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MRCPUK SEND Exam Syllabus Topics:
| Section | Objectives |
|---|---|
| Diabetes Mellitus | - Management
|
| Adrenal Disorders | - Adrenal Disease
|
| General Endocrinology | - Integrated Clinical Practice
|
| Reproductive Endocrinology | - Gonadal Disorders
|
| Thyroid Disorders | - Thyroid Disease
|
| Calcium and Bone Metabolism | - Parathyroid and Metabolic Bone Disease
|
| Pituitary and Hypothalamic Disorders | - Pituitary Disease
|
MRCPUK Endocrinology and Diabetes (Specialty Certificate Examination) Sample Questions:
A 46-year-old man of European descent was reviewed in the diabetes clinic. He had type 2 diabetes mellitus, which had been diagnosed 6 months previously. He had been symptom free and was a non-smoker but had a family history of cardiovascular disease. He exercised regularly and had managed to lose 8 kg.
On examination, his blood pressure was 148/76 mmHg, his weight was 76 kg and his body mass index was 24 kg/m2 (18-25).
Investigations:
urinary albumin:creatinine ratio0.6 mg/mmol (<2.5)
serum cholesterol5.6 mmol/L (<5.2)
serum HDL cholesterol0.90 mmol/L (>1.55)
fasting serum triglycerides2.20 mmol/L (0.45-1.69)
According to NICE guidelines (CG181, July 2014), what is the most appropriate management of his lipid profile?
- A. observe and repeat lipid profile in a few months
- B. start a statin
- C. assess cardiovascular risk using UKPDS risk engine
- D. start nicotinic acid
- E. start a fibrate
Correct Answer: B 🗳️
A 66-year-old woman was admitted with carpopedal spasm. During the previous week she had had 2 days of diarrhoea following treatment with ciprofloxacin for a urinary tract infection. She had long-standing rheumatoid arthritis treated with prednisolone 5 mg daily, and was also taking alendronic acid, omeprazole and furosemide.
Investigations:
serum creatinine115 ?mol/L (60-110)
serum corrected calcium1.79 mmol/L (2.20-2.60)
serum alkaline phosphatase124 U/L (45-105)
serum magnesium0.26 mmol/L (0.75-1.05)
plasma parathyroid hormone2.7 pmol/L (0.9-5.4)
Which medicine is most likely to be responsible for her metabolic derangement?
- A. furosemide
- B. prednisolone
- C. ciprofloxacin
- D. alendronic acid
- E. omeprazole
Correct Answer: E 🗳️
A 32-year-old woman with a recurrent history of Graves' thyrotoxicosis was being considered for radioiodine treatment. However, she wanted to conceive again at some stage and asked how soon she could become pregnant.
After what minimum interval would it be safe for her to conceive again?
- A. 12 months
- B. 8 months
- C. 4 months
- D. 2 months
- E. 6 months
Correct Answer: E 🗳️
A 52-year-old woman was referred to the clinic having lost 3-4 kg in weight over the previous 3 months. She also had palpitations and a sense of tremulousness. A diagnosis of thyrotoxicosis was confirmed by a blood test arranged by her general practitioner (GP).
Investigations (arranged by GP):
serum thyroid-stimulating hormone<0.01 mU/L (0.4-5.0)
serum free T435.8 pmol/L (10.0-22.0)
serum free T310.0 pmol/L (3.0-7.0)
On examination at her first clinic visit, she had a fine tremor, her pulse was 92 beats per minute and regular, and her eyes appeared normal. Her right thyroid lobe was moderately enlarged, and her left lobe was normal on examination. There was no associated lymphadenopathy. A technetium-99m thyroid isotope uptake scan was arranged (see image).
What is the most likely cause of her thyrotoxicosis?
- A. de Quervain's thyroiditis
- B. factitious thyrotoxicosis
- C. Graves' disease
- D. toxic thyroid adenoma
- E. toxic multinodular goitre
Correct Answer: C 🗳️
A 61-year-old woman was referred to the blood pressure clinic because of refractory hypertension. One year previously, her blood pressure, urea and electrolytes had been normal. Her current therapy included verapamil modified-release 240 mg daily and doxazosin 16 mg daily.
On examination, she was 1.63 m tall and weighed 90 kg with an elevated waist to hip ratio. Her blood pressure was 182/94 mmHg supine.
Investigations:
serum sodium137 mmol/L (137-144)
serum potassium2.8 mmol/L (3.5-4.9)
serum creatinine79 umol/L (60-110)
plasma renin activity (after 30 min supine)<1.1 pmol/mL/h (1.1-2.7)
plasma aldosterone (after 30 min supine)<135 pmol/L (135-400)
What is the most appropriate investigation?
- A. analysis of the SCNN1B and SCNN1G genes
- B. repeat renin and aldosterone concentrations after stopping verapamil for 2 weeks
- C. 24-h urine to assess free cortisol:cortisone ratio
- D. 24-h urinary electrolytes
- E. overnight dexamethasone suppression test
Correct Answer: E 🗳️
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