SEND Certification Exam Questions with AI Explanations

QUESTION: 36

A 17-year-old girl with Turner’s syndrome attended the clinic for review. She had been treated with growth hormone therapy for the previous 7 years, and had now reached her final adult height.
What is the most appropriate next step in management?

assess her bone density by DXA scan and continue growth hormone if bone mineral density is less than mean for age
continue growth hormone until 25 years old then reassess
start to reduce growth hormone therapy with a view to discontinuing in 2 years’ time
stop growth hormone therapy
withdraw growth hormone therapy for 3 months and evaluate growth hormone secretion

Answer(s): D

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QUESTION: 37

A 55-year-old man presented with a 3-year history of increasing pain in the right hip. He had been otherwise well and was taking no medication. He was reluctant to consider any intravenous treatment as he had a phobia of needles.

Investigations:
X-ray of hipssclerotic bone in right pubis and ischium suggestive of Paget’s disease

What is the most appropriate oral treatment?

calcium and vitamin D
ibandronate sodium
risedronate sodium
sodium clodronate
strontium ranelate

Answer(s): C

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QUESTION: 38

A 43-year-old man presented with a 2-year history of tiredness and reduced libido. He had not been found to have diabetes mellitus.
On examination, his body mass index was 22.4 kg/m2 (18–25), he was poorly virilised and had 10 mL testes.

Investigations:
-serum cortisol (09.00 h)220 nmol/L (200–700) serum testosterone4 nmol/L (9.0–35.0)
-plasma follicle-stimulating hormone1.2 U/L (1.0–7.0) plasma luteinising hormone1.2 U/L (1.0–10.0)
-serum prolactin150 mU/L (<360)
-serum thyroid-stimulating hormone1.2 mU/L (0.4–5.0) serum free T48.2 pmol/L (10.0–22.0)
-serum insulin-like growth factor 17.8 nmol/L (5.6–23.3) MR scan of pituitaryempty sella; no mass lesion

An insulin tolerance test was advised to assess both cortisol and growth hormone reserve. What is the most appropriate dose of insulin (in units/kg body weight) to administer?

0.01
0.05
0.1
0.5
1.0

Answer(s): C

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QUESTION: 39

A 27-year-old woman presented with oligomenorrhoea and hirsutism, and a 2-year history of infertility. Her body mass index was 26 kg/m2 (18–25). Her partner had a recent normal sperm count and motility test.

Investigations:
-serum androstenedione17.0 nmol/L (0.6–8.8) serum 17-hydroxyprogesterone2 nmol/L (1–10) serum testosterone2.8 nmol/L (0.5–3.0)
-serum sex hormone binding globulin18 nmol/L (40–137) serum follicle-stimulating hormone2.3 U/L (2.5–10.0) serum luteinising hormone8.3 U/L (2.5–10.0)
-serum prolactin152 mU/L (<360)

A diagnosis of polycystic ovary syndrome was made. What is the most effective next step to help her conceive?

clomifene
diet and exercise
in vitro fertilisation
metformin
orlistat

Answer(s): A

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QUESTION: 40

An 18-year-old man with cystic fibrosis was referred to clinic. Over recent months his lung function had deteriorated and he had lost weight. He was being treated for a chest infection at the time of the consultation.

Investigations:
-oral glucose tolerance test (75 g):
-fasting plasma glucose8.2 mmol/L (3.0–6.0) 2-h plasma glucose13.5 mmol/L (<7.8)

What is the most appropriate management?

repeat oral glucose tolerance test after chest infection has resolved
restrict refined carbohydrate intake
start gliclazide
start insulin
start sitagliptin

Answer(s): D

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MRCPUK SEND - Endocrinology and Diabetes (Specialty Certificate Examination) SEND Dumps in PDF

Free MRCPUK SEND Real Questions (page: 22)

QUESTION: 36

QUESTION: 37

QUESTION: 38

QUESTION: 39

QUESTION: 40