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NO.1 A 19-year-old man was seen in the diabetes clinic. He had lost 2 kg in weight since the diagnosis
of diabetes mellitus 18 months previously. At presentation, his body mass index was 33 kg/m2 (18-
25), his random plasma glucose was 18.0 mmol/L and his haemoglobin A1c was 56 mmol/mol (20-
42). He was taking gliclazide, and metformin had been added later. His father and grandfather had
developed diabetes mellitus during their twenties.
Investigations:
haemoglobin A1c56 mmol/mol (20-42)
serum C-peptide301 pmol/L (180-360)
anti-glutamic acid decarboxylase (GAD)
antibodiesnegative
What is the most likely diagnosis?
A. maturity-onset diabetes of the young
B. chronic pancreatitis
C. latent-onset diabetes of autoimmunity
D. type 1 diabetes mellitus
E. type 2 diabetes mellitus
Answer: A

SEND Practice Exam   

NO.2 A 17-year-old boy, with short stature, obesity and neurobehavioural problems, was referred
because of cold intolerance.
On examination, he and his mother had similar body habitus and short fingers (brachydactyly).
Investigations (before attending clinic):
serum sodium143 mmol/L (137-144) serum potassium4.4 mmol/L (3.5-4.9) serum creatinine93
umol/L (60-110) serum corrected calcium2.02 mmol/L (2.20-2.60) serum phosphate1.7 mmol/L (0.8-
1.4)
serum thyroid-stimulating hormone16.0 mU/L (0.4-5.0) serum free T410.0 pmol/L (10.0-22.0) plasma
parathyroid hormone27.0 pmol/L (0.9-5.4)
His mother's blood tests were all normal.
What is the most likely diagnosis in this boy?
A. pseudopseudohypoparathyroidism
B. polyglandular autoimmune syndrome type 1
C. McCune-Albright syndrome
D. pseudohypoparathyroidism
E. DiGeorge syndrome
Answer: D

SEND Practice Test   

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