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

1. A 55-year-old man presented with a 3-year history of increasing pain in the right hip. He had been otherwise well and was taking no medication. He was reluctant to consider any intravenous treatment as he had a phobia of needles.
Investigations:
X-ray of hipssclerotic bone in right pubis and ischium
suggestive of Paget's disease
What is the most appropriate oral treatment?

A) sodium clodronate
B) risedronate sodium
C) strontium ranelate
D) calcium and vitamin D
E) ibandronate sodium

2. A 47-year-old nuclear physics professor was referred for advice before taking up an overseas position, overseeing the dismantling of a reactor at the site of a recent nuclear accident. She stated that she would face a small risk of being exposed to significant radioactive contamination during her work and was concerned about her future risk of thyroid cancer.
What is the most appropriate advice?

A) wear lead neck shield while outdoors
B) no precautions are necessary for people aged 40 years or over
C) avoid consuming local milk and vegetables
D) take potassium iodide tablets
E) take selenium tablets

3. A 43-year-old man presented with a 2-year history of tiredness and reduced libido. He had not been found to have diabetes mellitus.
On examination, his body mass index was 22.4 kg/m2 (18-25), he was poorly virilised and had 10 mL testes.
Investigations:
serum cortisol (09.00 h)220 nmol/L (200-700) serum testosterone4 nmol/L (9.0-35.0) plasma follicle-stimulating hormone1.2 U/L (1.0-7.0) plasma luteinising hormone1.2 U/L (1.0-10.0) serum prolactin150 mU/L (<360) serum thyroid-stimulating hormone1.2 mU/L (0.4-5.0) serum free T48.2 pmol/L (10.0-22.0)
serum insulin-like growth factor 17.8 nmol/L (5.6-23.3)
MR scan of pituitaryempty sella; no mass lesion
An insulin tolerance test was advised to assess both cortisol and growth hormone reserve.
What is the most appropriate dose of insulin (in units/kg body weight) to administer?

A) 1.0
B) 0.01
C) 0.5
D) 0.1
E) 0.05

4. A 20-year-old woman with Turner's syndrome had heard that there was a risk of ovarian cancer associated with Turner's syndrome. She asked to undergo a pre-emptive oophorectomy.
For what genotype is oophorectomy most likely to be recommended?

A) 45X/47XXX
B) 45X/46XY
C) 45XO
D) 45X/46XX
E) 45X/46Xxi (Xq)

5. A 37-year-old man, who had previously undergone female-to-male gender reassignment surgery, attended the endocrine clinic for annual review. He had no complaints and was happy with the results of his treatment. His medication consisted of testosterone undecanoate 1 g intramuscularly every 3 months.
What variable is it most important to monitor?

A) serum luteinising hormone
B) serum testosterone
C) serum prostate-specific antigen
D) haematocrit
E) fasting plasma glucose

Solutions: