MRCPUK SEND - SEND - Endocrinology and Diabetes (Specialty Certificate Examination) Exam
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Total 200 questions
Question #6 (Topic: )
A 17-year-old boy was concerned about his height. He had been treated for Crohns
disease since the age of 13 with a combination of topical and systemic corticosteroids and
azathioprine. He was currently taking mercaptopurinE.
On examination, his height was on the 25th centile.
Investigations:
X-ray of right kneesee image
[MRCPUK-SEND-6.0/MRCPUK-SEND-7_2.png]
What is the most appropriate next step in management?
disease since the age of 13 with a combination of topical and systemic corticosteroids and
azathioprine. He was currently taking mercaptopurinE.
On examination, his height was on the 25th centile.
Investigations:
X-ray of right kneesee image
[MRCPUK-SEND-6.0/MRCPUK-SEND-7_2.png]
What is the most appropriate next step in management?
A. advise him that growth is complete
B. advise him that he will continue to grow for 12 months
C. investigate for growth hormone deficiency
D. refer for leg lengthening surgery
E. treat with growth hormone
Answer: A
Question #7 (Topic: )
A 78-year-old man presented with confusion, lethargy and thirst. He had hypertension
treated with lisinopril 20 mg daily.
On examination, he was dehydrated. His pulse was 110 beats per minute and his blood
pressure was 84/40 mmHg. Urinalysis showed ketones 1+.
Investigations:
serum sodium155 mmol/L (137144)
serum potassium5.2 mmol/L (3.54.9)
serum bicarbonate17 mmol/L (2028)
serum urea40.0 mmol/L (2.57.0)
serum creatinine358 mol/L (60110)
random plasma glucose78.0 mmol/L
He was treated with sodium chloride 0.9%. After 8 hours treatment, his urine output was
10 mL/h and his blood pressure was 121/50 mmHg.
Investigations (after 8 hours treatment):
serum sodium151 mmol/L (137144)
serum potassium4.9 mmol/L (3.54.9)
serum bicarbonate18 mmol/L (2028)
serum urea39.0 mmol/L (2.57.0)
serum creatinine347 mol/L (60110)
random plasma glucose48.0 mmol/L
What is the most appropriate next step in management?
treated with lisinopril 20 mg daily.
On examination, he was dehydrated. His pulse was 110 beats per minute and his blood
pressure was 84/40 mmHg. Urinalysis showed ketones 1+.
Investigations:
serum sodium155 mmol/L (137144)
serum potassium5.2 mmol/L (3.54.9)
serum bicarbonate17 mmol/L (2028)
serum urea40.0 mmol/L (2.57.0)
serum creatinine358 mol/L (60110)
random plasma glucose78.0 mmol/L
He was treated with sodium chloride 0.9%. After 8 hours treatment, his urine output was
10 mL/h and his blood pressure was 121/50 mmHg.
Investigations (after 8 hours treatment):
serum sodium151 mmol/L (137144)
serum potassium4.9 mmol/L (3.54.9)
serum bicarbonate18 mmol/L (2028)
serum urea39.0 mmol/L (2.57.0)
serum creatinine347 mol/L (60110)
random plasma glucose48.0 mmol/L
What is the most appropriate next step in management?
A. compound lactate solution (Hartmann’s solution)
B. sodium chloride 0.18% and glucose 4%
C. sodium chloride 0.18% and glucose 5%
D. sodium chloride 0.45%
E. sodium chloride 0.9%
Answer: E
Question #8 (Topic: )
A 35-year-old woman was referred with a left lower thyroid lesion. She was asymptomatic.
Examination confirmed the presence of a 2 ? 3-cm, firm, mobile, non-tender mass.
Investigations:
ultrasound-guided fine-needle aspiration biopsyThy 5
How is Thy 5 defined?
Examination confirmed the presence of a 2 ? 3-cm, firm, mobile, non-tender mass.
Investigations:
ultrasound-guided fine-needle aspiration biopsyThy 5
How is Thy 5 defined?
A. abnormal, diagnostic of malignancy
B. abnormal, suspicious (but not diagnostic of) malignancy
C. follicular lesions
D. non-diagnostic or inadequate
E. non-neoplastic (consistent with nodular goitre or thyroiditis)
Answer: A
Question #9 (Topic: )
A 52-year-old man had been found to have type 1 diabetes mellitus at the age of 25. He
had developed retinopathy at the age of 31 and a painless foot ulcer at the age of 40. His
renal function had subsequently deteriorated.
On examination, urinalysis showed protein 1+, glucose 2+.
What is the most likely diagnosis?
had developed retinopathy at the age of 31 and a painless foot ulcer at the age of 40. His
renal function had subsequently deteriorated.
On examination, urinalysis showed protein 1+, glucose 2+.
What is the most likely diagnosis?
A. focal segmental glomerulosclerosis
B. membranoproliferative glomerulonephritis
C. minimal change glomerulonephritis
D. nodular glomerulosclerosis
E. tubulointerstitial nephritis
Answer: D
Question #10 (Topic: )
A 19-year-old man presented with late development of his pubic and axillary hair. He was
otherwise well and was not taking any medication. His serum testosterone concentration
had been normal on two previous occasions.
On examination, he now had post-pubertal secondary sexual characteristics. He had 1520
mL testes.
Investigations:
serum testosterone27.0 nmol/L (9.035.0)
serum sex hormone binding globulin28 nmol/L (1062)
serum follicle-stimulating hormone2.0 U/L (1.07.0)
serum luteinising hormone2.9 U/L (1.010.0)
What is the chief product of the Sertoli cell?
otherwise well and was not taking any medication. His serum testosterone concentration
had been normal on two previous occasions.
On examination, he now had post-pubertal secondary sexual characteristics. He had 1520
mL testes.
Investigations:
serum testosterone27.0 nmol/L (9.035.0)
serum sex hormone binding globulin28 nmol/L (1062)
serum follicle-stimulating hormone2.0 U/L (1.07.0)
serum luteinising hormone2.9 U/L (1.010.0)
What is the chief product of the Sertoli cell?
A. anti-Müllerian hormone
B. kisspeptin
C. oestrogen
D. serum sex hormone binding globulin
E. testosterone
Answer: A
