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The clients only need 20-30 hours to learn the SEND exam questions: Endocrinology and Diabetes (Specialty Certificate Examination) and prepare for the test. Many people may complain that we have to prepare for the test but on the other side they have to spend most of their time on their most important things such as their jobs, learning and families. But if you buy our SEND study guide you can both do your most important thing well and pass the test easily because the preparation for the test costs you little time and energy.

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Many clients worry that after they our SEND exam simulation they may fail in the test and waste their money and energy. There are no needs to worry about that situation because our study materials boost high passing rate and hit rate and the possibility to fail in the SEND test is very little. But if there is someone unfortunately to fail in the test with our study materials we will refund them immediately in full at one time. The procedures of the refund are simple and the clients only need to provide the proof to prove that they have failed the SEND test and show us the pictures, scanning copies or the screenshot of the failure score. Then we will refund them immediately and they will get their money to buy our SEND exam questions: Endocrinology and Diabetes (Specialty Certificate Examination) back. In the course of refund if the clients have any problems they could contact our online customer service personnel or contact us by the mails. We will reply their questions sincerely and help them solve their problems at any time. We provide the best SEND study guide and hope our sincere service will satisfy all the clients.

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

1. 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) linagliptin
B) aliskiren
C) losartan
D) simvastatin
E) aspirin

2. A 73-year-old man with type 2 diabetes mellitus was reviewed because of deteriorating
blood glucose control. He was taking metformin 850 mg twice daily.
On examination, his body mass index was 29 kg/m2 (18-25).
Investigations:
serum creatinine102 umol/L (60-110)
haemoglobin A1c66 mmol/mol (20-42)
According to the NICE guidelines (CG87, May 2009), what would be the most appropriate
additional treatment?

A) sulfonylurea
B) insulin glargine
C) sitagliptin
D) thiazolidinedione
E) exenatide

3. A 58-year-old man presented with tiredness and breathlessness. He had been treated for type 2 diabetes mellitus and hypertension for the past 10 years. He was free of complications. His current medication included ramipril 10 mg daily, rosuvastatin 10 mg daily, metformin 500 mg three times daily, dapagliflozin 10 mg once daily and exenatide 10 micrograms twice daily.
On examination, his body mass index was 36 kg/m2 (18-25).
Investigations:
haemoglobin93 g/L (130-180)
MCV110 fL (80-96)
white cell count3.6 ? 109/L (4.0-11.0)
platelet count140 ? 109/L (150-400)
reticulocyte count0.5% (0.5-2.4)
serum ferritin250 ug/L (15-300)
serum vitamin B1240 ng/L (160-760)
serum folate3.0 ug/L (2.0-11.0)
Which medication is most likely to be contributing to his anaemia?

A) metformin
B) dapagliflozin
C) ramipril
D) exenatide
E) rosuvastatin

4. 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) 45X/46XX
B) 45XO
C) 45X/47XXX
D) 45X/46Xxi (Xq)
E) 45X/46XY

5. Five patients were referred to a rapid access thyroid clinic. Only four slots were available in the following month.
Which patient can safely be deferred to a later clinic?

A) 39-year-old woman with a slowly growing thyroid lump and a palpable cervical lymph node
B) 44-year-old woman with a history of sudden-onset pain in a thyroid lump
C) 16-year-old boy with a thyroid nodule
D) 45-year-old woman with a rapidly enlarging painless goitre
E) 67-year-old man with a goitre and hoarseness

Solutions: