MRCPUK SEND Exam Questions in PDF and Online

QUESTION: 11

A 32-year-old man presented with medullary thyroid cancer, treated by total thyroidectomy. He had a past history of primary hyperparathyroidism, treated by selective parathyroidectomy. Postoperatively, plasma calcitonin was undetectable and serum calcium was in the normal range.
Investigations:
RET genotypeheterozygote codon 634 C>T mutation

What is the most appropriate approach to annual screening for phaeochromocytoma?

biochemical screening
CT scan of adrenal glands
MIBG scanning
MR scan of adrenal glands
octreotide scanning

Answer(s): A

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QUESTION: 12

A 46-year-old Afro-Caribbean man with sarcoidosis was found to have hypercalcaemia and was treated with prednisolone 20 mg/day. Within 3 weeks his serum calcium had fallen to within the reference range.
How do glucocorticoids reduce serum calcium in sarcoidosis?

direct calcium shift into cells
increase intravascular fluid volume
promote urinary calcium excretion
reduces extrarenal 1-?-hydroxylase activity
suppress parathyroid hormone secretion

Answer(s): D

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QUESTION: 13

A 59-year-old man with an 8-year history of type 2 diabetes mellitus was seen in the outpatient clinic. He had worsening renal function in the absence of microalbuminuria.
On examination, his blood pressure was 175/90 mmHg. He had a femoral bruit, and absent dorsalis pedis pulses bilaterally.

Investigations:
-serum creatinine150 µmol/L (60–110)
-estimated glomerular filtration rate (MDRD)39 mL/min/1.73m2 (>60)

In addition to addressing his blood pressure, what is the most appropriate next investigation?

captopril diethylene triamine pentacaetic acid (DTPA) scan
lower limb angiography
mercaptoacetyltriglycine (MAG3) renography
MR angiography of renal arteries
renal ultrasound scan with Doppler studies

Answer(s): D

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QUESTION: 14

A 32-year-old man presented with persistent thirst. He had a past history of polydactyly, which had been corrected surgically in infancy. His family had remarked about his recent weight gain. His only concern was of blurring of vision and difficulty reading. His father and paternal grandfather had each developed type 2 diabetes mellitus when aged 41 and 56 years, respectively.
His body mass index was 34 kg/m2 (18–25). Urinalysis showed glucose 2+, ketones 1+.

Investigations:
serum sodium142 mmol/L (137–144) serum potassium3.8 mmol/L (3.5–4.9) serum chloride105 mmol/L (95–107) serum urea5.0 mmol/L (2.5–7.0) serum creatinine90 µmol/L (60–110) haemoglobin A1c91 mmol/mol (20–42) random plasma glucose11.3 mmol/L ultrasound scan of kidneysnormal

What is the most likely underlying diagnosis?

Bardet–Biedl syndrome
monogenic diabetes caused by a mutation in the glucokinase gene
monogenic diabetes caused by a mutation in the HNF-1? gene
Prader–Willi syndrome
type 2 diabetes mellitus

Answer(s): A

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QUESTION: 15

A 48-year-old woman presented with a 2-year history of weight gain, easy bruising and mood disturbance. Investigations:

fasting plasma glucose6.9 mmol/L (3.0–6.0)
low-dose dexamethasone suppression test (2 mg/day for 48 h): serum cortisol200 nmol/L (<50)
24-h urinary free cortisol (?3)670, 400 and 300 nmol (55–250) plasma adrenocorticotropic hormone (09.00 h)25.0 pmol/L (3.3–15.4) MR scan of pituitarynormal

What test is most likely to give a definitive diagnosis?

corticotropin-releasing hormone test
CT scan of chest
high-dose dexamethasone suppression text (8 mg/day for 48 h)
octreotide scan
petrosal sinus sampling

Answer(s): E

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

Free MRCPUK SEND Dumps Questions (page: 3)

QUESTION: 11

QUESTION: 12

QUESTION: 13

QUESTION: 14

QUESTION: 15