Endocrinology Exam Questions

Correct Answer: D

Rationale: Growth hormone is primarily released during sleep, particularly during the first few hours of deep sleep. This release is pulsatile in nature, with the majority occurring at night. Growth hormone plays a critical role in growth, repair, and development of body tissues during periods of rest and sleep. Additionally, the secretion of growth hormone is also influenced by factors such as stress, exercise, and nutritional status.

Correct Answer: C

Rationale: The gold standard for diagnosing acromegaly is the oral glucose tolerance test (OGTT) along with growth hormone (GH) measurement. During this test, the patient is given a glucose solution to drink, and then blood samples are taken to measure GH levels at specific time intervals. In a person without acromegaly, glucose ingestion would typically suppress GH levels. However, in individuals with acromegaly, GH levels remain elevated even after glucose administration due to the inability of glucose to inhibit GH release from the tumor.

Correct Answer: A

Rationale: In the syndrome of inappropriate antidiuretic hormone (SIADH), there is excessive secretion of antidiuretic hormone (ADH) leading to increased water reabsorption in the kidney tubules. This results in dilutional hyponatremia because the amount of water reabsorbed is greater than the electrolytes, such as sodium, leading to a relative decrease in their concentration in the blood. As a result, hyponatremia occurs in SIADH, contributing to symptoms such as nausea, confusion, and seizures due to the imbalance in electrolytes.

Correct Answer: A

Rationale: Acromegaly is a disorder caused by excessive growth hormone production by the pituitary gland in adults, leading to an increase in muscle mass (hypertrophy). Hoffman syndrome, characterized by increased muscle mass with slowness of activity, is a clinical feature often seen in individuals with acromegaly. The excessive growth hormone levels in acromegaly can cause acral growth, soft tissue swelling, and muscle hypertrophy, contributing to the characteristic features of the condition, including Hoffman syndrome. Therefore, the correct answer is Acromegaly.

Correct Answer: B

Rationale: Nephrogenic diabetes insipidus (NDI) is a condition where the kidneys are unable to respond to antidiuretic hormone (ADH) as they should, leading to excessive urination and extreme thirst. One of the main causes of nephrogenic diabetes insipidus is the use of certain medications, with lithium being the most common culprit. Lithium can interfere with the kidney's response to ADH, resulting in decreased water reabsorption and the characteristic symptoms of diabetes insipidus. Other causes of NDI can include genetic mutations affecting the vasopressin receptor gene or other underlying conditions such as hypercalcemia, hypokalemia, or obstructive uropathy.