Exam Name: Endocrinology and Diabetes (Specialty Certificate Examination)
Certification Provider: MRCPUK
Corresponding Certification: MRCPUK Certification
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- Total Questions: 200
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MRCPUK SEND Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Reproductive and Other Endocrine Conditions | 15% | - Disorders of puberty and sex development - Endocrine hypertension and rare syndromes - Obesity and lipid disorders - Polycystic ovary syndrome |
| Topic 2: Diabetes Mellitus | 40% | - Other forms of diabetes
|
| Topic 3: Thyroid Disorders | 15% | - Thyroid nodules and cancer - Thyroiditis and subclinical dysfunction - Hypothyroidism and myxoedema coma - Hyperthyroidism: Graves’ disease, toxic nodular disease |
| Topic 4: Pituitary and Hypothalamic Disorders | 15% | - Diabetes insipidus and SIADH - Pituitary adenomas: prolactinoma, acromegaly, Cushing's disease - Hypothalamic dysfunction - Hypopituitarism and hormone replacement |
| Topic 5: Adrenal and Parathyroid/Metabolic Bone Disorders | 15% | - Primary/secondary hyperaldosteronism - Cushing's syndrome, Addison's disease, phaeochromocytoma - Osteoporosis, osteomalacia, Paget's disease - Hyperparathyroidism, hypoparathyroidism |
MRCPUK Endocrinology and Diabetes (Specialty Certificate Examination) Sample Questions:
A 32-year-old man presented with persistent thirst. He had a past history of polydactyly, which had been corrected surgically in infancy. His family had remarked about his recent weight gain. His only concern was of blurring of vision and difficulty reading. His father and paternal grandfather had each developed type 2 diabetes mellitus when aged 41 and 56 years, respectively.
His body mass index was 34 kg/m2 (18-25). Urinalysis showed glucose 2+, ketones 1+.
Investigations:
serum sodium142 mmol/L (137-144)
serum potassium3.8 mmol/L (3.5-4.9)
serum chloride105 mmol/L (95-107)
serum urea5.0 mmol/L (2.5-7.0)
serum creatinine90 umol/L (60-110)
haemoglobin A1c91 mmol/mol (20-42)
random plasma glucose11.3 mmol/L
ultrasound scan of kidneysnormal
What is the most likely underlying diagnosis?
- A. type 2 diabetes mellitus
- B. monogenic diabetes caused by a mutation in the glucokinase gene
- C. Bardet-Biedl syndrome
- D. Prader-Willi syndrome
- E. monogenic diabetes caused by a mutation in the HNF-1? gene
Correct Answer: C 🗳️
A 25-year-old man presented with a 2-month history of thirst and polyuria. He had minimal weight loss and his body mass index was 26 kg/m2 (18-25). He had had sensorineural deafness since childhood. There was a very strong family history of sensorineural deafness and type 2 diabetes mellitus.
Urinalysis showed no ketones.
Investigations:
random plasma glucose18.0 mmol/L
What is the most appropriate next step in management?
- A. genetic testing for maturity-onset diabetes of the young
- B. test for mitochondrial diabetes
- C. water deprivation test to assess posterior pituitary function
- D. measurement of glutamic acid decarboxylase antibodies
- E. test for HFE genotype
Correct Answer: B 🗳️
A 52-year-old woman had been found to have type 2 diabetes mellitus approximately 6
months previously.
Investigations:
haemoglobin A1c50 mmol/mol (20-42)
What is the lifetime risk of her identical twin sister also developing type 2 diabetes mellitus?
- A. 40-50%
- B. >60%
- C. 20-30%
- D. <5%
- E. 5-10%
Correct Answer: B 🗳️
A 32-year-old woman, with a 22-year history of type 1 diabetes mellitus, was seen in a pre-pregnancy diabetes clinic. She was a primigravida.
On examination, she had early background retinopathy, her blood pressure was 128/68 mmHg, and her body mass index was 29.7 kg/m2 (18-25).
Investigations:
haemoglobin A1c56 mmol/mol (20-42)
urinary albumin:creatinine ratio1.2 mg/mmol (<3.5)
Over the years her haemoglobin A1c concentration had varied between 58 and 69 mmol/mol. She had impaired awareness of hypoglycaemia and experienced approximately two severe hypoglycaemic events per year. She was worried about the risk of severe congenital malformations in her baby.
To what extent will the average risk of severe congenital malformation be increased in infants born to this mother with pregestational diabetes?
- A. four-fold
- B. two-fold
- C. six-fold
- D. eight-fold
- E. ten-fold
Correct Answer: B 🗳️
A 15-year-old boy with a 10-year history of type 1 diabetes mellitus was referred to the adolescent diabetes clinic from the paediatric clinic. Diabetes control had always been satisfactory and his recent haemoglobin A1c concentration was 67 mmol/mol (20-42). He felt generally well, although on a growth chart his weight had fallen steadily from the 50th centile 18 months previously to the 10th centile, and his height had fallen from the 50th centile to the 25th centile. He had stage 4 genital development and stage 4 pubic hair, and testicular volume was 15 mL.
What is the most appropriate investigation?
- A. serum testosterone
- B. thyroid-stimulating hormone and free thyroxine
- C. short tetracosactide (Synacthen@) test
- D. insulin-like growth factor 1
- E. anti-tissue transglutaminase antibodies
Correct Answer: E 🗳️
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