Free SEND Exam Braindumps
SEND - Endocrinology and Diabetes (Specialty Certificate Examination) Questions 11–15 (page: 4)

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 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?

A 59-year-old man with an 8-year history of type 2 diabetes mellitus was seen in the outpatient clinic. He had worsening renal function in the absence of microalbuminuria.
On examination, his blood pressure was 175/90 mmHg. He had a femoral bruit, and absent dorsalis pedis pulses bilaterally.

Investigations:
-serum creatinine150 µmol/L (60–110)
-estimated glomerular filtration rate (MDRD)39 mL/min/1.73m2 (>60)

In addition to addressing his blood pressure, what is the most appropriate next investigation?

A 32-year-old man presented with persistent thirst. He had a past history of polydactyly, which had been corrected surgically in infancy. His family had remarked about his recent weight gain. His only concern was of blurring of vision and difficulty reading. His father and paternal grandfather had each developed type 2 diabetes mellitus when aged 41 and 56 years, respectively.
His body mass index was 34 kg/m2 (18–25). Urinalysis showed glucose 2+, ketones 1+.

Investigations:
serum sodium142 mmol/L (137–144) serum potassium3.8 mmol/L (3.5–4.9) serum chloride105 mmol/L (95–107) serum urea5.0 mmol/L (2.5–7.0) serum creatinine90 µmol/L (60–110) haemoglobin A1c91 mmol/mol (20–42) random plasma glucose11.3 mmol/L ultrasound scan of kidneysnormal

What is the most likely underlying diagnosis?

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 (3.0–6.0)
low-dose dexamethasone suppression test (2 mg/day for 48 h): serum cortisol200 nmol/L (<50)
24-h urinary free cortisol (?3)670, 400 and 300 nmol (55–250) plasma adrenocorticotropic hormone (09.00 h)25.0 pmol/L (3.3–15.4) MR scan of pituitarynormal

What test is most likely to give a definitive diagnosis?