What is the most appropriate treatment?

March 14, 2021PdfprepSENDSEND exam questions, SEND practice exam, Specialty Certificate Examinations

A 33-year-old woman presented with tiredness, palpitations, weight loss and emotional lability 9 weeks after the birth of her third child. On examination, she had a sinus tachycardia, a fine tremor, slight lid retraction and...

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What is the most likely diagnosis?

March 11, 2021PdfprepSENDSEND exam questions, SEND practice exam, Specialty Certificate Examinations

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...

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What is the most appropriate next step in investigation of his thyroid status?

March 11, 2021PdfprepSENDSEND exam questions, SEND practice exam, Specialty Certificate Examinations

A 39-year-old man was admitted with severe burns. On examination, he was noted to be persistently tachycardic. Investigations: serum thyroid-stimulating hormone0.2 mU/L (0.4C5.0) serum free T410.0 pmol/L (10.0C22.0) serum free T32.5 pmol/L (3.0C7.0) What is...

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What is the probability of resolution of thyrotoxicosis with this dose?

March 10, 2021PdfprepSENDSEND exam questions, SEND practice exam, Specialty Certificate Examinations

A 39-year-old woman with Graves’ disease was considered suitable for treatment with radioiodine. She was keen that her thyrotoxicosis should not recur. The plan was to request a 600 MBq dose. What is the probability...

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What is the lifetime risk of her identical twin sister also developing type 2 diabetes mellitus?

March 9, 2021PdfprepSENDSEND exam questions, SEND practice exam, Specialty Certificate Examinations

A 52-year-old woman had been found to have type 2 diabetes mellitus approximately 6 months previously. Investigations: haemoglobin A1c50 mmol/mol (20C42) What is the lifetime risk of her identical twin sister also developing type 2...

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What is the most appropriate step in management?

March 8, 2021PdfprepSENDSEND exam questions, SEND practice exam, Specialty Certificate Examinations

A 57-year-old man was admitted to hospital with joint pains. He was found to have gout. He had been found to have type 2 diabetes mellitus at the age of 47 years and developed nephropathy...

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What is the most appropriate next step in management?

March 6, 2021PdfprepSENDSEND exam questions, SEND practice exam, Specialty Certificate Examinations

A 26-year-old woman was recovering from diabetic ketoacidosis and had been switched to her usual basal bolus insulin regimen. Her capillary blood glucose measurements during the day were high but fasting plasma glucose was in...

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What is the most appropriate advice to give to the surgical team about perioperative management?

March 5, 2021PdfprepSENDSEND exam questions, SEND practice exam, Specialty Certificate Examinations

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...

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serum creatinine115 ?

March 4, 2021PdfprepSENDSEND exam questions, SEND practice exam, Specialty Certificate Examinations

A 66-year-old woman was admitted with carpopedal spasm. During the previous week she had had 2 days of diarrhoea following treatment with ciprofloxacin for a urinary tract infection. She had long-standing rheumatoid arthritis treated with...

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24-h urinary free cortisol (?

March 4, 2021PdfprepSENDSEND exam questions, SEND practice exam, Specialty Certificate Examinations

A 48-year-old woman presented with a 2-year history of weight gain, easy bruising and mood disturbance. Investigations: fasting plasma glucose6.9 mmol/L (3.0C6.0) low-dose dexamethasone suppression test (2 mg/day for 48 h): serum cortisol200 nmol/L (<50)...

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