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

1. A 54-year-old man was referred to the diabetes foot clinic with a plantar foot ulcer of 3 months' duration under the right first metatarsal head. He had a 10-year history of type 2 diabetes mellitus. He lived alone and had to do his own shopping and cleaning.
On examination, the ulcer was 3 ? 2 cm in area, 4 mm in depth, and had a clean granulating base. He had strong palpable pedal pulses and sensory neuropathy in both feet.
What is the most effective intervention to heal this ulcer?

A) ambulatory vacuum-assisted pump therapy
B) removable pressure-relieving boot
C) long-term oral antibiotics
D) total contact casting
E) Manuka honey-impregnated wound dressing

2. Carbimazole is routinely used in the management of thyroid disease.
What does carbimazole inhibit?

A) thyroid peroxidase
B) presentation of thyroid antigens to autoreactive T cells
C) sodium/iodide symporter
D) thyroglobulin synthesis
E) deiodinase type 1

3. A 17-year-old boy had panhypopituitarism, including diabetes insipidus, following treatment for a craniopharyngioma. He was taking appropriate replacement therapy. In the transition clinic, he was keen to continue growth hormone replacement therapy following a 12-month break after reaching final height.
Which is the most appropriate test to assess his growth hormone status?

A) growth hormone day profile
B) insulin tolerance test
C) clonidine test
D) insulin-like growth factor 1
E) insulin-like growth factor-binding protein 3

4. A 64-year-old man attended the diabetes clinic for annual review. He complained of very recent tingling in his feet. A monofilament was used to screen for the presence of chronic sensorimotor diabetic peripheral neuropathy.
What force should a monofilament deliver?

A) 10 g
B) 5 g
C) 2 g
D) 20 g
E) 1 g

5. A 23-year-old woman presented to the outpatient clinic complaining of an inability to lose weight and irregular menses. Her food diary suggested that she consumed only 900 kilocalories daily. She had previously been found to have hypothyroidism and was treated with levothyroxine 75 micrograms daily.
On examination, her body mass index was 40.2 kg/m2 (18-25).
Investigations:
serum testosterone3.6 nmol/L (0.5-3.0) plasma follicle-stimulating hormone3.0 U/L (2.5-10.0) plasma luteinising hormone9.0 U/L (2.5-10.0) serum thyroid-stimulating hormone4.6 mU/L (0.4-5.0) serum free T412.8 pmol/L (10.0-22.0)
What is the most appropriate next step?

A) titrate levothyroxine dosage
B) add orlistat
C) add exenatide
D) bariatric surgery
E) add metformin

Solutions: