Which of the following statements correctly describes the pathophysiology of Cushing's disease?

Correct Answer: A

Rationale: Rationale: A: Correct. Cushing's disease is caused by a pituitary adenoma secreting excess ACTH, stimulating adrenal cortex to produce excess cortisol. B: Incorrect. Cushing's disease does not result from excess cortisol secretion by the pituitary adenoma. C: Incorrect. Cushing's disease is not caused by an adrenal adenoma secreting excess ACTH. D: Incorrect. Cushing's disease is not caused by an adrenal adenoma secreting excess cortisol. Summary: The correct answer is A because it accurately describes the pathophysiology of Cushing's disease, where a pituitary adenoma secretes excess ACTH leading to increased cortisol production. Choices B, C, and D are incorrect as they misinterpret the primary source of hormone overproduction in Cushing's disease.

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: D

Rationale: The correct answer is D because synthesis of thyroid hormones (T3 and T4) occurs by the coupling of iodinated tyrosine residues on thyroglobulin within thyroid follicles. Thyroglobulin acts as a precursor for thyroid hormone synthesis. Choices A, B, and C are incorrect because thyroid hormone synthesis does not occur in parafollicular cells, extracellularly in plasma, or require cholesterol for the coupling of iodinated tyrosine residues on thyroglobulin.

Correct Answer: B

Rationale: The correct answer is B: Dry skin. In hypothyroidism, the thyroid gland does not produce enough thyroid hormone, leading to decreased metabolism. This can result in several symptoms, including dry skin due to reduced sweat gland activity. Hyporeflexia (A) is not a common symptom of hypothyroidism. Oily skin (C) is more commonly associated with hyperthyroidism, where thyroid hormone levels are elevated. Excessive hair growth (D) is not typically seen in hypothyroidism; instead, hair loss is a common symptom.

Correct Answer: B

Rationale: Correct Answer: B (Rheumatic carditis) Rationale: 1. Rheumatic carditis is a heart condition, which may lead to a decreased cardiac output and subsequently a lower pulse rate during sleep. 2. Anxiety neurosis can lead to increased sympathetic activity, causing an elevated pulse rate during sleep. 3. Pulmonary tuberculosis can cause systemic inflammation and increased metabolic demand, resulting in an elevated pulse rate during sleep. 4. Atropine, a parasympatholytic drug, inhibits the action of the parasympathetic nervous system, leading to an increased pulse rate.

Correct Answer: C

Rationale: Erythropoietin is primarily secreted from the kidney, specifically by the Juxtaglomerular cells in the kidney's cortex. These cells are responsible for sensing oxygen levels and regulating erythropoietin production accordingly. Mesenchymal tumors, cerebellar haemangioblastoma, and lymphoma are not associated with erythropoietin secretion, making them incorrect choices. Mesenchymal tumors originate from connective tissues, cerebellar haemangioblastoma is a type of brain tumor, and lymphoma is a cancer of the lymphatic system. Only the Juxtaglomerular cells in the kidney have the physiological role of secreting erythropoietin in response to hypoxia.

Correct Answer: B

Rationale: The correct answer is B: Chronic pancreatitis. Hypoglycemia is not typically associated with chronic pancreatitis as it is more related to pancreatic insufficiency and impaired glucose regulation. A: Glycogen storage disease can lead to hypoglycemia due to the inability to properly release stored glucose. C: Galactosaemia can cause hypoglycemia due to the impaired breakdown of galactose into glucose. D: Post-gastrectomy can lead to hypoglycemia due to rapid glucose absorption and altered hormonal responses.

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: D

Rationale: The correct answer is D because oxytocin and anti-diuretic hormone are synthesized in the hypothalamus and stored in the posterior pituitary gland before being released into the bloodstream. This process is essential for regulating various physiological functions. Choices A and C are incorrect as oxytocin and anti-diuretic hormone are not complex steroids and are not released from the anterior pituitary. Choice B is also incorrect because while these hormones are indeed synthesized in the posterior pituitary, they are stored in the posterior pituitary before their release.