Category: Endocrinology

MRCP-0430

A young woman is concerned that she has put on weight since she was a medical student, as she now no longer finds time to exercise. She decides to try various weight loss tablets temporarily. After 2 months, she is successfully losing weight but also has trouble with increased stool frequency, difficulty in climbing stairs and getting up out of chairs. However, she has no problems walking on the flat. She also has difficulty in sleeping at the moment but puts that down to the increased frequency of headaches for the past 2 months. Which one of the following is the most likely cause of her weakness?

MRCP-0431

In which of the following is there Growth hormone deficiency (GHD)?

MRCP-0432

A 35-year-old man is referred to the clinic by his GP. He complains of lethargy and tiredness. He has recently been discharged from the hospital after being admitted to the intensive care unit following a motorbike accident. His thyroid function testing is : TSH 0.3 IU/l (0.5-4.5), Free T4 8 pmol/l (9-25), Free T3 3.1 pmol/l (3.4-7.2). Which of the following is most likely to be the diagnosis?

MRCP-0433

A 26-year-old woman is 24 weeks pregnant had a recent ultrasound that shows the foetus large for dates. She has an oral glucose tolerance test (OGTT) which was requested due to a combination of her Asian ethnicity and background of obesity. The following results are obtained: (Time (hours) : Blood glucose (mmol/l)), 0 : 9.2, 2 : 14.2. What is the most appropriate management?

MRCP-0434

A 33-year-old woman presents to the clinic with chronic fatigue. She has 3 children and a full-time job and is finding it very difficult to hold everything together. There is no significant past medical history. On examination, her BP is 145/80 mmHg and her BMI is 28. Investigations show: Hb 12.5 g/dL, WCC 6.7 x109/L, PLT 204 x109/L, Na+ 141 mmol/L, K+ 4.9 mmol/L, Creatinine 120 μmol/L, Total cholesterol 5.0 mmol/L, TSH 7.8 U/l, Free T4 10.0 pmol/l (10-22), Free T3 4.9 pmol/l (5-10). Which of the following is the most likely diagnosis?

MRCP-0435

Which of the following allows for a diagnose of diabetes mellitus?

MRCP-0436

A 24-year-old woman develops hyperthyroidism 6 weeks after delivery. On examination, she has a painless, firm enlarged thyroid gland. Which of the following statements is most correct regarding her probable diagnosis?

MRCP-0422

A 16-year-old woman presents with a 7 month history of secondary amenorrhoea and three months history of galactorrhoea. She has been otherwise well. She had menarche at the age of 12 and has otherwise had regular periods. She has been sexually active for approximately one year and has occasionally used condoms for contraception. She smokes five cigarettes daily and occasionally smokes cannabis. On examination, she appears well, and clinically euthyroid, has a pulse of 70 bpm and blood pressure of 112/70 mmHg. Investigations show: Serum oestradiol 130 nmol/L (130-600), Serum LH 4.5 mU/L (2-20), Serum FSH 2.2 mU/L (2-20), Serum prolactin 6340 mU/L (50-450), Free T4 7.2 pmol/L (10-22), TSH 2.2 mU/L (0.4-5.0). What is the most likely diagnosis?

MRCP-0423

A 27-year-old woman is admitted on the medical intake. She is 10 weeks postpartum and has been generally unwell for two weeks with malaise, sweating and anxiety. On examination, she is haemodynamically stable and clinically euthyroid. TFTs show the following: Free T4 33 pmol/L (9-23), Free T3 8 nmol/L (3.5-6), TSH <0.02 mU/L (0.5-5). What is the appropriate management?

MRCP-0424

A 40-year-old woman presents with weight loss, palpitations, diarrhoea and cessation of periods. She has been treated by her GP for anxiety. Examination reveals a single nodule on the left of her thyroid, about 1.5 cm in diameter. Thyroid scan shows increased uptake within the nodule with reduced activity throughout the rest of the gland. Thyroid function tests showed a free thyroxine of 30 pmol/l (9–25 pmol/l), TSH < 0.05 mU/l (0.5–5). Based on these findings, what would be the definitive treatment?