Endocrinology Exam Questions

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: D

Rationale: Increased serum aldosterone level is typically associated with conditions such as Conn's syndrome or primary hyperaldosteronism. These conditions lead to an excess of aldosterone, which results in increased sodium resorption and potassium excretion by the kidneys. This imbalance can lead to hypertension (Choice A), hypernatraernia (elevated sodium level) (Choice B), and hypokalaemia (low potassium level) (Choice C). However, metabolic acidosis (Choice D) is not directly associated with increased aldosterone levels. Instead, metabolic acidosis may be seen in conditions like renal tubular acidosis or diabetic ketoacidosis.

Correct Answer: A

Rationale: The most common cause of Addison's disease is autoimmune adrenalitis, also known as autoimmune adrenal insufficiency. In autoimmune adrenalitis, the adrenal glands are damaged by immune system-mediated processes, leading to their dysfunction. This autoimmune destruction typically presents as bilateral adrenal cortex atrophy due to the formation of granulomas. Therefore, the commonest cause of Addison's disease is the presence of granulomas in the adrenal glands, making option A, Granuloma, the correct choice.

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: B

Rationale: Myxoedema coma is a severe form of hypothyroidism that can lead to the slowing down of various body functions, including reduced heart rate (bradycardia). As the condition progresses and the body's metabolism becomes more depressed, one of the compensatory mechanisms is an increase in heart rate (tachycardia) to try to maintain adequate tissue perfusion. Therefore, tachycardia is a characteristic feature of myxoedema coma, rather than hypertension or euthermia which are not typically associated with this condition. Hypoventilation is also a common feature of myxoedema coma due to the decreased metabolic rate and respiratory drive.