MRCP Part 1 Endocrinology & Renal Medicine

Question 1

A patient with known type 2 diabetes presents with confusion, blood glucose 58 mmol/L, and serum osmolality 360 mOsm/kg. There is no ketoacidosis. What is the diagnosis?

Accepted Answer

Hyperosmolar hyperglycaemic state

Answer

Diabetic ketoacidosis

Answer

Lactic acidosis

Answer

Euglycaemic DKA

Question 2

Which enzyme deficiency most commonly causes congenital adrenal hyperplasia?

Accepted Answer

21-hydroxylase deficiency

Answer

11-beta-hydroxylase deficiency

Answer

17-alpha-hydroxylase deficiency

Answer

3-beta-hydroxysteroid dehydrogenase deficiency

Question 3

A patient on long-term lithium therapy presents with polyuria and polydipsia. Plasma osmolality is high but urine osmolality is low and does not concentrate after DDAVP administration. What is the diagnosis?

Accepted Answer

Nephrogenic diabetes insipidus

Answer

Central diabetes insipidus

Answer

Primary polydipsia

Answer

SIADH

Question 4

Which investigation is the gold standard for diagnosing Cushing's syndrome?

Accepted Answer

Overnight 1mg dexamethasone suppression test

Answer

Single morning cortisol

Answer

24-hour urinary free cortisol

Answer

ACTH stimulation test

Question 5

A patient is found to have a serum calcium of 2.95 mmol/L, low PTH, and high phosphate. What is the most likely diagnosis?

Accepted Answer

Hypoparathyroidism

Answer

Primary hyperparathyroidism

Answer

Sarcoidosis

Answer

Hypercalcaemia of malignancy

Question 6

Which drug used for type 2 diabetes has been shown to reduce cardiovascular death and hospitalisation for heart failure in patients with established CVD?

Accepted Answer

Empagliflozin

Answer

Glipizide

Answer

Sitagliptin

Answer

Pioglitazone