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The first goal of our company is to help all people to pass the SEND exam and get the related certification in the shortest time. Through years of concentrated efforts of our excellent experts and professors, our company has compiled the best helpful and useful SEND test training materials to meet all people’s demands, and in addition, we can assure to everyone that our study materials have a higher quality than other study materials in the global market, at the same time, these people will be easier to be admitted to the human resources supervisor. The SEND learn prep from our company has helped thousands of people to pass the exam and get the related certification, and then these people have enjoyed a better job and a better life. It has been generally accepted that the SEND study questions are of significance for a lot of people to pass the exam and get the related certification.

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

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

2. A 54-year-old woman was referred for assessment of low bone mineral density. Three months previously, after complaining of bloating and flatulence, she had been found to have coeliac disease and had been started on a gluten-free diet. She had no history of fracture and had not lost height. There was no family history of osteoporosis. Her only medication was omeprazole.
Investigations:
serum corrected calcium2.42 mmol/L (2.20-2.60) serum alkaline phosphatase122 U/L (45-105)
plasma parathyroid hormone7.9 pmol/L (0.9-5.4)
DXA scansee image What is the most appropriate treatment?

A) alendronic acid alone
B) strontium ranelate
C) alendronic acid, and calcium and vitamin D
D) calcium and vitamin D, and intravenous zoledronic acid
E) calcium and vitamin D

3. A 73-year-old man with type 2 diabetes mellitus was reviewed because of borderline hypertension. He was taking metformin 1 g twice daily, gliclazide 160 mg twice daily, aspirin 75 mg daily and simvastatin 20 mg at night. He had a history of diabetic retinopathy.
On examination, his body mass index was 34 kg/m2 (18-25); his blood pressure was 146/86 mmHg. When he returned 2 months later, his blood pressure was 142/88 mmHg.
Investigations:
serum creatinine102 umol/L (60-110)
haemoglobin A1c66 mmol/mol (20-42)
urinary albumin:creatinine ratio
(untimed specimen)7.4 mg/mmol (<2.5)
According to NICE guidelines (CG66, May 2008), what is the target for blood pressure reduction?

A) <150/90 mmHg
B) <120/70 mmHg
C) <140/80 mmHg
D) <125/70 mmHg
E) <130/80 mmHg

4. A 26-year-old woman presented acutely with abdominal pain. On examination, her blood pressure was 124/72 mmHg.
Investigations:
24-h urinary dopamine10 000 nmol (<3100)
24-h urinary adrenaline43 nmol (<144)
24-h urinary noradrenaline146 nmol (<570)
CT scan of abdomen3-cm left para-aortic mass
She underwent surgical exploration and removal of the lesion, which proved to be a paraganglioma. One local lymph node, removed at the same time, was also positive for the presence of tumour.
What is the most likely underlying genetic syndrome?

A) von Hippel-Lindau syndrome
B) succinate dehydrogenase type B mutation
C) multiple endocrine neoplasia type 2a
D) neurofibromatosis type 1 mutation
E) Gardner's syndrome

5. A 72-year-old man with a dense residual hemiparesis and unsafe swallow was fed via a percutaneous gastrostomy for 20 hours each day. He resided in a nursing home and had type 2 diabetes mellitus that had been well controlled on metformin.
His glucose concentrations were uncontrolled on metformin powder at maximum dose. While not being fed, his blood glucose was measured.
Investigations:
capillary blood glucose3.1 mmol/L
According to the Joint British Diabetes Societies Guidelines (2012), what is the most appropriate management?

A) Glucogel@ ? 2 down gastrostomy tube
B) Fortisip@ 110 mL
C) restart feed to deliver carbohydrate 20 g rapidly
D) Glucogel@ ? 2 given buccally
E) glucose 20% 150 mL intravenously

Solutions: