Having a good command of professional knowledge will do a great help to your life. With the advent of knowledge times, we all need some professional certificates such as MRCPUK to prove ourselves in different working or learning condition. So making right decision of choosing useful practice materials is of vital importance. Here we would like to introduce our SEND practice materials for you with our heartfelt sincerity. With passing rate more than 98 percent from exam candidates who chose our SEND study guide, we have full confidence that your SEND actual test will be a piece of cake by them.

DOWNLOAD DEMO

Considerate Service

We think of providing the best services as our obligation. So we have patient colleagues offering help 24/7 and solve your problems about SEND practice materials all the way. We have considerate services as long as you need us. Besides, to fail while trying hard is no dishonor. If you fail the exam with our SEND study guide unfortunately, we will switch other versions or give your full money back assuming that you fail this time, and prove it with failure document. Do not underestimate your ability, we will be your strongest backup while you are trying with our SEND actual tests.

Efficiency in different aspects

To go with the changing neighborhood, we need to improve our efficiency of solving problems, which reflects in many aspect as well as dealing with exams. Our SEND practice materials can help you realize it. To those time-sensitive exam candidates, our high-efficient SEND actual tests comprised of important news will be best help. Only by practicing them on a regular base, you will see clear progress happened on you. Besides, rather than waiting for the gain of our SEND practice materials, you can download them immediately after paying for it, so just begin your journey toward success now.

Whole Package of Services

Our company conducts our business very well rather than unprincipled company which just cuts and pastes content from others and sell them to exam candidates. By virtue of our SEND practice materials, many customers get comfortable experiences of Whole Package of Services and of course passing the SEND study guide successfully. As to some exam candidate are desperately eager for useful SEND actual tests, our products help you and other customer who are having an acute shortage of efficient practice materials.

Accessible content

To assimilate those useful knowledge better, many customers eager to have some kinds of practice materials worth practicing. All content is clear and easily understood in our SEND practice materials. They are accessible with reasonable prices and various versions for your option. All content are in compliance with regulations of the exam. As long as you are determined to succeed, our SEND study guide will be your best reliance

Professional Team

To make sure your situation of passing the certificate efficiently, our SEND practice materials are compiled by first-rank experts. So the proficiency of our team is unquestionable. They help you review and stay on track without wasting your precious time on useless things. They handpicked what the SEND study guide usually tested in exam recent years and devoted their knowledge accumulated into these SEND actual tests. We are on the same team, and it is our common wish to help your realize it. So good luck!

MRCPUK Endocrinology and Diabetes (Specialty Certificate Examination) Sample Questions:

1. A 63-year-old woman was incidentally found to have a 3-cm right adrenal mass on a CT scan of abdomen during investigation for abdominal pain. Her medical history included angina, hypertension and hypercholesterolaemia. She was taking oestrogen-containing hormone replacement therapy, atenolol, bendroflumethiazide, simvastatin and aspirin.
On examination, her pulse was 60 beats per minute and regular, and her blood pressure was 150/90 mmHg. She was obese with a body mass index of 34 kg/m2 (18-25). Fundoscopy revealed grade II hypertensive retinopathy.
Investigations:
serum sodium137 mmol/L (137-144)
serum potassium3.0 mmol/L (3.5-4.9)
serum creatinine100 umol/L (60-110)
plasma renin activity (after 30 min supine)0.4 pmol/mL/h (1.1-2.7)
plasma aldosterone (after 30 min supine)200 pmol/L (135-400)
overnight dexamethasone suppression test (after 1 mg dexamethasone):
serum cortisol75 nmol/L (<50)
24-h urinary free cortisol140 nmol (55-250)
24-h urinary metanephrine<1 umol (<2)
24-h urinary normetanephrine1 umol (<3)
What is the most likely cause of the hypertension?

A) renovascular disease
B) phaeochromocytoma
C) Cushing's syndrome
D) Conn's syndrome
E) essential hypertension

2. A 33-year-old man was referred to the diabetes clinic with an 8-month history of weight loss and polydipsia. Two months previously his general practitioner had found a high fasting plasma glucose concentration of 17.5 mmol/L (3.0-6.0) and a haemoglobin A1c of 116 mmol/mol (20-42). The patient was taking metformin 1 g twice daily. He reported in the diabetes clinic that his home capillary blood glucose concentrations persisted to be high, ranging between 15-24 mmol/L.
On examination, his body mass index was 23 kg/m2 (18-25).
His blood tests were repeated in the diabetes clinic and he was treated with a basal bolus insulin regimen. Urinalysis was negative for ketones.
Investigations (in diabetes clinic):
haemoglobin A1c110 mmol/mol (20-42)
serum C-peptide200 pmol/L (180-360)
anti-glutamic acid decarboxylase (GAD)
antibodies69 IU/mL (<10)
anti-IA2 antibodiesnegative
What is the most likely diagnosis?

A) latent autoimmune diabetes in adults
B) haemochromatosis
C) type 1 diabetes mellitus
D) mitochondrial diabetes mellitus
E) maturity-onset diabetes of the young

3. 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?

A) pituitary surgery
B) bromocriptine
C) cabergoline
D) octreotide
E) stereotactic pituitary radiosurgery

4. A 34-year-old woman with a 21-year history of type 1 diabetes mellitus had started treatment with subcutaneous insulin pump therapy 18 months previously. Her haemoglobin A1c before starting pump therapy was 77 mmol/mol (20-42) and she had experienced severe hypoglycaemic events without warning symptoms over the previous 4 years.
At review in clinic, she reported continuing episodes of severe hypoglycaemia without warning symptoms despite regular monitoring and advice from her insulin pump nurse specialist.
On examination, her blood pressure was 134/80 mmHg and fundoscopy revealed moderate background diabetic retinopathy. Examination of the feet revealed strong, palpable pedal pulses and early evidence of sensory neuropathy.
Investigations:
estimated glomerular filtration rate (MDRD)24 mL/min/1.73 m2 (>60)
haemoglobin A1c56 mmol/mol (20-42)
24-h urinary total protein2.3 g (<0.2)
What is the most appropriate next step in management?

A) refer for allogeneic pancreatic islet cell transplantation
B) refer for continuous glucose monitoring
C) change to intensified subcutaneous insulin injections
D) refer for combined pancreas and kidney transplantation
E) refer for allogeneic pancreas transplantation

5. A 64-year-old man was referred to the foot clinic. He had tripped over his cat 1 week previously and had complained of an ache in his left foot since then. He had a 12-year history of type 2 diabetes mellitus and hypertension. He was taking metformin, gliclazide, pioglitazone, bendroflumethiazide, ramipril, simvastatin and aspirin.
On examination, his blood pressure was 154/88 mmHg. Foot examination showed absent vibration perception to his ankle. The dorsalis pedis and posterior tibial pulses were easily palpable on both feet.
Investigations:
serum urea12.6 mmol/L (2.5-7.0) serum creatinine166 umol/L (60-110) haemoglobin A1c79 mmol/mol (20-42)
urinary albumin:creatinine ratio8.7 mg/mmol (<2.5)
X-ray of left footsee image

What is the most appropriate initial management for this deformity?

A) bed rest
B) custom-made hospital footwear
C) removable aircast boot
D) full contact plaster cast
E) referral for urgent surgery

Solutions: