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There is no doubt that the IT examination plays an essential role in the IT field. On the one hand, there is no denying that the SEND practice exam materials provides us with a convenient and efficient way to measure IT workers' knowledge and ability(SEND best questions). On the other hand, up to now, no other methods have been discovered to replace the examination. That is to say, the IT examination is still regarded as the only reliable and feasible method which we can take (SEND certification training), and other methods are too time- consuming and therefore they are infeasible, thus it is inevitable for IT workers to take part in the IT exam. However, how to pass the MRCPUK SEND exam has become a big challenge for many people and if you are one of those who are worried, congratulations, you have clicked into the right place--SEND practice exam materials. Our company is committed to help you pass exam and get the IT certification easily. Our company has carried out cooperation with a lot of top IT experts in many countries to compile the SEND best questions for IT workers and our exam preparation are famous for their high quality and favorable prices. The shining points of our SEND certification training files are as follows.

Only need to practice for 20 to 30 hours

You will get to know the valuable exam tips and the latest question types in our SEND certification training files, and there are special explanations for some difficult questions, which can help you to have a better understanding of the difficult questions. All of the questions we listed in our SEND practice exam materials are the key points for the IT exam, and there is no doubt that you can practice all of SEND best questions within 20 to 30 hours, even though the time you spend on it is very short, however the contents you have practiced are the quintessence for the IT exam. And of course, if you still have any misgivings, you can practice our SEND certification training files again and again, which may help you to get the highest score in the IT exam.

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

1. A 61-year-old woman was found incidentally to have a raised serum calcium concentration. She was otherwise well. Her father had undergone a neck operation many years previously.
Investigations:
serum corrected calcium2.78 mmol/L (2.20-2.60)
plasma parathyroid hormone10.8 pmol/L (0.9-5.4)
Her general practitioner thought she had primary hyperparathyroidism.
Which further finding is most likely to cast doubt upon this diagnosis?

A) normal parathyroid radioisotope scan (sestamibi scan)
B) high serum 25-OH-cholecalciferol
C) normal serum phosphate concentration
D) low urinary calcium excretion
E) low serum magnesium concentration

2. A 26-year-old woman was urgently referred to clinic with a 6-week history of retroorbital headaches and deteriorating vision. Her past medical history was unremarkable, although on questioning she admitted that she had recently found it increasingly difficult to cope with her busy job.
On examination, her pulse was 60 beats per minute and regular, and her blood pressure was 110/75 mmHg lying and 90/60 mmHg standing. She was pale and had dry skin. Visual acuities were reduced (6/12 right; 6/24 left), and she had a bitemporal inferior quadrantanopia.
Investigations:
serum sodium132 mmol/L (137-144) serum potassium4.0 mmol/L (3.5-4.9)
short tetracosactide Synacthen@ test (250 micrograms): serum cortisol (30 min after tetracosactide)185 nmol/L (>550)
plasma follicle-stimulating hormone2.7 U/L plasma luteinising hormone3.5 U/L serum prolactin1050 mU/L (<360) serum thyroid-stimulating hormone0.3 mU/L (0.4-5.0) serum free T48.0 pmol/L (10.0-22.0)
serum insulin-like growth factor 14.7 nmol/L (7.5-37.3)
MR scan of brainsee image

What is the most likely diagnosis?

A) Rathke's cleft cyst
B) autoimmune hypophysitis
C) prolactinoma
D) non-functioning pituitary adenoma
E) craniopharyngioma

3. A pregnant 36-year-old woman presented to the diabetes outpatient clinic. She had type 2
diabetes mellitus treated with diet, lifestyle changes and metformin 500 mg twice daily.
On examination, her blood pressure was 128/84 mmHg.
Investigations:
haemoglobin A1c47 mmol/mol (20-42)
urinary albumin:creatinine ratio1.6 mg/mmol (<3.5)
Which is the best agent to reduce the risk of pre-eclampsia in this patient?

A) folic acid
B) labetalol
C) aspirin
D) omega-3-marine triglycerides
E) insulin

4. A 73-year-old man with type 2 diabetes mellitus was referred to the outpatient clinic. He had a history of microalbuminuria and hypertension. He was taking ramipril, amlodipine and metformin.
On examination, his blood pressure was 125/75 mmHg.
Investigations:
haemoglobin A1c57 mmol/mol (20-42)
What additional drug is most likely to prevent glomerular filtration rate decline?

A) simvastatin
B) losartan
C) aspirin
D) aliskiren
E) linagliptin

5. A 58-year-old man was referred to the endocrine clinic after a CT scan of abdomen had shown a 4.5-cm left adrenal mass, with a Hounsfield unit measurement of 11 (consistent with high lipid content). He had a 10-year history of type 2 diabetes mellitus and was taking metformin. He was also taking atenolol for hypertension.
On examination at the clinic, his blood pressure was 162/94 mmHg. He was centrally obese with a body mass index of 27 kg/m2 (18-25).
Investigations:
serum potassium3.9 mmol/L (3.5-4.9)
plasma renin activity (after 30 min upright)1.0 pmol/mL/h (3.0-4.3)
plasma aldosterone (after 4 h upright)680 pmol/L (330-830)
overnight dexamethasone suppression test (after 1 mg dexamethasone):
serum cortisol164 nmol/L (<50)
24-h urinary free cortisol132 nmol (55-250)
24-h urinary catecholamines
(adrenaline and noradrenaline)normal
As the lesion was >4 cm in diameter, laparoscopic adrenalectomy was recommended.
What is the most appropriate advice to give to the surgical team about perioperative
management?

A) no special precautions are required
B) short tetracosactide (Synacthen@) test 48 h postoperatively
C) give corticosteroid cover during and after surgery and reassess postoperatively
D) give preoperative ?-adrenergic receptor blockade in case the lesion is an occult phaeochromocytoma
E) measure cortisol and aldosterone 2 weeks postoperatively

Solutions: