Free SEND Exam Braindumps
SEND - Endocrinology and Diabetes (Specialty Certificate Examination) Questions 71–75 (page: 16)

A 58-year-old man presented with tiredness and breathlessness. He had been treated for type 2 diabetes mellitus and hypertension for the past 10 years. He was free of complications. His current medication included ramipril 10 mg daily, rosuvastatin 10 mg daily, metformin 500 mg three times daily, dapagliflozin 10 mg once daily and exenatide 10 micrograms twice daily.

On examination, his body mass index was 36 kg/m2 (18–25). Investigations:
haemoglobin93 g/L (130–180)
MCV110 fL (80–96) white cell count3.6 ? 109/L (4.0–11.0) platelet count140 ? 109/L (150–400) reticulocyte count0.5% (0.5–2.4) serum ferritin250 µg/L (15–300) serum vitamin B1240 ng/L (160–760) serum folate3.0 µg/L (2.0–11.0)

Which medication is most likely to be contributing to his anaemia?

A 52-year-old woman had been found to have type 2 diabetes mellitus approximately 6 months previously. Investigations:
haemoglobin A1c50 mmol/mol (20–42)

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

A 25-year-old woman who was 4 months pregnant presented with weight loss of 3 kg over the previous 4 weeks, associated with intermittent palpitations, tremor and feeling of warmth. She was not taking any medication.
On examination, her pulse was 100 beats per minute and regular, and her blood pressure was 130/60 mmHg. A symmetrical non-tender goitre was palpable, with an audible bruit. There was no exophthalmos.

Investigations:
-serum thyroid-stimulating hormone<0.1 mU/L (0.4–5.0) serum free T445.2 pmol/L (10.0–22.0)
-serum free T322.8 pmol/L (3.0–7.0)
-anti-thyroid stimulating hormone receptor antibodies40 U/L (<7)

What is the most appropriate treatment?

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 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?