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MRCPUK SEND Exam Syllabus Topics:
| Section | Objectives |
|---|---|
| General Endocrinology | - Integrated Clinical Practice
|
| Pituitary and Hypothalamic Disorders | - Pituitary Disease
|
| Calcium and Bone Metabolism | - Parathyroid and Metabolic Bone Disease
|
| Adrenal Disorders | - Adrenal Disease
|
| Reproductive Endocrinology | - Gonadal Disorders
|
| Thyroid Disorders | - Thyroid Disease
|
| Diabetes Mellitus | - Complications
|
MRCPUK Endocrinology and Diabetes (Specialty Certificate Examination) Sample Questions:
A 24-year-old man was referred for investigation of infertility. He had been having unprotected intercourse with his partner for 18 months, but the couple had failed to conceive. He had been treated for Hodgkin's lymphoma at the age of 17.
What is the most appropriate investigation?
- A. serum testosterone
- B. testicular biopsy
- C. semen analysis
- D. serum inhibin
- E. serum follicle-stimulating hormone
Correct Answer: C 🗳️
A 35-year-old woman with a 12-year history of type 1 diabetes mellitus was reviewed in the multidisciplinary pump clinic, because her diabetes was treated with an insulin pump. She had a group 2, C1 lorry-driving licence.
Specific driving-related questioning showed that she kept fast-acting carbohydrate in her vehicles and she reported good hypoglycaemic warnings. Data downloaded from her pump indicated significant variability in her blood glucose readings with few results below 2 mmol/L. She declared that this happened occasionally and she was able to explain the events.
According to implementation by the UK of the Third European Union Directive on driving, what is the most appropriate advice?
- A. she must surrender her licence for 6 months
- B. she should stop driving voluntarily until blood glucose levels increase
- C. she can continue to drive
- D. her licence must be surrendered immediately until further assessment
- E. she must appear before a Driver and Vehicle Licensing Agency-accredited diabetes specialist for assessment within 1 month
Correct Answer: C 🗳️
A 16-year-old boy was referred to the endocrine clinic with symptoms of delayed puberty.
On examination, he had a reduced sense of smell, small-sized testes and underdeveloped
secondary sexual characteristics.
Investigations:
serum testosterone3.5 nmol/L (9.0-35.0)
serum follicle-stimulating hormone1.0 U/L (1.0-7.0)
serum luteinising hormone1.5 U/L (1.0-10.0)
serum prolactin220 mU/L (<360)
MR scan of brainnormal
He asked about his future fertility.
What will be the most useful agent for him to achieve fertility?
- A. testosterone
- B. clomifene
- C. octreotide
- D. gonadotropin-releasing hormones
- E. bromocriptine
Correct Answer: D 🗳️
A 25-year-old woman with type 1 diabetes mellitus was admitted to hospital with a 12-hour
history of nausea and lethargy.
On examination, her temperature was 37.5C, she was dehydrated and her Glasgow coma
score was 14. Urinalysis showed glucose 2+, ketones 3+, protein negative.
Investigations:
white cell count12.0 ? 109/L (4.0-11.0)
neutrophil count8.0 ? 109/L (1.5-7.0)
random plasma glucose22.0 mmol/L
arterial blood gases, breathing air:
pH7.20 (7.35-7.45)
serum C-reactive protein12 mg/L (<10)
She was treated with intravenous sodium chloride 0.9% and fixed-rate intravenous insulin
infusion, and initially improved. Twelve hours into her admission, she complained of a
headache.
On examination, her temperature was 37.3C and her Glasgow coma score was 15. Her
pulse was 85 beats per minute and her blood pressure was 110/70 mmHg. There was no
neck stiffness, papilloedema or focal neurological signs.
What is the most likely cause for her headache?
- A. bacterial meningitis
- B. viral encephalitis
- C. cerebral oedema
- D. sagittal sinus thrombosis
- E. tension headache
Correct Answer: E 🗳️
A 49-year-old woman presented with a slowly enlarging lump in her neck.
On examination, there was a 3.5-cm firm nodule in the left lobe of the thyroid gland, with no associated lymphadenopathy.
Investigations:
serum thyroid-stimulating hormone<0.05 mU/L (0.4-5.0)
serum free T426.0 pmol/L (10.0-22.0)
serum free T38.6 pmol/L (3.0-7.0)
An ultrasound scan showed an enlarged thyroid gland, with small nodules throughout. There was a larger hypoechoic 3.3-cm nodule with increased intranodular vascularity in the lower pole of the left lobe, with no associated lymphadenopathy.
What is the most appropriate management?
- A. partial thyroidectomy
- B. fine-needle aspiration of the nodule
- C. isotope uptake scan
- D. core biopsy of the thyroid nodule
- E. radioactive iodine treatment
Correct Answer: C 🗳️
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