Free Exam: DebopriyaMRCP2Endocrine
Number of Questions in Test: 44
Number of Questions in Preview: 5
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[cmimg]0/6506684_ZT6PZXUH.jpg[/cmimg]
A 56-year-old seaman presents to his general practitioner with this appearance on the front of his legs.
He has had this lesion for at least one year and has received treatment with topical steroids and courses of antibiotics. Despite this the lesion has deteriorated. The lesion is painless and recently he has noticed that the centre has broken down and is slightly oozing.
He has a five year history of diabetes mellitus and receives metformin 500 mg tds. He has also undergone dermatological surgery for skin malignancies on his face over the last six years.
What is this skin lesion?
A 56-year-old seaman presents to his general practitioner with this appearance on the front of his legs.
He has had this lesion for at least one year and has received treatment with topical steroids and courses of antibiotics. Despite this the lesion has deteriorated. The lesion is painless and recently he has noticed that the centre has broken down and is slightly oozing.
He has a five year history of diabetes mellitus and receives metformin 500 mg tds. He has also undergone dermatological surgery for skin malignancies on his face over the last six years.
What is this skin lesion?
| Type: | Multiple choice |
| Points: | 4 |
| Randomize answers: | No |
Question 2
A 65-year-old female is admitted with an intracranial bleed under the care of the neurosurgeons.
Following magnetic resonance angiography she undergoes clipping of a cerebral arterial aneurysm and was well the following morning.
The surgical team document the following blood chemistry results on successive postoperative days:
[cmimg]0/6506684_ZORZCADG.jpg[/cmimg]
Normal Ranges:
[cmimg]0/6506684_C3O2FHI5.jpg[/cmimg]
On day four she was commenced on a fluid restriction of 1 litre per day. Investigations at that time show:
[cmimg]0/6506684_X5YN3HR9.jpg[/cmimg]
What diagnosis would most likely explain these findings?
Following magnetic resonance angiography she undergoes clipping of a cerebral arterial aneurysm and was well the following morning.
The surgical team document the following blood chemistry results on successive postoperative days:
[cmimg]0/6506684_ZORZCADG.jpg[/cmimg]
Normal Ranges:
[cmimg]0/6506684_C3O2FHI5.jpg[/cmimg]
On day four she was commenced on a fluid restriction of 1 litre per day. Investigations at that time show:
[cmimg]0/6506684_X5YN3HR9.jpg[/cmimg]
What diagnosis would most likely explain these findings?
| Type: | Multiple choice |
| Points: | 4 |
| Randomize answers: | No |
Question 3
A 56-year-old male with a 12 year history of diabetes mellitus presents for annual review.
He is currently receiving gliclazide at a dose of 80 mg twice daily. Examination reveals a pulse of 76 beats per minute regular and a blood pressure of 152/90 mmHg. Fundal examination reveals bilateral dot haemorrhages with scattered hard exudates. He has loss of vibration sensation in to the ankles but all pulses are palpable.
Investigations reveal:
Serum sodium 138 mmol/L (137-144)
Serum potassium 3.8 mmol/L (3.5-4.9)
Serum urea 10.2 mmol/L (2.5-7.5)
Serum creatinine 160 μmol/L (60-110)
Glucose 12.1 mmol/L (3.0-6.0)
HbA1c 9.5% (3.8-6.4)
Cholesterol 5.5 mmol/L (<5.2)
Triglycerides 2.8 mmol/L (0.45-1.69)
Which of the following measures would you adopt to improve this patient's prognosis?
He is currently receiving gliclazide at a dose of 80 mg twice daily. Examination reveals a pulse of 76 beats per minute regular and a blood pressure of 152/90 mmHg. Fundal examination reveals bilateral dot haemorrhages with scattered hard exudates. He has loss of vibration sensation in to the ankles but all pulses are palpable.
