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MRCPUK SEND Exam Syllabus Topics:

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

1. A 55-year-old male-to-female transsexual was reviewed in clinic. She lived as a woman but had not undergone gender reassignment surgery. She was treated with cyproterone acetate 50 mg twice daily and estradiol 2 mg twice daily.
What are the most important tests for monitoring safe replacement?

A) serum prostate-specific antigen and full blood count
B) lipid profile and liver function tests
C) liver function tests and full blood count
D) lipid profile and serum prostate-specific antigen
E) liver function tests and serum prostate-specific antigen

2. A 55-year-old man with mild polyuria and tiredness was seen on a renal ward. He had had a living-related kidney transplant 6 months previously. He had good graft function while being treated with prednisolone 5 mg daily, mycophenolate mofetil 1 g twice daily and tacrolimus 3 mg twice daily. He was also taking atenolol 50 mg daily and simvastatin 40 mg daily.
Investigations:
haemoglobin A1c75 mmol/mol (20-42)
random plasma glucose18.0 mmol/L
Which drug is most likely to be responsible for his diabetes of new onset?

A) mycophenolate mofetil
B) simvastatin
C) atenolol
D) prednisolone
E) tacrolimus

3. A 26-year-old physiologist was seen in the diabetes outpatient clinic. She had type 1 diabetes mellitus of 9 months' duration, treated with subcutaneous insulin.
She asked what symptoms of hypoglycaemia she might experience.
In what order are responses to hypoglycaemia most likely to occur as blood glucose falls?

A) autonomic, counter-regulatory hormones, neuroglycopenia
B) autonomic, neuroglycopenia, counter-regulatory hormones
C) counter-regulatory hormones, neuroglycopenia, autonomic
D) counter-regulatory hormones, autonomic, neuroglycopenia
E) neuroglycopenia, autonomic, counter-regulatory hormones

4. A 67-year-old man underwent an isotope bone scan after being found to have a raised serum alkaline phosphatase (of bone origin). The blood test had been ordered because of mild lower back pain, which had now resolved. He was not taking any medication.
Examination was normal.
Investigations:
isotope bone scansee image

What is the most likely diagnosis?

A) prostate cancer
B) multiple myeloma
C) fibrous dysplasia
D) Paget's disease
E) osteomalacia

5. A 76-year-old woman with type 2 diabetes mellitus was reviewed. Treatment with thiazolidinedione was being considered, but she was worried about the effect this medication might have on the incidence of complications. She had known background retinopathy.
What complication is more likely to worsen in a patient taking a thiazolidinedione?

A) retinal vein thrombosis
B) macular oedema
C) retinal haemorrhages
D) hard exudates
E) cataract

Solutions: