MRCPUK SEND

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多くの候補者はSEND　Endocrinology and Diabetes (Specialty Certificate Examination)質問と回答に疑問を抱える時、専門人員にお問い合わせて頼っています。弊社は行き届いたアフターサービスを提供しますので、あなたにとって最善の選択です。さらに、弊社は24時間の問い合わせサービスを提供します。つまり、もしあなたは何の質問があれば、弊社の係員はあなたのお問い合わせを待ち、あなたの疑問を解決し努力します。お気軽にお問い合わせください。私たちはあなたのためによく準備しています。

MRCPUK SEND試験問題集をすぐにダウンロード：成功に支払ってから、我々のシステムは自動的にメールであなたの購入した商品をあなたのメールアドレスにお送りいたします。（12時間以内で届かないなら、我々を連絡してください。Note：ゴミ箱の検査を忘れないでください。）

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弊社のスローガンは「品質によって生存し、革新し発展すること」です。私達はこの分野のリーダであることを熱望しており、常に革新を続けていきます。我々は力の限りで高質量のSEND　Endocrinology and Diabetes (Specialty Certificate Examination)問題と回答を合理的な価格で提供し、すべてのお客様に最高のサービスを与えます。あなたが試験準備中に学習パートナーを探しているなら、弊社はあなたの最良の選択であることを保証します。我々のSENDテスト練習はあなたに最も専業のガイドを提供します。古い言葉が言うように、機会は二度がありません。我々の試験問題集はあなたの検討に値します。今、私は参考のためにSEND練習資料の輝きポイントをリストさせます。

一年間の無料アップデット

お支払い後、あなたは’弊社のVIPになり、弊社からSEND質問と回答の一年間の無料更新版を得られます。我々の専門家はこの分野での最新動向に注意を払いますので、これらの変化をSENDテスト練習にすぐに追加します。つまり、我々は定期的にSEND練習問題の更新版をリリースします。弊社のシステムは更新版をあなたのメールボックスに送ります。あなたが時代のペースを追いたいなら、私たちのEndocrinology and Diabetes (Specialty Certificate Examination)テスト模擬を購入する機会を逃してはいけません。

MRCPUK Endocrinology and Diabetes (Specialty Certificate Examination) 認定 SEND 試験問題:

1. A 48-year-old man was referred by his general practitioner, whose letter stated: 'Please review this man's blood pressure management, as he has requested a second opinion, having seen information on the internet about the need for more detailed investigation. He has been having treatment for 10 years.'
At the consultation, the patient confirmed that he was currently taking bendroflumethiazide
2.5 mg daily, atenolol 50 mg daily and perindopril 8 mg daily. His clinic blood pressure was 169/108 mmHg. Clinical examination was otherwise normal.
Investigations:
serum sodium142 mmol/L (137-144)
serum potassium3.9 mmol/L (3.5-4.9)
estimated glomerular filtration rate (MDRD)>60 mL/min/1.73 m2 (>60)
ambulant plasma renin activity0.5 pmol/mL/h (3.0-4.3)
ambulant plasma aldosterone380 pmol/L (330-830)
What is the most appropriate next step in management?

A) withdraw atenolol and repeat renin and aldosterone
B) CT scan of adrenal glands
C) fludrocortisone suppression test
D) urine steroid profile
E) add amlodipine

2. A 32-year-old man presented with medullary thyroid cancer, treated by total thyroidectomy. He had a past history of primary hyperparathyroidism, treated by selective parathyroidectomy. Postoperatively, plasma calcitonin was undetectable and serum calcium was in the normal range.
Investigations:
RET genotypeheterozygote codon 634 C>T mutation
What is the most appropriate approach to annual screening for phaeochromocytoma?

A) CT scan of adrenal glands
B) biochemical screening
C) MR scan of adrenal glands
D) octreotide scanning
E) MIBG scanning

3. A 46-year-old man of European descent was reviewed in the diabetes clinic. He had type 2 diabetes mellitus, which had been diagnosed 6 months previously. He had been symptom free and was a non-smoker but had a family history of cardiovascular disease. He exercised regularly and had managed to lose 8 kg.
On examination, his blood pressure was 148/76 mmHg, his weight was 76 kg and his body mass index was 24 kg/m2 (18-25).
Investigations:
urinary albumin:creatinine ratio0.6 mg/mmol (<2.5)
serum cholesterol5.6 mmol/L (<5.2)
serum HDL cholesterol0.90 mmol/L (>1.55)
fasting serum triglycerides2.20 mmol/L (0.45-1.69)
According to NICE guidelines (CG181, July 2014), what is the most appropriate management of his lipid profile?

A) start nicotinic acid
B) start a fibrate
C) start a statin
D) assess cardiovascular risk using UKPDS risk engine
E) observe and repeat lipid profile in a few months

4. A 17-year-old boy, with short stature, obesity and neurobehavioural problems, was referred because of cold intolerance.
On examination, he and his mother had similar body habitus and short fingers (brachydactyly).
Investigations (before attending clinic):
serum sodium143 mmol/L (137-144) serum potassium4.4 mmol/L (3.5-4.9) serum creatinine93 umol/L (60-110) serum corrected calcium2.02 mmol/L (2.20-2.60) serum phosphate1.7 mmol/L (0.8-1.4)
serum thyroid-stimulating hormone16.0 mU/L (0.4-5.0) serum free T410.0 pmol/L (10.0-22.0) plasma parathyroid hormone27.0 pmol/L (0.9-5.4)
His mother's blood tests were all normal.
What is the most likely diagnosis in this boy?

A) McCune-Albright syndrome
B) DiGeorge syndrome
C) polyglandular autoimmune syndrome type 1
D) pseudopseudohypoparathyroidism
E) pseudohypoparathyroidism

5. An 18-year-old woman presented with a 2-month history of polyuria and polydipsia. She
had been previously fit and well with regular periods. She was not taking any contraception.
Investigations:
serum potassium5.2 mmol/L (3.5-4.9)
serum corrected calcium2.30 mmol/L (2.20-2.60)
serum cortisol (09.00 h)350 nmol/L (200-700)
She went on to have a water deprivation test, the results of which are detailed below.
time (h)serum osmolality (mosmol/kg)urine osmolality (mosmol/kg) normal: 278-300normal: 100-1000 08.3028952 11.3029282 14.30301153 15.30-172
She was then given intramuscular DDAVP@ 2 micrograms at 16.00 h.
time (h)serum osmolality (mosmol/kg)urine osmolality (mosmol/kg) normal: 278-300normal: 100-1000 16.3030017.30-530 18.30-532
Results from an MR scan of pituitary are shown (see image).

What is the most likely diagnosis?

A) non-functioning pituitary adenoma
B) craniopharyngioma
C) autoimmune (lymphocytic) hypophysitis
D) psychogenic polydipsia
E) Rathke's cleft cyst

質問と回答：