Which of the following signs strongly support a diagnosis of pituitary adenoma?

Correct Answer: B

Rationale: The correct answer is B: Bitemporal Hemianopsia. Pituitary adenomas can compress the optic chiasm, leading to bitemporal hemianopsia. This occurs due to the loss of peripheral vision on both sides. Carpo-pedal spasm (A) is associated with hypocalcemia, Chvostek's sign (C) is a facial spasm seen in hypocalcemia, and tremor (D) can be seen in conditions such as Parkinson's disease, but they are not specific to pituitary adenoma. Bitemporal hemianopsia is a classic sign of pituitary adenoma due to its location near the optic chiasm.

Correct Answer: B

Rationale: Thyroid acropathy, also known as thyroid dermopathy, is a skin condition commonly associated with Graves' disease. This autoimmune disorder causes an overactive thyroid gland, leading to high levels of thyroid hormones in the blood. The excess thyroid hormones can trigger changes in the skin, resulting in thyroid acropathy. Subclinical hypothyroidism (choice A) is characterized by slightly elevated TSH levels with normal thyroid hormone levels, not typically associated with thyroid acropathy. Myxoedema (choice C) refers to severe hypothyroidism and is not linked to thyroid acropathy. Medullary carcinoma of the thyroid (choice D) is a type of thyroid cancer and is not known to cause thyroid acropathy. Therefore, the correct answer is B, Graves' disease, as it is the most common condition associated with thyroid acropathy.

Correct Answer: A

Rationale: The correct answer is A because Klinefelter's syndrome is characterized by small, soft testes due to the presence of an extra X chromosome (47, XXY). This leads to hypogonadism and inadequate testosterone production, resulting in underdeveloped testes. Choice B (46, XO) is incorrect as it refers to Turner syndrome. Choice C (upper segment> lower segment) is unrelated to Klinefelter's syndrome. Choice D (Gynaecomastia) is a symptom of Klinefelter's syndrome but not the defining characteristic.

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: A

Rationale: The correct answer is A: Cirrhosis. In cirrhosis, there is a decrease in the binding proteins for T4, leading to decreased total T4 levels in the plasma. Pregnancy, euthyroid sick syndrome, and familial excess thyroid binding globulin are all conditions associated with increased total T4 levels due to various physiological changes. In pregnancy, there is an increase in thyroid hormone production to support fetal development. Euthyroid sick syndrome is a condition where there is a decrease in binding proteins, leading to an increase in free T4 levels but normal total T4 levels. Familial excess thyroid binding globulin causes an increase in total T4 levels due to excessive binding proteins.