Targeted learning

Based on the research results of the examination questions over the years, the experts give more detailed explanations of the contents of the frequently examined contents and difficult-to-understand contents, and made appropriate simplifications for infrequently examined contents. SEND test questions make it possible for students to focus on the important content which greatly shortens the students’ learning time. With SEND exam torrent, you will no longer learn blindly but in a targeted way. With SEND exam guide, you only need to spend 20-30 hours to study and you can successfully pass the exam. You will no longer worry about your exam because of bad study materials. If you decide to choose and practice our SEND test questions, our life will be even more exciting.

Some candidates may considerate whether the SEND exam guide is profession, but it can be sure that the contents of our study materials are compiled by industry experts after them refining the contents of textbooks, they have good knowledge of exam. SEND test questions also has an automatic scoring function, giving you an objective rating after you take a mock exam to let you know your true level. At the same time, SEND exam torrent will also help you count the type of the wrong question, so that you will be more targeted in the later exercises and help you achieve a real improvement. SEND exam guide will be the most professional and dedicated tutor you have ever met, you can download and use it with complete confidence.

DOWNLOAD DEMO

Very comprehensive contents

The contents of SEND test questions are compiled strictly according to the content of the exam. The purpose of our preparation of our study materials is to allow the students to pass the exam smoothly. SEND test questions are not only targeted but also very comprehensive. Although experts simplify the contents of the textbook to a great extent in order to make it easier for students to learn, there is no doubt that SEND exam guide must include all the contents that the examination may involve. We also hired a dedicated staff to constantly update SEND exam torrent. With SEND exam guide, you do not need to spend money on buying any other materials. During your preparation, SEND exam torrent will accompany you to the end.

Simulate the real test environment

SEND test questions have a mock examination system with a timing function, which provides you with the same examination environment as the real exam. Although some of the hard copy materials contain mock examination papers, they do not have the automatic timekeeping system. Therefore, it is difficult for them to bring the students into a real test state. With SEND exam guide, you can perform the same computer operations as the real exam, completely taking you into the state of the actual exam, which will help you to predict the problems that may occur during the exam, and let you familiarize yourself with the exam operation in advance and avoid rushing during exams.

MRCPUK SEND Exam Syllabus Topics:

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

1. A 42-year-old woman, with type 1 diabetes mellitus of 22 years' duration, attended for annual review. She was using biphasic insulin twice daily and taking aspirin 75 mg, simvastatin 40 mg and ramipril 10 mg daily.
On examination, her blood pressure was 164/87 mmHg.
Investigations:
serum potassium5.9 mmol/L (3.5-4.9)
serum creatinine197 umol/L (60-110)
estimated glomerular filtration rate (MDRD)26 mL/min/1.73 m2 (>60)
haemoglobin A1c72 mmol/mol (20-42)
urinary albumin:creatinine ratio27.0 mg/mmol (<3.5)
urine culturenegative
What is the most important next step in management?

A) check bicarbonate
B) change to intensive insulin regimen
C) add aliskiren
D) refer to a nephrologist
E) add furosemide

2. A 52-year-old man had been found to have type 1 diabetes mellitus at the age of 25. He had developed retinopathy at the age of 31 and a painless foot ulcer at the age of 40. His renal function had subsequently deteriorated.
On examination, urinalysis showed protein 1+, glucose 2+.
What is the most likely diagnosis?

A) nodular glomerulosclerosis
B) minimal change glomerulonephritis
C) tubulointerstitial nephritis
D) focal segmental glomerulosclerosis
E) membranoproliferative glomerulonephritis

3. A 32-year-old woman presented at 34 weeks of pregnancy, after an episode of vaginal bleeding. Gestational diabetes had been diagnosed at 28 weeks and insulin was started at 29 weeks. Her pre-pregnancy body mass index was 32 kg/m2 (18-25) and there was no family history of diabetes. She was treated with betamethasone 12 mg over 2 days. She was taking 60 units of insulin subcutaneously daily (40 units prandial in three divided doses, and 20 units intermediate-acting insulin), which had been unchanged for 3 weeks.
On examination, she was apyrexial, her pulse was 96 beats per minute and her blood pressure was 124/74 mmHg. Urinalysis showed blood 1+, protein 1+, glucose 2+, ketones 3+.
Investigations:
serum sodium134 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 umol/L (60-110) random plasma glucose7.2 mmol/L
What is the most appropriate next step in management?

A) measure venous bicarbonate
B) continue to monitor blood glucose in hospital
C) increase subcutaneous insulin doses by 2-4 units
D) start intravenous insulin
E) discharge and monitor blood glucose at home

4. A 64-year-old man presented with palpitations, fatigue and malaise. Two months previously, he had sustained an acute myocardial infarction complicated by ventricular tachycardia and cardiac arrest, and had been discharged taking amiodarone 200 mg daily.
On examination, he appeared well, his pulse was 90 beats per minute and regular, and he
had mild tremor of his hands but no other abnormal signs.
Investigations:
serum thyroid-stimulating hormone6.2 mU/L (0.4-5.0)
serum free T418.2 pmol/L (10.0-22.0)
serum free T34.8 pmol/L (3.0-7.0)
What is the most appropriate next step in management?

A) repeat thyroid function tests in 12 months
B) start levothyroxine
C) repeat thyroid function tests in 2 months
D) isotope scan of thyroid
E) discontinue amiodarone

5. A 30-year-old man was reviewed in the diabetes clinic. He had type 1 diabetes mellitus of 6 months' duration, treated with subcutaneous insulin in a basal bolus regimen (short-acting insulin three times daily; long-acting insulin once daily).
Investigations:
haemoglobin A1c52 mmol/mol (20-42)
At what arterialised venous blood glucose threshold would a patient typically expect to develop neuroglycopenic symptoms?

A) 3.1-3.4 mmol/L
B) <2.3 mmol/L
C) 3.5-3.9 mmol/L
D) 2.3-2.6 mmol/L
E) 2.7-3.0 mmol/L

Solutions: