MRCPUK SEND : Endocrinology and Diabetes (Specialty Certificate Examination)

The world has witnessed the birth and boom of IT industry, the unemployment crisis has stroke all kind of workers, more and more people are facing an increasing number of challenges. At this time, an appropriate MRCPUK MRCPUK exam certification might become your biggest advantage. The specialized knowledge with SEND exam prep files are your foundation of foothold in this competitive society.

Fast Delivery

The world has come into a high-speed period, as people always say, time is money. People want to get the thing they buy immediately after payment. As for SEND training material, we have a distinct character like all the other electronic products that is fast delivery. After payment, we would check about your individual information like email address and the MRCPUK SEND latest practice questions, aim to avoid any error. You don’t need to wait too long to get it, the SEND pdf vce would be delivered in 5 to 10 minutes to your email. At that time you can start your reviewing immediately. So choosing us is equivalent to choosing high efficiency.

Guarantee 99% Passing Rate

Our SEND exam prep file has won good reputation among numerous candidates and peers in the industry through continuous SEND innovation and creation. The average passing rate of our candidates has already reached to 99%, which is first-class in this industry. 20 to 32 hours’ learning of SEND exam training test is enough for you to pass exam. So after carefully calculating about the costs and benefits, our MRCPUK SEND latest practice questions should be the best choice for every candidate. The High passing rate also proves that choosing us is choosing the path lead to success.

Targeted and Efficient SEND valid study material

When college graduates and on-job office workers in IT field learn that receiving SEND exam certification will give them an upper hand in the job market, or other benefits like promotion, many of them will decide to take part in SEND exam. But preparation for the exam would be tired and time-consuming. We can guarantee that you won’t waste too much time and energy to pass exam once you purchase our SEND exam test simulator. Our expert group and technical team develop the efficient SEND valid study material targeted to the real exam. Firstly, all types of questions are included in our SEND training material that wide coverage will be helpful for you to pass exam. Secondly, clear explanations of some questions will help you understand knowledge points deeply. So choosing our SEND valid study material would help you get through the SEND exam smoothly and quickly.

First Class After-sales Service

Not only the MRCPUK SEND exam test simulator, but also our after-sale service is first-class in this industry. We provide 24/7 (24 hours 7 days) online customers service. You can feel that our customer service staff are warmhearted and reliable. Our SEND pdf vce will try our best to help our candidates no matter you are a new or old customer. Every question raised by you would receive a careful reply. Helping you to have a good experience and pass exam with MRCPUK SEND valid study material smoothly is the same goal of all staff in our company.

Instant Download: Upon successful payment, Our systems will automatically send the product you have purchased to your mailbox by email. (If not received within 12 hours, please contact us. Note: don't forget to check your spam.)

MRCPUK SEND Exam Syllabus Topics:

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

1. A 50-year-old woman with acromegaly presented with persistent sweating and headaches
despite having undergone trans-sphenoidal surgery and pituitary radiotherapy 2 years
previously. She had been intolerant of treatment with octreotide.
Investigations:
serum growth hormone11.1 ?g/L (<0.4)
serum insulin-like growth factor 186.2 nmol/L (5.6-23.3)
Following imaging, it was judged that there was no role for repeat surgery. She was treated
with pegvisomant 10 mg. Six months into treatment, her symptoms had improved.
Investigations (6 months later):
serum growth hormone20.3 ?g/L (<0.4)
serum insulin-like growth factor 115.2 nmol/L (5.6-23.3)
What is the most appropriate next step in management?

A) increase dosage of pegvisomant
B) arrange another full course of pituitary radiotherapy
C) continue present dosage of pegvisomant
D) add cabergoline
E) stop pegvisomant

2. A 45-year-old woman was found to be hypertensive by her general practitioner. She was otherwise well and was not taking any medication. However, she regularly ate health food containing liquorice. There was no family history of significant illness.
On examination, her blood pressure was 170/110 mmHg.
Investigations:
serum sodium140 mmol/L (137-144)
serum potassium3.8 mmol/L (3.5-4.9)
serum creatinine70 umol/L (60-110)
plasma renin activity (after 30 min supine)0.5 pmol/mL/h (1.1-2.7)
plasma aldosterone (after 30 min supine)450 pmol/L (135-400)
During the investigations, her blood pressure was controlled with doxazosin. What is the most likely diagnosis?

A) Gitelman's syndrome
B) apparent mineralocorticoid excess
C) pseudohyperaldosteronism
D) renal artery stenosis
E) primary hyperaldosteronism

3. A 37-year-old woman was seen in clinic with a 2-month history of mild galactorrhoea. She had a long-standing history of hypothyroidism, treated with levothyroxine 125 micrograms daily, and a history of mental health issues, treated with risperidone. Her menstrual cycle was regular.
An MR scan of brain, requested elsewhere as part of a workup for headaches and other somatic symptoms, was available.
Investigations:
serum prolactin3000 mU/L (<360)
serum thyroid-stimulating hormone4.8 mU/L (0.4-5.0)
serum free T411.0 pmol/L (10.0-22.0)
MR scan of brainno abnormalities reported
What is the most appropriate next step in the management of her hyperprolactinaemia?

A) reassurance of no significant pituitary pathology
B) add cabergoline
C) MR scan of pituitary fossa
D) increase levothyroxine dosage
E) stop risperidone

4. A 72-year-old woman presented with a painless swelling in the front of the neck, which she had first noticed 2-3 months previously. She was otherwise well, with no symptoms of mass effect in her neck, and was not taking any medication.
On examination, her thyroid gland was moderately enlarged, and felt uniformly nodular. There was no associated lymphadenopathy. Her pulse was 78 beats per minute and regular, and there were no signs of thyrotoxicosis.
Investigations:
serum thyroid-stimulating hormone<0.01 mU/L (0.4-5.0)
serum free T424.8 pmol/L (10.0-22.0)
serum free T310.3 pmol/L (3.0-7.0)
technetium-99m scan of thyroid (20-min uptake)patchy uptake in both thyroid lobes
What is the most appropriate management?

A) carbimazole plus levothyroxine
B) partial thyroidectomy
C) total thyroidectomy
D) radioiodine
E) repeat thyroid function tests after 6 months

5. A 28-year-old man was seen in the lipid clinic following a referral from the general surgical team. He had had two episodes of acute pancreatitis over the preceding 6 months, which settled spontaneously. He had a past medical history of HIV disease and was taking highly active antiretroviral (HAART) therapy. He drank 12 units of alcohol per week.
On examination, he had no stigmata of hyperlipidaemia.
Investigations:
fasting plasma glucose6.2 mmol/L (3.0-6.0)
haemoglobin A1c44 mmol/mol (20-42)
serum cholesterol7.5 mmol/L (<5.2)
fasting serum triglycerides23.70 mmol/L (0.45-1.69)
serum thyroid-stimulating hormone0.7 mU/L (0.4-5.0)
serum free T414.3 pmol/L (10.0-22.0)
What class of antiretroviral drug is the most likely cause of his metabolic disturbance?

A) nucleoside reverse transcriptase inhibitors (e.g. zidovudine)
B) protease inhibitors (e.g. ritonavir)
C) integrase inhibitors (e.g. raltegravir)
D) entry inhibitors (e.g. enfuvirtide)
E) non-nucleoside reverse transcriptase inhibitors (e.g. nevirapine)

Solutions: