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MRCPUK SEND Exam Syllabus Topics:
| Section | Objectives |
|---|---|
| Diabetes Mellitus | - Diabetic complications and emergencies - Type 1 and Type 2 diabetes management |
| Endocrine Emergencies | - Diabetic ketoacidosis and hyperosmolar states - Thyroid and adrenal crisis |
| Calcium, Bone and Metabolic Disease | - Osteoporosis and metabolic bone disease - Calcium and vitamin D disorders |
| Neuroendocrine Tumours and Multiple Endocrine Neoplasia | - MEN syndromes - Carcinoid and pancreatic NETs |
| Metabolic Disorders | - Lipid disorders - Obesity management |
| Adrenal Disorders | - Addison disease and adrenal insufficiency - Cushing syndrome |
| Pituitary and Hypothalamic Disorders | - Pituitary adenomas and hypopituitarism - Diabetes insipidus and SIADH |
| Thyroid Disease | - Hyperthyroidism and hypothyroidism - Thyroid nodules and cancer |
| Reproductive Endocrinology | - Polycystic ovary syndrome (PCOS) - Hypogonadism and infertility |
MRCPUK Endocrinology and Diabetes (Specialty Certificate Examination) Sample Questions:
A 24-year-old woman was referred with an 18-month history of worsening hirsutism, primarily on her face, but also new hair growth on her chest. She was shaving weekly. She had always been overweight, but had recently gained 5 kg and her body mass index was 31 kg/m2 (18-25). Her periods were regular.
What is the most relevant next investigation?
- A. serum 17-hydroxyprogesterone
- B. serum testosterone
- C. plasma thyroid-stimulating hormone
- D. overnight dexamethasone suppression test (after 1 mg dexamethasone)
- E. serum dehydroepiandrosterone
Correct Answer: B 🗳️
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. lipid profile and liver function tests
- B. lipid profile and serum prostate-specific antigen
- C. serum prostate-specific antigen and full blood count
- D. liver function tests and full blood count
- E. liver function tests and serum prostate-specific antigen
Correct Answer: A 🗳️
A 58-year-old woman was referred with an incidental finding of mild hypercalcaemia. She had no relevant symptoms or significant medical history. She was taking no medication.
Investigations:
serum creatinine101 umol/L (60-110) serum corrected calcium2.71 mmol/L (2.20-2.60) serum alkaline phosphatase78 U/L (45-105)
plasma parathyroid hormone6.8 pmol/L (0.9-5.4) serum 25-OH-cholecalciferol76 nmol/L (45-90)
What is the most appropriate next investigation?
- A. bone mineral density scan
- B. ultrasound scan of neck
- C. calcium-sensing receptor gene mutation analysis
- D. calcium:creatinine clearance ratio
- E. parathyroid isotope scan
Correct Answer: D 🗳️
A 63-year-old woman with diet-controlled type 2 diabetes mellitus was admitted with biventricular cardiac failure. She had a history of myocardial infarction 3 years previously. She was taking aspirin 75 mg daily, simvastatin 20 mg daily, furosemide 40 mg daily and ramipril 10 mg daily. She responded well to increased diuretic therapy.
Urinalysis showed glucose 1+.
Investigations:
haemoglobin112 g/L (115-165)
serum sodium135 mmol/L (137-144)
serum potassium4.7 mmol/L (3.5-4.9)
serum creatinine162 umol/L (60-110)
estimated glomerular filtration rate28 mL/min/1.73 m2 (>60)
serum troponin T<0.01 ug/L (<0.01)
haemoglobin A1c66 mmol/mol (20-42)
What is the most appropriate treatment for her diabetes after discharge?
- A. subcutaneous insulin
- B. linagliptin
- C. exenatide
- D. dapagliflozin
- E. gliclazide
Correct Answer: E 🗳️
A 33-year-old woman presented with tiredness, palpitations, weight loss and emotional
lability 9 weeks after the birth of her third child.
On examination, she had a sinus tachycardia, a fine tremor, slight lid retraction and a mild
diffuse non-tender goitre.
Investigations:
serum thyroid-stimulating hormone<0.01 mU/L (0.4-5.0)
serum free T434.3 pmol/L (10.0-22.0)
technetium-99m scan of thyroid (20-min uptake)<1% (0.4-3.0)
What is the most appropriate treatment?
- A. propylthiouracil
- B. carbimazole
- C. aqueous iodine oral solution
- D. potassium perchlorate
- E. propranolol
Correct Answer: E 🗳️
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