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MRCP 1 – Endocrinology Exam Questions and Answers (Latest Update 2024)
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MRCP 1 – Endocrinology Exam Questions and Answers (Latest Update 2024)
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MRCP 1 – Endocrinology Exam Questionsand Answers (Latest Update 2024)
titrate up metformin and encourage lifestyle changes to aim
for a HbA1c of 48 mmol/mol (6.5%), but should only add a
second drug if the HbA1c rises to 58 mmol/mol (7.5%) -
Correct Answer ✅ titrate up metformin and encourage
lifestyle changes to aim for a HbA1c of 48 mmol/mol (6.5%),
but should only add a second drug if the HbA1c rises to 58
mmol/mol (7.5%)
HbA1c should be checked every 3-6 months until stable, then
6 monthly - Correct Answer ✅
Metformin is still first-line and should be offered if the HbA1c
rises to 48 mmol/mol (6.5%)* on lifestyle interventions.
the HbA1c has risen to 58 mmol/mol (7.5%) then a second
drug should be added from the following list:
→ sulfonylurea
→ gliptin
→ pioglitazone
→ SGLT-2 inhibitor
,MRCP 1 – Endocrinology Exam Questions
and Answers (Latest Update 2024)
if despite this the HbA1c rises to, or remains above 58
mmol/mol (7.5%) then triple therapy with one of the following
combinations should be offered:
→ metformin + gliptin + sulfonylurea
→ metformin + pioglitazone + sulfonylurea
→ metformin + sulfonylurea + SGLT-2 inhibitor
→ metformin + pioglitazone + SGLT-2 inhibitor
→ OR insulin therapy should be considered - Correct
Answer ✅ Metformin is still first-line and should be offered if
the HbA1c rises to 48 mmol/mol (6.5%)* on lifestyle
interventions.
the HbA1c has risen to 58 mmol/mol (7.5%) then a second
drug should be added from the following list:
→ sulfonylurea
→ gliptin
→ pioglitazone
→ SGLT-2 inhibitor
if despite this the HbA1c rises to, or remains above 58
mmol/mol (7.5%) then triple therapy with one of the following
combinations should be offered:
,MRCP 1 – Endocrinology Exam Questions
and Answers (Latest Update 2024)
→ metformin + gliptin + sulfonylurea
→ metformin + pioglitazone + sulfonylurea
→ metformin + sulfonylurea + SGLT-2 inhibitor
→ metformin + pioglitazone + SGLT-2 inhibitor
→ OR insulin therapy should be considered
Criteria for glucagon-like peptide1 (GLP1) mimetic (e.g.
exenatide)
if triple therapy is not effective, not tolerated or
contraindicated then NICE advise that we consider
combination therapy with metformin, a sulfonylurea and a
glucagonlike peptide1 (GLP1) mimetic if:
→ BMI >= 35 kg/m² and specific psychological or other
medical problems associated with obesity or
→ BMI < 35 kg/m² and for whom insulin therapy would have
significant occupational implications or - Correct Answer ✅
Addisonian crisis
N/V confusion, abdominal pain, extreme weakness,
hypoglycemia, dehydration, decreased BP
, MRCP 1 – Endocrinology Exam Questions
and Answers (Latest Update 2024)
Causes
sepsis or surgery causing an acute exacerbation of chronic
insufficiency (Addison's, Hypopituitarism)
adrenal haemorrhage eg Waterhouse-Friderichsen syndrome
(fulminant meningococcemia)
steroid withdrawal
The short synacthen test is the best test to diagnose
Addison's disease
Bloods : hyponatraemia , hyperkalaemia ,hypoglycaemia
Management of Addisonian crisis (medical emergency):
IV fluids +
corticosteroids (e.g iv dexamethasone) - Correct Answer ✅
Addisonian crisis
N/V confusion, abdominal pain, extreme weakness,
hypoglycemia, dehydration, decreased BP
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