Which of the following proteins is the primary source of bound T4 in the plasma?

Correct Answer: D

Rationale: The correct answer is D: Thyroxine-binding globulin (TBG). TBG is the primary source of bound T4 in the plasma as it specifically binds to and transports thyroid hormones. This protein has the highest affinity for T4 compared to other plasma proteins. Albumin (A) and gamma globulins (B) can also bind to thyroid hormones, but TBG is the primary carrier. Thyroid peroxidase (C) is an enzyme involved in thyroid hormone production, not in binding T4 in the plasma.

Correct Answer: B

Rationale: The correct answer is B: Cretinism. Cretinism is the most common cause of preventable mental deficiency worldwide due to severe iodine deficiency during pregnancy. Iodine is crucial for thyroid hormone production, which is essential for fetal brain development. Beriberi disease (A) is caused by thiamine deficiency and affects the nervous system, not mental deficiency. Folate deficiency (C) can cause neural tube defects but not mental deficiency. Vitamin A deficiency (D) can lead to blindness and immune system issues, but not the most common cause of preventable mental deficiency.

Correct Answer: D

Rationale: Step-by-step rationale: 1. Gynaecomastia is a known side effect of spironolactone, digitalis, and cimetidine. 2. Rifampicin is not associated with gynaecomastia. 3. Rifampicin is an antibiotic used to treat tuberculosis and other infections. 4. The mechanism of action of rifampicin does not involve hormonal changes that could lead to gynaecomastia. Summary of incorrect choices: - A: Spironolactone is a potassium-sparing diuretic that can cause gynaecomastia. - B: Digitalis (digoxin) can lead to gynaecomastia as a side effect. - C: Cimetidine, an H2 receptor antagonist, is also known to cause gynaecomastia.

Correct Answer: B

Rationale: The correct answer is B: Weight loss. Hypothyroidism is characterized by an underactive thyroid gland, leading to a decreased metabolic rate. This typically results in weight gain, not weight loss. Choices A, C, and D are all associated with hypothyroidism. Loss of libido can occur due to hormonal imbalances, cardiac failure can result from the decreased metabolic rate affecting the heart, and organic psychosis can be a symptom of severe untreated hypothyroidism.

Correct Answer: A

Rationale: The correct answer is A: Acute pancreatitis. Hyperparathyroidism is not typically associated with acute pancreatitis. Hyperparathyroidism is characterized by excessive production of parathyroid hormone, leading to increased calcium levels in the blood. Nephrocalcinosis, palpable neck swelling, and pseudogout are commonly seen in hyperparathyroidism due to the effects of elevated calcium levels on the kidneys, parathyroid glands, and joints, respectively. Acute pancreatitis, on the other hand, is more commonly associated with gallstones, alcohol consumption, or certain medications, rather than hyperparathyroidism.