MRCPUK SEND Exam With Confidence Using Practice Dumps

A 17-year-old Caucasian girl presented with primary amenorrhea.

On examination, her body mass index was 21 kg/m2 (18–25). Her body habitus was normal and she had appropriate breast development. There was no hirsutism or acne.

Investigations:

serum oestradiol<180 pmol/L (200–400)

serum testosterone31.7 nmol/L (0.5–3.0)

serum follicle-stimulating hormone4.0 U/L (2.5–10.0)

serum luteinising hormone6.0 U/L (2.5–10.0)

What is the most likely diagnosis?

A 16-year-old boy was referred to the diabetes clinic following the discovery of a random plasma glucose concentration of 18.0 mmol/L. His general practitioner had begun treatment with metformin. The patient had a body mass index of 35 kg/m2 (18–25). He had had problems throughout his childhood, and had been taken out of school and was educated at home by his mother. He was attending the ophthalmology clinic for visual problems.

On examination, he was obese. He had hearing aids in both ears and evidence of acanthosis nigricans. Neither parent had a history of diabetes mellitus.

What is the most likely diagnosis?

A 55-year-old dental nurse was referred for bone densitometry after sustaining a non-displaced fracture of the femur after falling down a step. She had experienced no other fractures. Her only medical problem was long-standing anaemia of unknown cause. The only family history was of persistent dental abscesses affecting her father. She had three children who were well. She was taking no medication.

Examination was normal.

Investigations:

haemoglobin102 g/L (115–165)

MCV85 fL (80–96)

white cell count6.0 ? 109/L (4.0–11.0)

platelet count245 ? 109/L (150–400)

erythrocyte sedimentation rate25 mm/1st h (<30)

serum creatinine85 µmol/L (60–110)

serum corrected calcium2.40 mmol/L (2.20–2.60)

serum alkaline phosphatase56 U/L (45–105)

DXA scan spine (L2–L4)T score +5.8

DXA scan total hipT score +5.4

What is the most likely diagnosis?