MRCPUK SEND : Endocrinology and Diabetes (Specialty Certificate Examination)

  • Exam Code: SEND
  • Exam Name: Endocrinology and Diabetes (Specialty Certificate Examination)
  • Updated: Sep 21, 2026
  • Q & A: 200 Questions and Answers

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MRCPUK SEND Exam Syllabus Topics:

SectionObjectives
Diabetes Mellitus- Management
  • 1. Oral and injectable therapies
  • 2. Insulin therapy
  • 3. Lifestyle interventions
  • 4. Technology and glucose monitoring
- Diagnosis and Classification
  • 1. Type 1 diabetes
  • 2. Type 2 diabetes
  • 3. Other specific types of diabetes
  • 4. Gestational diabetes
- Complications
  • 1. Perioperative and inpatient diabetes management
  • 2. Microvascular complications
  • 3. Acute metabolic emergencies
  • 4. Macrovascular complications
Adrenal Disorders- Adrenal Disease
  • 1. Cushing syndrome
  • 2. Adrenal insufficiency
  • 3. Primary aldosteronism
  • 4. Pheochromocytoma and adrenal incidentaloma
Thyroid Disorders- Thyroid Disease
  • 1. Hypothyroidism
  • 2. Hyperthyroidism
  • 3. Thyroid nodules and cancer
  • 4. Thyroiditis and special clinical situations
Pituitary and Hypothalamic Disorders- Pituitary Disease
  • 1. Pituitary hormone deficiency
  • 2. Pituitary tumors
  • 3. Hypothalamic disorders
  • 4. Pituitary hormone excess
General Endocrinology- Integrated Clinical Practice
  • 1. Endocrine hypertension
  • 2. Neuroendocrine disorders
  • 3. Investigation, imaging and interpretation of endocrine tests
  • 4. Genetic endocrine syndromes
Reproductive Endocrinology- Gonadal Disorders
  • 1. Male hypogonadism
  • 2. Polycystic ovary syndrome
  • 3. Female reproductive endocrinology
  • 4. Disorders of puberty and fertility
Calcium and Bone Metabolism- Parathyroid and Metabolic Bone Disease
  • 1. Hypoparathyroidism
  • 2. Osteoporosis
  • 3. Hyperparathyroidism
  • 4. Disorders of calcium, phosphate and vitamin D metabolism

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

Question #1

A 62-year-old woman was referred with difficulty in swallowing and a painful, swollen neck.
On examination, her neck was tender to palpation with a small, diffuse goitre. There was no
associated neck lymphadenopathy.
Investigations:
serum thyroid-stimulating hormone<0.04 mU/L (0.4-5.0)
serum free T426.0 pmol/L (10.0-22.0)
serum free T312.0 pmol/L (3.0-7.0)
What is the most likely diagnosis?

  • A. toxic adenoma
  • B. Graves' disease
  • C. thyroid carcinoma
  • D. haemorrhage into a thyroid cyst
  • E. subacute thyroiditis
Reveal Solution  Discussion  0

Correct Answer: E  🗳️

Question #2

A 28-year-old man was seen in the lipid clinic following a referral from the general surgical team. He had had two episodes of acute pancreatitis over the preceding 6 months, which settled spontaneously. He had a past medical history of HIV disease and was taking highly active antiretroviral (HAART) therapy. He drank 12 units of alcohol per week.
On examination, he had no stigmata of hyperlipidaemia.
Investigations:
fasting plasma glucose6.2 mmol/L (3.0-6.0)
haemoglobin A1c44 mmol/mol (20-42)
serum cholesterol7.5 mmol/L (<5.2)
fasting serum triglycerides23.70 mmol/L (0.45-1.69)
serum thyroid-stimulating hormone0.7 mU/L (0.4-5.0)
serum free T414.3 pmol/L (10.0-22.0)
What class of antiretroviral drug is the most likely cause of his metabolic disturbance?

  • A. protease inhibitors (e.g. ritonavir)
  • B. non-nucleoside reverse transcriptase inhibitors (e.g. nevirapine)
  • C. nucleoside reverse transcriptase inhibitors (e.g. zidovudine)
  • D. entry inhibitors (e.g. enfuvirtide)
  • E. integrase inhibitors (e.g. raltegravir)
Reveal Solution  Discussion  0

Correct Answer: A  🗳️

Question #3

A 27-year-old woman with type 1 diabetes mellitus was invited to attend a structured education (e.g. DAFNE) coursE.
Which quality of life domain is most affected when a person is found to have type 1 diabetes mellitus?

  • A. sex life
  • B. enjoyment of leisure activities
  • C. working life and work-related opportunities
  • D. freedom to eat as one wishes
  • E. family life
Reveal Solution  Discussion  0

Correct Answer: D  🗳️

Question #4

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

Correct Answer: C  🗳️

Question #5

A 27-year-old woman presented with oligomenorrhoea and hirsutism, and a 2-year history of infertility. Her body mass index was 26 kg/m2 (18-25). Her partner had a recent normal sperm count and motility test.
Investigations:
serum androstenedione17.0 nmol/L (0.6-8.8)
serum 17-hydroxyprogesterone2 nmol/L (1-10)
serum testosterone2.8 nmol/L (0.5-3.0)
serum sex hormone binding globulin18 nmol/L (40-137)
serum follicle-stimulating hormone2.3 U/L (2.5-10.0)
serum luteinising hormone8.3 U/L (2.5-10.0)
serum prolactin152 mU/L (<360)
A diagnosis of polycystic ovary syndrome was made.
What is the most effective next step to help her conceive?

  • A. orlistat
  • B. in vitro fertilisation
  • C. diet and exercise
  • D. clomifene
  • E. metformin
Reveal Solution  Discussion  0

Correct Answer: D  🗳️

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