Which of the following visual field deficits is most likely present in a patient with pituitary adenoma compressing his optic chiasm?

Correct Answer: C

Rationale: The correct answer is C: Bi-temporal hemianopia. Pituitary adenoma compressing the optic chiasm typically leads to bi-temporal hemianopia due to compression of the crossing fibers from the nasal visual fields. This results in loss of peripheral vision in both temporal visual fields. A: Bilateral inferior visual field deficits and B: Bilateral superior visual field deficits are less likely as they are not typical patterns associated with optic chiasm compression. D: Right homonymous hemianopia is incorrect as it is not associated with compression of the optic chiasm by a 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: D

Rationale: The correct answer is D: Fine hairs. In secondary hypothyroidism, the pituitary gland fails to produce enough thyroid-stimulating hormone (TSH), resulting in low thyroid hormone levels. Fine hairs (or hair thinning) is a symptom of hyperthyroidism, not hypothyroidism. Normal cholesterol levels (Choice A) are seen in secondary hypothyroidism due to decreased metabolic rate. Menorrhagia (Choice B) can occur due to hormonal imbalances caused by untreated hypothyroidism. Low TSH levels (Choice C) are a characteristic feature of secondary hypothyroidism as the pituitary gland is not producing enough TSH to stimulate the thyroid gland.

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.