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SEND - Endocrinology and Diabetes (Specialty Certificate Examination)
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SEND - Endocrinology and Diabetes (Specialty Certificate Examination) Practice Questions

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SEND - Endocrinology and Diabetes (Specialty Certificate Examination) Questions and Answers

Questions 1

A 54-year-old man was referred from the urology department with erectile dysfunction.

On examination, he had normal secondary sexual characteristics. Testicular volume was estimated at 15 mL bilaterally.


random plasma glucose8.0 mmol/L

serum testosterone8.1 nmol/L (9.0–35.0)

plasma follicle-stimulating hormone3.4 U/L (1.0–7.0)

plasma luteinising hormone4.7 U/L (1.0–10.0)

serum prolactin410 mU/L (<360)

What is the most appropriate next step in management?



check for macroprolactinaemia


fasting plasma glucose


prescribe sildenafil


prescribe testosterone replacement


serum testosterone (09.00 h)

Questions 2

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.


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?



captopril diethylene triamine pentacaetic acid (DTPA) scan


lower limb angiography


mercaptoacetyltriglycine (MAG3) renography


MR angiography of renal arteries


renal ultrasound scan with Doppler studies

Questions 3

A 61-year-old woman was found incidentally to have a raised serum calcium concentration. She was otherwise well. Her father had undergone a neck operation many years previously.


serum corrected calcium2.78 mmol/L (2.20–2.60)

plasma parathyroid hormone10.8 pmol/L (0.9–5.4)

Her general practitioner thought she had primary hyperparathyroidism.

Which further finding is most likely to cast doubt upon this diagnosis?



high serum 25-OH-cholecalciferol


low serum magnesium concentration


low urinary calcium excretion


normal parathyroid radioisotope scan (sestamibi scan)


normal serum phosphate concentration