Endocrinology Exam Questions and Answers

Correct Answer: A

Rationale: The most common cause of Cushing's disease is an ACTH-producing pituitary adenoma. In this condition, the pituitary gland produces excessive amounts of adrenocorticotropic hormone (ACTH), which stimulates the adrenal glands to produce high levels of cortisol. This leads to the signs and symptoms of Cushing's disease, such as weight gain, high blood pressure, and muscle weakness. Adrenocortical adenoma refers to a benign tumor of the adrenal cortex that can also cause Cushing's syndrome, but it is not as common as an ACTH-producing pituitary adenoma. Ectopic ACTH secretion occurs when a non-pituitary tumor produces ACTH, leading to Cushing's syndrome. McCune-Albright syndrome is a rare genetic disorder that can cause various endocrine abnormalities, but it is not a common cause of Cushing's disease.

Correct Answer: D

Rationale: The renin-angiotensin-aldosterone axis does not involve the hypothalamus or pituitary gland; instead, it primarily involves the kidneys and the renin-secreting cells. In this axis, renin is released in response to low blood pressure, leading to the formation of angiotensin II and the subsequent release of aldosterone from the adrenal glands. Feedback mechanisms for this axis primarily involve the regulation of renin release based on blood pressure rather than involving direct negative feedback from downstream hormones on the hypothalamus or pituitary gland. On the other hand, choices A, B, and C all involve classic examples of hypothalamic-pituitary negative feedback loops where the end hormone suppresses the release of the stimulating hormones at the hypothalamic and pituitary levels.

Correct Answer: D

Rationale: Myxoedema is a severe form of hypothyroidism characterized by a range of symptoms and signs. Ascites, cerebellar ataxia, and increased incidence of pernicious anaemia are recognized features of myxoedema. However, thyroid acropachy is not a recognized feature of myxoedema. Thyroid acropachy is a condition characterized by clubbing of the fingers and toes, swelling of the hands and feet, and periosteal new bone formation, typically seen in patients with Graves' disease, which is a form of hyperthyroidism.

Correct Answer: A

Rationale: Dermal hyperpigmentation, also known as hyperpigmentation of the skin, is commonly associated with conditions such as Addison's disease, hemochromatosis, and bronchogenic carcinoma. In Addison's disease, there is increased production of melanin due to elevated levels of adrenocorticotropic hormone (ACTH) which stimulates melanocytes. Hemochromatosis can cause hyperpigmentation due to excess iron deposits in the skin. Bronchogenic carcinoma can lead to a condition known as acanthosis nigricans, characterized by dark, velvety discoloration of the skin primarily around the neck and armpits. However, Conn's syndrome, which is a primary aldosteronism resulting from an adrenal adenoma or hyperplasia, is not typically associated with dermal hyperpigmentation.

Correct Answer: B

Rationale: The adrenal cortex is the outer region of the adrenal glands and is responsible for producing several hormones, including aldosterone. Aldosterone is a mineralocorticoid hormone that plays a crucial role in regulating electrolyte balance, particularly sodium and potassium, in the body. It helps maintain blood pressure and fluid balance by acting on the kidneys to reabsorb sodium and water while excreting potassium in the urine. Adrenaline and noradrenaline (also known as epinephrine and norepinephrine) are produced by the adrenal medulla, which is the inner region of the adrenal glands. Cortisol is another hormone produced by the adrenal cortex, but aldosterone specifically regulates electrolyte balance.