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Updated: Sep 08, 2025
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MRCPUK Endocrinology and Diabetes (Specialty Certificate Examination) Sample Questions:
1. A 40-year-old man presented with a 4-month history of increasing central obesity. His medical history included HIV infection and allergic rhinitis. He was taking highly active antiretroviral therapy and nasal fluticasone.
On examination, he had marked central adiposity. His blood pressure was 160/95 mmHg.
Investigations:
serum sodium140 mmol/L (137-144)
serum potassium3.8 mmol/L (3.5-4.9)
serum cholesterol5.5 mmol/L (<5.2)
fasting serum triglycerides8.20 mmol/L (0.45-1.69)
serum cortisol (09.00 h)<50 nmol/L (200-700)
serum thyroid-stimulating hormone4.6 mU/L (0.4-5.0)
serum free T49.3 pmol/L (10.0-22.0)
What is the most likely diagnosis?
A) Addison's disease
B) glucocorticoid resistance
C) Cushing's syndrome
D) hypothyroidism
E) HIV-associated lipodystrophy
2. A 73-year-old man with type 2 diabetes mellitus was referred to the outpatient clinic. He had a history of microalbuminuria and hypertension. He was taking ramipril, amlodipine and metformin.
On examination, his blood pressure was 125/75 mmHg.
Investigations:
haemoglobin A1c57 mmol/mol (20-42)
What additional drug is most likely to prevent glomerular filtration rate decline?
A) aspirin
B) aliskiren
C) simvastatin
D) linagliptin
E) losartan
3. A 34-year-old man was referred to the diabetes outpatient clinic with impaired glucose tolerance. He had a family history of diabetes mellitus and had a body mass index of 34.6 kg/m2 (18-25).
On examination, his blood pressure was 140/82 mmHg.
He wished to delay the onset of frank diabetes mellitus.
What is the most effective way of achieving this outcome?
A) acarbose
B) orlistat
C) lifestyle changes aimed at weight loss
D) metformin
E) ramipril
4. A 67-year-old man underwent an isotope bone scan after being found to have a raised serum alkaline phosphatase (of bone origin). The blood test had been ordered because of mild lower back pain, which had now resolved. He was not taking any medication.
Examination was normal.
Investigations:
isotope bone scansee image
What is the most likely diagnosis?
A) osteomalacia
B) fibrous dysplasia
C) Paget's disease
D) multiple myeloma
E) prostate cancer
5. A 20-year-old woman with Turner's syndrome had heard that there was a risk of ovarian cancer associated with Turner's syndrome. She asked to undergo a pre-emptive oophorectomy.
For what genotype is oophorectomy most likely to be recommended?
A) 45XO
B) 45X/46Xxi (Xq)
C) 45X/47XXX
D) 45X/46XY
E) 45X/46XX
Solutions:
| Question # 1 Answer: C | Question # 2 Answer: C | Question # 3 Answer: C | Question # 4 Answer: C | Question # 5 Answer: D |
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