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Free MRCPUK SEND Exam Braindumps (page: 4)

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200 Questions & Answers
Page 4 of 51

A 76-year-old man with a 17-year history of type 2 diabetes mellitus attended for his annual review. Comparison of his retinal screening report with the previous year’s report showed that his visual acuity was unchanged at 6/9 in both eyes. The previous year’s right eye retinal image had been reported as ‘pre- proliferative retinopathy’, whereas this year’s was reported as ‘pre-proliferative retinopathy with maculopathy’. What is the most appropriate next step?

  1. routine referral to an ophthalmologist
  2. routine re-screen in 6 months
  3. routine re-screen in 12 months
  4. urgent referral to an ophthalmologist within 2 weeks
  5. urgent re-screen within 2 weeks

Answer(s): A



A 32-year-old woman presented to the outpatient clinic with a 1-year history of amenorrhoea that began after stopping her oral contraceptive pill. She had previously had two successful pregnancies and was otherwise well. Examination was normal and no visual field defect was present on testing to confrontation.

Investigations:
-serum sodium138 mmol/L (137–144) serum potassium3.8 mmol/L (3.5–4.9)
-plasma follicle-stimulating hormone2.0 U/L (2.5–10.0) plasma luteinising hormone2.0 U/L (2.5–10.0)
-serum prolactin1050 mU/L (<360) MR scan of pituitarysee image



What is the most appropriate treatment?

  1. bromocriptine
  2. cabergoline
  3. octreotide
  4. pituitary surgery
  5. stereotactic pituitary radiosurgery

Answer(s): D



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?

  1. biochemical screening
  2. CT scan of adrenal glands
  3. MIBG scanning
  4. MR scan of adrenal glands
  5. octreotide scanning

Answer(s): A



A 46-year-old Afro-Caribbean man with sarcoidosis was found to have hypercalcaemia and was treated with prednisolone 20 mg/day. Within 3 weeks his serum calcium had fallen to within the reference range.
How do glucocorticoids reduce serum calcium in sarcoidosis?

  1. direct calcium shift into cells
  2. increase intravascular fluid volume
  3. promote urinary calcium excretion
  4. reduces extrarenal 1-?-hydroxylase activity
  5. suppress parathyroid hormone secretion

Answer(s): D






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