Investigations reveal:
Serum sodium 138 mmol/L (137-144)
Serum potassium 3.8 mmol/L (3.5-4.9)
Serum urea 10.2 mmol/L (2.5-7.5)
Serum creatinine 160 μmol/L (60-110)
Glucose 12.1 mmol/L (3.0-6.0)
HbA1c 9.5% (3.8-6.4)
Cholesterol 5.5 mmol/L (<5.2)
Triglycerides 2.8 mmol/L (0.45-1.69)
Which of the following measures would you adopt to improve this patient's prognosis?
| Type: | Multiple choice |
| Points: | 4 |
| Randomize answers: | No |
Question 4
A 42-year-old male presents with impotence and reduced libido of six months duration.
He has been married for 15 years and has two children. He smokes five cigarettes per day and drinks approximately 12 units of alcohol weekly.
Examination reveals an obese male who is phenotypically normal with normal secondary sexual characteristics.
Investigations are as follows:
[cmimg]0/6506684_IWNCLZ43.jpg[/cmimg]
[cmimg]0/6506684_R9DQPY2T.jpg[/cmimg]
Which of the following investigations would you select for the further investigation of this patient?
He has been married for 15 years and has two children. He smokes five cigarettes per day and drinks approximately 12 units of alcohol weekly.
Examination reveals an obese male who is phenotypically normal with normal secondary sexual characteristics.
Investigations are as follows:
[cmimg]0/6506684_IWNCLZ43.jpg[/cmimg]
[cmimg]0/6506684_R9DQPY2T.jpg[/cmimg]
Which of the following investigations would you select for the further investigation of this patient?
| Type: | Multiple choice |
| Points: | 4 |
| Randomize answers: | No |
Question 5
16-year-old boy was seen in casualty with a three day history of nausea and vomiting.
He had a 12 year history of insulin-dependent diabetes mellitus. Over the past three years he had been less attentive to his glycaemic control and been admitted on several occasions in diabetic ketoacidosis.
On examination he was alert and oriented. His mouth was dry but there was no loss of skin turgor. Examination was otherwise unremarkable.
Investigations revealed:
[cmimg]0/6506684_O6WVBTNW.jpg[/cmimg]
Urinalysis protein trace.
[cmimg]0/6506684_7YOR7Q3K.jpg[/cmimg]
He was treated with intravenous fluids and with an intravenous insulin sliding scale and his symptoms improved within 24 hours. After 36 hours he had good glycaemic control and was able to eat and drink without feeling nauseated. However, when the intravenous fluids were discontinued, the nausea and vomiting resumed. The intravenous fluids were continued but abnormalities in his blood biochemistry became apparent.
Seven days after admission to hospital his biochemistry results showed:
[cmimg]0/6506684_P3S7DO1A.jpg[/cmimg]
What single test would be best to determine the cause of these biochemical abnormalities?
He had a 12 year history of insulin-dependent diabetes mellitus. Over the past three years he had been less attentive to his glycaemic control and been admitted on several occasions in diabetic ketoacidosis.
On examination he was alert and oriented. His mouth was dry but there was no loss of skin turgor. Examination was otherwise unremarkable.
Investigations revealed:
[cmimg]0/6506684_O6WVBTNW.jpg[/cmimg]
Urinalysis protein trace.
[cmimg]0/6506684_7YOR7Q3K.jpg[/cmimg]
He was treated with intravenous fluids and with an intravenous insulin sliding scale and his symptoms improved within 24 hours. After 36 hours he had good glycaemic control and was able to eat and drink without feeling nauseated. However, when the intravenous fluids were discontinued, the nausea and vomiting resumed. The intravenous fluids were continued but abnormalities in his blood biochemistry became apparent.
Seven days after admission to hospital his biochemistry results showed:
[cmimg]0/6506684_P3S7DO1A.jpg[/cmimg]
What single test would be best to determine the cause of these biochemical abnormalities?
| Type: | Multiple choice |
| Points: | 4 |
| Randomize answers: | No |