponatremia occurs in SIADH, contributing to symptoms such as nausea, confusion, and seizures due to the imbalance in electrolytes.

Correct Answer: C

Rationale: The gold standard for diagnosing acromegaly is the oral glucose tolerance test (OGTT) along with growth hormone (GH) measurement. During this test, the patient is given a glucose solution to drink, and then blood samples are taken to measure GH levels at specific time intervals. In a person without acromegaly, glucose ingestion would typically suppress GH levels. However, in individuals with acromegaly, GH levels remain elevated even after glucose administration due to the inability of glucose to inhibit GH release from the tumor.

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:

Rationale: Oxytocin and Vasopressin, also known as antidiuretic hormone (ADH), are the hormones stored in the posterior pituitary gland. These hormones are produced by the hypothalamus and then transported and stored in the posterior pituitary gland until they are released into the bloodstream when needed. Oxytocin plays a role in uterine contractions during childbirth and milk ejection during lactation, while Vasopressin regulates water balance in the body by acting on the kidneys to reduce urine production and conserve water. The other hormones listed, such as Prolactin, TSH, GH, ACTH, FSH, and LH, are produced by the anterior pituitary gland.

Correct Answer: A

Rationale: Oxytocin is a hormone produced by the hypothalamus and released by the pituitary gland. In the bloodstream, oxytocin is mostly bound to a carrier protein called neurophysin. This binding helps to protect oxytocin from being degraded too quickly in the bloodstream, thus allowing it to exert its effects on target tissues such as the uterus and mammary glands. Oxytocin plays important roles in stimulating uterine contractions during labor, facilitating milk letdown during breastfeeding, and promoting social bonding and emotional connections.