About MRCPUK Endocrinology and Diabetes (Specialty Certificate Examination) exam torrent

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MRCPUK SEND Exam Syllabus Topics:

MRCPUK Endocrinology and Diabetes (Specialty Certificate Examination) Sample Questions:

1. A 23-year-old woman presented to the outpatient clinic complaining of an inability to lose weight and irregular menses. Her food diary suggested that she consumed only 900 kilocalories daily. She had previously been found to have hypothyroidism and was treated with levothyroxine 75 micrograms daily.
On examination, her body mass index was 40.2 kg/m2 (18-25).
Investigations:
serum testosterone3.6 nmol/L (0.5-3.0) plasma follicle-stimulating hormone3.0 U/L (2.5-10.0) plasma luteinising hormone9.0 U/L (2.5-10.0) serum thyroid-stimulating hormone4.6 mU/L (0.4-5.0) serum free T412.8 pmol/L (10.0-22.0)
What is the most appropriate next step?

A) bariatric surgery
B) add orlistat
C) titrate levothyroxine dosage
D) add metformin
E) add exenatide

2. A 17-year-old girl was referred to the outpatient clinic with irritability, weight loss and difficulty sleeping. At the age of 4, she had presented with rapid growth, breast development and vaginal bleeding. The results of a gonadotropin-releasing hormone (GnRH) stimulation test performed at that time are given below.
serum oestradiolplasma FSHplasma LH
(200-400 pmol/L)(2.5-10.0 U/L)(2.5-10.0 U/L)
0 min365<0.7<0.5
30 min-<0.7<0.5
60 min-<0.7<0.5
She had been treated with GnRH analogue until the age of 11 and puberty had then progressed normally.
On examination, she was found to be tremulous, tachycardic and hyper-reflexic. Several large, irregular cafe-au-lait spots were found.
Investigations:
serum thyroid-stimulating hormone<0.05 mU/L (0.4-5.0)
serum free T436.0 pmol/L (10.0-22.0)
What is the most likely diagnosis?

A) neurofibromatosis type 1
B) multiple endocrine neoplasia type 2
C) Cowden's syndrome
D) Carney's complex
E) McCune-Albright syndrome

3. A 17-year-old boy with a 7-year history of type 1 diabetes mellitus was transferred to the adolescent diabetes clinic. He had a history of poor clinic attendance. He admitted to having lost weight recently. His eyes had been photographed by a community ophthalmologist 1 week previously. A photograph of the right fundus is shown (see image).

Investigations:
haemoglobin A1c104 mmol/mol (20-42)
What is the most likely explanation for the retinal appearance?

A) benign choroidal naevus
B) preproliferative diabetic retinopathy
C) macular oedema
D) drusen
E) retinitis pigmentosa

4. A 62-year-old woman was referred with difficulty in swallowing and a painful, swollen neck.
On examination, her neck was tender to palpation with a small, diffuse goitre. There was no
associated neck lymphadenopathy.
Investigations:
serum thyroid-stimulating hormone<0.04 mU/L (0.4-5.0)
serum free T426.0 pmol/L (10.0-22.0)
serum free T312.0 pmol/L (3.0-7.0)
What is the most likely diagnosis?

A) subacute thyroiditis
B) haemorrhage into a thyroid cyst
C) thyroid carcinoma
D) Graves' disease
E) toxic adenoma

5. A 36-year-old woman was referred to the endocrine clinic with abnormal thyroid function
tests. She gave a 3-year history of increased sweating and anxiety following an assault and, initially, her symptoms had been attributed to post-traumatic stress disorder.
Investigations:
serum thyroid-stimulating hormone (TSH)3.1 mU/L (0.4-5.0)
serum free T429.8 pmol/L (10.0-22.0)
serum free T33.5 pmol/L (3.0-7.0)
What is the most likely interpretation of her thyroid function test results?

A) TSH-secreting pituitary adenoma
B) factitious thyrotoxicosis
C) use of combined oral contraceptive pill
D) resistance to thyroid hormone
E) assay interference

Solutions: