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QUESTION NO: 1
An 18-year-old woman presented with a 2-month history of polyuria and polydipsia. She had been previously fit and well with regular periods. She was not taking any contraception.
Investigations:
serum potassium5.2 mmol/L (3.5-4.9)
serum corrected calcium2.30 mmol/L (2.20-2.60)
serum cortisol (09.00 h)350 nmol/L (200-700)
She went on to have a water deprivation test, the results of which are detailed below.
time (h)serum osmolality (mosmol/kg)urine osmolality (mosmol/kg) normal: 278-300normal: 100-
1000 08.3028952 11.3029282 14.30301153 15.30-172
She was then given intramuscular DDAVP@ 2 micrograms at 16.00 h.
time (h)serum osmolality (mosmol/kg)urine osmolality (mosmol/kg) normal: 278-300normal: 100-
1000 16.3030017.30-530 18.30-532
Results from an MR scan of pituitary are shown (see image).
What is the most likely diagnosis?
A. autoimmune (lymphocytic) hypophysitis
B. craniopharyngioma
C. non-functioning pituitary adenoma
D. psychogenic polydipsia
E. Rathke's cleft cyst
Answer: A
QUESTION NO: 2
A 43-year-old man was in an ENT ward, having recently undergone removal of a carotid body tumour.
Five years previously, he had undergone a similar procedure in another hospital. He also recalled that his brother had undergone surgery for a similar condition, and that his father, who had since died, might also have had neck surgery.
The ENT surgeons were concerned that there might be an underlying genetic diagnosis.
What is the most likely diagnosis?
A. multiple endocrine neoplasia type 2
B. neurofibromatosis type 1
C. succinate dehydrogenase A deficiency
D. succinate dehydrogenase D deficiency
E. von Hippel-Lindau disease
Answer: D
QUESTION NO: 3
A 33-year-old woman was reviewed in the insulin pump clinic. She had had type 1 diabetes mellitus for 10 years. She had been treated with a continuous subcutaneous insulin infusion 3 years previously, because of frequent hypoglycaemic episodes. She had recently undergone continuous glucose monitoring (see image).
Investigations:
haemoglobin A1c43 mmol/mol (20-42)
What is the most likely cause of the blood glucose trace seen between 08.00 h and 10.00 h?
A. blocked infusion set
B. dawn phenomenon
C. inadequate basal insulin rate
D. inadequate mealtime insulin bolus
E. overcorrection of hypoglycaemia
Answer: D
QUESTION NO: 4
A 37-year-old man, who had previously undergone female-to-male gender reassignment surgery, attended the endocrine clinic for annual review. He had no complaints and was happy with the results of his treatment. His medication consisted of testosterone undecanoate 1 g intramuscularly every 3 months.
What variable is it most important to monitor?
A. fasting plasma glucose
B. haematocrit
C. serum luteinising hormone
D. serum prostate-specific antigen
E. serum testosterone
Answer: B
QUESTION NO: 5
A 32-year-old woman with a recurrent history of Graves' thyrotoxicosis was being considered for radioiodine treatment. However, she wanted to conceive again at some stage and asked how soon she could become pregnant.
After what minimum interval would it be safe for her to conceive again?
A. 2 months
B. 4 months
C. 6 months
D. 8 months
E. 12 months
Answer: C
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Updated: May 27, 2022