Which of the following is the most important mechanism of action of propylthiouracil in the treatment of Graves' disease?

Correct Answer: B

Rationale: The correct answer is B: Inhibition of the function of thyroid peroxidase. Propylthiouracil inhibits thyroid peroxidase, an enzyme essential for thyroid hormone synthesis. By blocking this enzyme, propylthiouracil reduces the production of thyroid hormones, helping to manage hyperthyroidism in Graves' disease. Explanation: 1. Propylthiouracil directly inhibits thyroid peroxidase, unlike other antithyroid medications that target different mechanisms. 2. Inhibition of thyroid peroxidase leads to decreased synthesis of thyroid hormones, effectively controlling hyperthyroidism. 3. Other choices are incorrect because propylthiouracil does not primarily affect the production of thyroid-stimulating immunoglobulins (choice A), peripheral conversion of T4 to T3 (choice C), or iodine organification (choice D) in the treatment of Graves' disease. In summary, the inhibition of thyroid peroxidase by

Correct Answer: A

Rationale: The correct answer is A because parathyroid hormone does not directly stimulate osteoblasts to increase bone formation. Instead, it indirectly increases bone resorption by stimulating osteoclasts. Parathyroid hormone also increases calcium reabsorption from the distal tubule of the kidney (choice C) and inhibits phosphate reabsorption in the proximal tubule of the kidney (choice D). By understanding the physiological actions of parathyroid hormone, we can deduce that direct stimulation of osteoblasts is not one of its functions.

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: C

Rationale: The correct answer is C: Purple skin striae. This is the most common sign of Cushing's syndrome due to the excessive production of cortisol leading to thinning of the skin and formation of purple stretch marks. Hirsutism (A) is excessive hair growth, not specific to Cushing's. Obesity (B) can be a symptom, but it is not the most common. Skin hyperpigmentation (D) is seen in Addison's disease, not Cushing's.

Correct Answer: C

Rationale: Step-by-step rationale: 1. Tertiary hyperparathyroidism occurs due to prolonged secondary hyperparathyroidism in response to chronic renal failure. 2. In chronic renal failure, impaired kidney function leads to reduced activation of vitamin D and impaired calcium regulation. 3. Persistent hypocalcemia triggers the parathyroid glands to overproduce parathyroid hormone, leading to tertiary hyperparathyroidism. 4. Rickets (choice A) is associated with vitamin D deficiency, pseudohypoparathyroidism (choice B) is a genetic disorder, and malabsorption syndrome (choice D) affects nutrient absorption, but they are not commonly linked to tertiary hyperparathyroidism.