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MRCPUK SEND Exam Syllabus Topics:

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

1. A 25-year-old woman who was 4 months pregnant presented with weight loss of 3 kg over the previous 4 weeks, associated with intermittent palpitations, tremor and feeling of warmth. She was not taking any medication.
On examination, her pulse was 100 beats per minute and regular, and her blood pressure was 130/60 mmHg. A symmetrical non-tender goitre was palpable, with an audible bruit. There was no exophthalmos.
Investigations:
serum thyroid-stimulating hormone<0.1 mU/L (0.4-5.0)
serum free T445.2 pmol/L (10.0-22.0)
serum free T322.8 pmol/L (3.0-7.0)
anti-thyroid stimulating hormone receptor
antibodies40 U/L (<7)
What is the most appropriate treatment?

A) propylthiouracil
B) carbimazole
C) subtotal thyroidectomy
D) radioactive iodine
E) propranolol

2. A 32-year-old woman with a recurrent history of Graves' thyrotoxicosis was being considered for radioiodine treatment. However, she wanted to conceive again at some stage and asked how soon she could become pregnant.
After what minimum interval would it be safe for her to conceive again?

A) 4 months
B) 12 months
C) 8 months
D) 2 months
E) 6 months

3. A 36-year-old woman was seen in the clinic with a recurrence of hyperthyroidism after a 2year remission. She had been treated with carbimazole for 18 months following her original presentation. She was moderately symptomatic and was keen to be treated in the same way again. She was planning a pregnancy.
Investigations: serum prolactin240 mU/L (<360) serum thyroid-stimulating hormone<0.1 mU/L (0.4-5.0) serum free T428.0 pmol/L (10.0-22.0)
anti-thyroid-stimulating hormone receptor antibodies44 U/L (<7)
What is the most appropriate next step in management?

A) propylthiouracil
B) carbimazole
C) radioiodine treatment
D) referral for thyroidectomy
E) block-and-replace treatment with carbimazole and levothyroxine

4. A 23-year-old woman was found to have type 1 diabetes mellitus following a short history of polyuria, polydipsia and unintentional weight loss. She started taking insulin aspart before meals and insulin detemir daily.
What is the most appropriate time from diagnosis to start screening for microalbuminuria?

A) 5 years
B) 2 years
C) immediately
D) 1 year
E) 10 years

5. A 15-year-old boy was referred by the school nurse because she was concerned about his weight. There was no past history of note. He was not taking any medication. His height was 1.61 m and he weighed 70.5 kg.
Investigations: growth chartsee image

What is the most likely diagnosis?

A) Prader-Willi syndrome
B) Cushing's disease
C) simple obesity
D) growth hormone deficiency
E) leptin deficiency

Solutions: