MRCPUK SEND : Endocrinology and Diabetes (Specialty Certificate Examination)

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

2. A 55-year-old man with type 2 diabetes mellitus presented with foot swelling and discomfort. He had a peripheral sensory neuropathy attributed to diabetes mellitus. A midfoot Charcot's arthropathy was suspected, and a plain X-ray was arranged (see image).

Which is the talonavicular joint?

A) 1
B) 2
C) 5
D) 4
E) 3

3. A 39-year-old woman with Graves' disease was considered suitable for treatment with radioiodine. She was keen that her thyrotoxicosis should not recur. The plan was to request a 600 MBq dose.
What is the probability of resolution of thyrotoxicosis with this dose?

A) 20%
B) >95%
C) 60%
D) 40%
E) 80%

4. A 56-year-old woman presented with a swelling in her neck, which she had noticed by chance 6 weeks previously. The swelling had not changed in size since she first noticed it, and was completely asymptomatic.
On examination, there was a smooth nodule in the thyroid that moved up on swallowing and there was no lymphadenopathy.
Investigations:
ultrasound scan of thyroidsingle 4.7-cm hypoechoic nodule
in upper left lobe
serum thyroid-stimulating hormone0.8 mU/L (0.4-5.0)
What is the most appropriate next step in management?

A) fine-needle aspiration for cytology
B) serial ultrasound examinations
C) isotope uptake scan
D) FDG-PET CT scan
E) hemithyroidectomy

5. A 20-year-old woman with Turner's syndrome had heard that there was a risk of ovarian cancer associated with Turner's syndrome. She asked to undergo a pre-emptive oophorectomy.
For what genotype is oophorectomy most likely to be recommended?

A) 45XO
B) 45X/46Xxi (Xq)
C) 45X/46XX
D) 45X/47XXX
E) 45X/46XY

Solutions: