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MRCPI Part 1 → Endocrinology and metabolic medicine

Endocrinology and metabolic medicine for MRCPI Part 1

Endocrinology and metabolic medicine accounts for roughly 8% of the MRCPI Part 1 blueprint. This bank has 1 item tagged to it.

How much of MRCPI Part 1 is endocrinology and metabolic medicine?

Around 8% of the paper, per RCPI examination regulations and training curricula. That weighting is why the DocPasser mock builder samples sections in proportion rather than shuffling everything into one pile — practising a flat distribution trains you for a paper that does not exist.

Verification status. All 3 published figures on this page have been read in the source document and dated above. Source of truth: RCPI examination regulations and training curricula, Royal College of Physicians of Ireland. How we verify.

Sample endocrinology and metabolic medicine questions

A 34-year-old woman presents with fatigue, weight loss, dizziness on standing and increased pigmentation of her palmar creases and buccal mucosa. Sodium 128 mmol/L, potassium 5.6 mmol/L, glucose 3.1 mmol/L. Which investigation will confirm the diagnosis?

  1. Overnight dexamethasone suppression test Wrong direction. That tests for cortisol EXCESS in suspected Cushing syndrome.
  2. 24-hour urinary free cortisol Again a test for excess rather than deficiency, and unhelpful at the low end of the range.
  3. Random cortisol alone Unreliable in isolation because cortisol is pulsatile and diurnal. A 9am cortisol can be suggestive at the extremes but does not confirm the diagnosis.
  4. Plasma metanephrines Wrong. These investigate phaeochromocytoma, which causes episodic hypertension, headache, palpitations and sweating.
  5. Short Synacthen test correct Correct. The picture is primary adrenal insufficiency: hyponatraemia, hyperkalaemia, hypoglycaemia and pigmentation from ACTH excess. The short Synacthen test demonstrates a failure of cortisol to rise adequately after synthetic ACTH.

The point: Pigmentation distinguishes primary adrenal failure (high ACTH) from secondary (low ACTH, no pigmentation, and aldosterone preserved so potassium is normal). Take blood for cortisol and ACTH, then treat immediately in a crisis, do not wait for the result.

Source: Endocrine Society clinical practice guideline — primary adrenal insufficiency Endocrine Society · tier 2, specialty society or college

The other sections of MRCPI Part 1

Cardiology · Respiratory medicine · Gastroenterology and hepatology · Neurology · Nephrology · Rheumatology · Haematology · Infectious diseases and tropical medicine · Oncology and palliative care · Dermatology · Clinical pharmacology and therapeutics · Clinical sciences and statistics · Acute and critical care medicine

Back to MRCPI Part 1

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