Which one of the following statements describes the underlying pathology of Grave's disease?

Correct Answer: A

Rationale: Graves' disease is an autoimmune disorder where autoantibodies, known as thyroid-stimulating immunoglobulins (TSIs) or thyroid-stimulating antibodies (TSAs), bind to and stimulate the thyroid-stimulating hormone (TSH) receptors on thyroid follicular cells. This leads to increased production and secretion of thyroid hormones T3 (triiodothyronine) and T4 (thyroxine), causing hyperthyroidism. The autoantibodies essentially mimic the action of TSH, resulting in excess thyroid hormone release and manifestation of hyperthyroid symptoms. This underlying pathology of Graves' disease is distinct from other causes of hyperthyroidism, making choice A the correct statement.

Correct Answer: B

Rationale: Sheehan's syndrome, also known as postpartum hypopituitarism, is a condition characterized by pituitary gland dysfunction due to severe blood loss during childbirth, resulting in ischemic necrosis of the pituitary gland. As a consequence of pituitary hormone deficiency, one of the hallmark manifestations of Sheehan's syndrome is persistent lactation despite stopping breastfeeding. This occurs due to inadequate prolactin inhibition, leading to continuous milk production. Other common symptoms of Sheehan's syndrome include fatigue, weight loss, menstrual irregularities, hypothyroidism, adrenal insufficiency, and other pituitary hormone deficiencies. Cardiac failure, fever, and striking cachexia are not typical presentations associated with Sheehan's syndrome.

Correct Answer: A

Rationale: Congenital adrenal hyperplasia (CAH) is the most common cause of ambiguous genitalia in newborns. This condition is due to a deficiency of enzymes in the adrenal gland that are necessary for the production of cortisol. As a result, the body produces excess androgens (masculinizing hormones), leading to abnormal genital development in females. The external genitalia may appear ambiguous, with features of both male and female genitalia. This condition can be detected through newborn screening and confirmed through further hormonal and genetic testing. Treatment involves hormone replacement therapy to normalize hormone levels and surgery may be required to reconstruct the genitalia.

Correct Answer: A

Rationale: Gastroparesis is a complication of diabetes mellitus. It is a condition that affects the normal spontaneous movement of the muscles in the stomach, causing delayed emptying of food from the stomach into the small intestine. This can lead to symptoms such as nausea, vomiting, bloating, and poor appetite. Diabetes can damage the nerves that control the stomach muscles, resulting in gastroparesis. Managing blood sugar levels and following a proper diet can help in controlling the symptoms of gastroparesis in individuals with diabetes. Exophthalmos, hirsutism, and moon facies are not typically associated with complications of diabetes mellitus.

Correct Answer: A

Rationale: Graves' disease is an autoimmune disorder where autoantibodies, known as thyroid-stimulating immunoglobulins (TSIs) or thyroid-stimulating antibodies (TSAs), bind to and stimulate the thyroid-stimulating hormone (TSH) receptors on thyroid follicular cells. This leads to increased production and secretion of thyroid hormones T3 (triiodothyronine) and T4 (thyroxine), causing hyperthyroidism. The autoantibodies essentially mimic the action of TSH, resulting in excess thyroid hormone release and manifestation of hyperthyroid symptoms. This underlying pathology of Graves' disease is distinct from other causes of hyperthyroidism, making choice A the correct statement.

Correct Answer: D

Rationale: Grave's disease is the most common cause of hyperthyroidism. It is an autoimmune disorder where the body's immune system mistakenly attacks the thyroid gland, leading to overproduction of thyroid hormones. This results in symptoms such as weight loss, rapid heartbeat, heat intolerance, and tremors. While toxic thyroid adenoma, toxic multinodular goitre, and thyroiditis are also potential causes of hyperthyroidism, Grave's disease is the most prevalent among them.

Correct Answer: C

Rationale: Cortisol secretion is directly stimulated by adrenocorticotropic hormone (ACTH), which is produced and released by the anterior pituitary gland in response to corticotropin-releasing hormone (CRH) from the hypothalamus. ACTH acts on the adrenal cortex to stimulate the production and release of cortisol. Aldosterone is another hormone produced by the adrenal cortex, but it is not directly involved in the stimulation of cortisol secretion. Prolactin is a hormone produced by the pituitary gland that plays a role in lactation, not cortisol secretion. High blood potassium levels can stimulate aldosterone secretion but do not directly stimulate cortisol secretion.

Correct Answer: A

Rationale: Hypertonicity (increased osmolarity or high concentration of solutes in the blood) is the most potent stimulus for the hypothalamic production of arginine vasopressin (also known as antidiuretic hormone or ADH). When the body senses increased plasma osmolality, the osmoreceptors in the hypothalamus stimulate the release of vasopressin from the posterior pituitary gland. Vasopressin acts on the kidneys to increase water reabsorption and decrease urine output, helping to restore normal osmolarity. This mechanism helps to conserve water and maintain body fluid balance in response to dehydration or increased solute concentration in the blood.

Correct Answer: B

Rationale: ADH (antidiuretic hormone), also known as vasopressin, is secreted by the posterior lobe of the pituitary gland. ADH plays a key role in regulating water balance in the body by controlling the reabsorption of water in the kidneys. When the body senses a decrease in blood volume or an increase in blood osmolarity, ADH is released to signal the kidneys to conserve water, leading to concentrated urine production and water retention in the body.