MRCPUK SEND real exam prep : Endocrinology and Diabetes (Specialty Certificate Examination)

  • Exam Code: SEND
  • Exam Name: Endocrinology and Diabetes (Specialty Certificate Examination)
  • Updated: Nov 01, 2026
  • Q&As: 200 Questions and Answers

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About MRCPUK SEND Real Exam

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MRCPUK SEND Exam Syllabus Topics:

SectionWeightObjectives
Pituitary and Hypothalamic Disorders15%- Diabetes insipidus and SIADH
- Hypothalamic dysfunction
- Hypopituitarism and hormone replacement
- Pituitary adenomas: prolactinoma, acromegaly, Cushing's disease
Diabetes Mellitus40%- Type 1 Diabetes
  • 1. Acute complications: DKA, hypoglycaemia
    • 2. Long-term microvascular/macrovascular complications
      • 3. Pathogenesis and natural history
        • 4. Insulin therapy and delivery systems
          - Other forms of diabetes
          • 1. Monogenic diabetes
            • 2. Pancreatic/endocrine-induced diabetes
              - Type 2 Diabetes
              • 1. Epidemiology and risk factors
                • 2. Oral and injectable non-insulin therapies
                  • 3. Gestational diabetes
                    • 4. Cardiovascular risk management
                      Adrenal and Parathyroid/Metabolic Bone Disorders15%- Osteoporosis, osteomalacia, Paget's disease
                      - Hyperparathyroidism, hypoparathyroidism
                      - Primary/secondary hyperaldosteronism
                      - Cushing's syndrome, Addison's disease, phaeochromocytoma
                      Reproductive and Other Endocrine Conditions15%- Endocrine hypertension and rare syndromes
                      - Polycystic ovary syndrome
                      - Disorders of puberty and sex development
                      - Obesity and lipid disorders
                      Thyroid Disorders15%- Hyperthyroidism: Graves’ disease, toxic nodular disease
                      - Thyroiditis and subclinical dysfunction
                      - Hypothyroidism and myxoedema coma
                      - Thyroid nodules and cancer

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

                      Question #1

                      A 24-year-old woman was referred with an 18-month history of worsening hirsutism, primarily on her face, but also new hair growth on her chest. She was shaving weekly. She had always been overweight, but had recently gained 5 kg and her body mass index was 31 kg/m2 (18-25). Her periods were regular.
                      What is the most relevant next investigation?

                      • A. overnight dexamethasone suppression test (after 1 mg dexamethasone)
                      • B. plasma thyroid-stimulating hormone
                      • C. serum dehydroepiandrosterone
                      • D. serum testosterone
                      • E. serum 17-hydroxyprogesterone
                      Reveal Solution  Discussion  0

                      Correct Answer: D  🗳️

                      Question #2

                      A 72-year-old woman presented with a painless swelling in the front of the neck, which she had first noticed 2-3 months previously. She was otherwise well, with no symptoms of mass effect in her neck, and was not taking any medication.
                      On examination, her thyroid gland was moderately enlarged, and felt uniformly nodular. There was no associated lymphadenopathy. Her pulse was 78 beats per minute and regular, and there were no signs of thyrotoxicosis.
                      Investigations:
                      serum thyroid-stimulating hormone<0.01 mU/L (0.4-5.0)
                      serum free T424.8 pmol/L (10.0-22.0)
                      serum free T310.3 pmol/L (3.0-7.0)
                      technetium-99m scan of thyroid (20-min uptake)patchy uptake in both thyroid lobes
                      What is the most appropriate management?

                      • A. total thyroidectomy
                      • B. repeat thyroid function tests after 6 months
                      • C. partial thyroidectomy
                      • D. carbimazole plus levothyroxine
                      • E. radioiodine
                      Reveal Solution  Discussion  0

                      Correct Answer: E  🗳️

                      Question #3

                      A 17-year-old Caucasian girl presented with primary amenorrhea.
                      On examination, her body mass index was 21 kg/m2 (18-25). Her body habitus was normal and she had appropriate breast development. There was no hirsutism or acne.
                      Investigations:
                      serum oestradiol<180 pmol/L (200-400) serum testosterone31.7 nmol/L (0.5-3.0) serum follicle-stimulating hormone4.0 U/L (2.5-10.0) serum luteinising hormone6.0 U/L (2.5-10.0)
                      What is the most likely diagnosis?

                      • A. adrenocortical carcinoma
                      • B. androgen-secreting ovarian tumour
                      • C. polycystic ovary syndrome
                      • D. complete androgen insensitivity syndrome
                      • E. ovarian hyperthecosis
                      Reveal Solution  Discussion  0

                      Correct Answer: D  🗳️

                      Question #4

                      A 35-year-old man presented with newly diagnosed type 2 diabetes mellitus. He had no medical history of note.
                      When should he inform the UK Driver and Vehicle Licensing Agency (DVLA) of his medical condition?

                      • A. if he starts taking an oral hypoglycaemic agent
                      • B. immediately
                      • C. if he starts using basal night-time insulin
                      • D. if he requires laser treatment to one eye
                      • E. if he becomes unable to read a car number plate with one eye at 20.5 m
                      Reveal Solution  Discussion  0

                      Correct Answer: C  🗳️

                      Question #5

                      A 28-year-old woman presented to the emergency department with a 3-day history of abdominal pain. Her past medical history included intermenstrual bleeding, and she was undergoing 6-monthly renal ultrasound surveillance for a cystic lesion.
                      Investigations:
                      serum creatinine84 umol/L (60-110)
                      serum corrected calcium3.20 mmol/L (2.20-2.60)
                      serum phosphate0.7 mmol/L (0.8-1.4)
                      plasma parathyroid hormone19.5 pmol/L (0.9-5.4)
                      What is the most likely condition underlying the clinical presentation?

                      • A. multiple endocrine neoplasia type 1
                      • B. von Hippel-Lindau syndrome
                      • C. hyperparathyroidism-jaw tumour syndrome
                      • D. Cowden's syndrome
                      • E. multiple endocrine neoplasia type 2B
                      Reveal Solution  Discussion  0

                      Correct Answer: C  🗳️

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