MRCPUK SEND

幸せは自分の心が決めます。あなたは自分の心に準じてSEND試験に早く申し込みましょう。我々社は質高いSENDトレーニング資料と行き届いたサービスを提供して、あなたはSEND試験に合格するのを助けます。我々の商品を選んで、あなたは絶対後悔しないと信じられます。

お客様の需要に従って、わが社はSENDトレーニング資料に三つのバージョンを作り上げました。一つはPDF版で、印刷できてSEND練習問題を便利に閲覧しながらメモを取ります。二つはソフト版で、windowsシステムを搭載したパソコンに使用しなければいけない。パソコンにSEND試験の実際環境を模擬して実行されます。SEND本番試験の雰囲気を体験できます。三つはオンライン版で、携帯やIPADなどの電子設備に使用することができる。あなたはいつでも、どこでも、SENDオンラインテストエンジンを使用して学習することができます。それは時間が余裕ではないお客様に対し大きなメリットです。

二十四時間のオンラインサービス

我が社の係員は心を込めて誠心誠意にお客様のあらゆる要求に答えします。いかなる場合でも、いかなる時間でも本社の係員に連絡し、SENDについての問題解決に力を入れて努力します。ご使用がわからない場合に、ヘルプが必要な場合に、遠慮なく私たちに連絡してください。

SEND試験問題集をすぐにダウンロード：成功に支払ってから、我々のシステムは自動的にメールであなたの購入した商品をあなたのメールアドレスにお送りいたします。（12時間以内で届かないなら、我々を連絡してください。Note：ゴミ箱の検査を忘れないでください。）

高い通過率

SEND模擬テストエンジンは繰り返しの練習であなたの解答能力を高めることができます。更に、本当な問題と正確の解答もSEND勉強資料のメリットです。本社のSEND勉強資料を使ったお客様の試験通過率は９８％に達し、採集したデータによると、SEND試験に参加したほとんどのお客様は合格しました。高い通過率こそ我が社は業界に一席を占める重要な保証です。

MRCPUK SEND 試験シラバストピック:

MRCPUK Endocrinology and Diabetes (Specialty Certificate Examination) 認定 SEND 試験問題：

問題 #1
A 64-year-old man was reviewed in the diabetes clinic. He had a history of type 2 diabetes mellitus treated for 12 years. He had sustained a previous episode of acute kidney injury believed to be secondary to renal artery stenosis and exposure to an ACE inhibitor. He was being treated with metformin 500 mg three times daily and gliclazide 80 mg twice daily.
Investigations:
serum sodium143 mmol/L (137-144)
serum potassium4.4 mmol/L (3.5-4.9)
serum creatinine123 umol/L (60-110)
estimated glomerular filtration rate (MDRD)51 mL/min/1.73 m2 (>60)
haemoglobin A1c75 mmol/mol (20-42)
He required a third drug that would not require dose adjustment if renal function were to decline in the future.
What additional medication is most appropriate?

A. linagliptin
B. alogliptin
C. vildagliptin
D. saxagliptin
E. sitagliptin

問題 #2
A 17-year-old boy with a 10-year history of type 1 diabetes mellitus was admitted with diabetic ketoacidosis after a night of binge drinking.
He was treated appropriately with a fixed-rate intravenous insulin infusion and intravenous sodium chloride 0.9%.
Twenty-four hours after admission, he was eating and drinking normally. He was taking his usual doses of subcutaneous insulin and his urinary ketones were undetectable.
Investigations (6 hours previously):
venous blood gases, breathing air: PO25.6 kPa PCO23.8 kPa pH7.29 bicarbonate16 mmol/L base excess-1 mmol/L
lactate1.1 mmol/L
What is the likely most cause of these results?

A. hyperchloraemia
B. continued ketonaemia
C. alcohol toxicity
D. concurrent aspirin ingestion
E. hyporeninaemic hypoaldosteronism

問題 #3
A 47-year-old nuclear physics professor was referred for advice before taking up an overseas position, overseeing the dismantling of a reactor at the site of a recent nuclear accident. She stated that she would face a small risk of being exposed to significant radioactive contamination during her work and was concerned about her future risk of thyroid cancer.
What is the most appropriate advice?

A. take potassium iodide tablets
B. take selenium tablets
C. wear lead neck shield while outdoors
D. no precautions are necessary for people aged 40 years or over
E. avoid consuming local milk and vegetables

問題 #4
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. craniopharyngioma
B. autoimmune (lymphocytic) hypophysitis
C. non-functioning pituitary adenoma
D. Rathke's cleft cyst
E. psychogenic polydipsia

問題 #5
An 80-year-old man was referred because of weight gain and low mood but said he was otherwise well. He had a complex cardiac history including a ventricular fibrillation arrest and a permanent pacemaker, but he had been very well for the past 3 years. He was taking amiodarone 100 mg daily, lisinopril 40 mg daily and furosemide 80 mg daily.
On examination, he had a pacemaker in situ and his pulse was 84 beats per minute and regular. He had a 2/6 mid-systolic murmur in the aortic area with no radiation, mild ankle oedema, and scanty basal crackles bilaterally on auscultation of his chest.
Investigations (before attending clinic):
serum thyroid-stimulating hormone19.0 mU/L (0.4-5.0)
serum free T411.0 pmol/L (10.0-22.0)
anti-thyroid peroxidase antibodies300 IU/mL (<50)
What is the most appropriate next step in management?

A. start liothyronine sodium 10 micrograms twice daily
B. start levothyroxine 25 micrograms daily
C. start levothyroxine 100 micrograms daily
D. review with repeat thyroid tests in 3 months
E. stop amiodarone

解説：