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100+ Free SCE Endocrinology and Diabetes Practice Questions

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2025: 58.6% UK resident doctors; 40.1% all candidates Pass Rate
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A patient has confirmed ACTH-dependent Cushing syndrome. Pituitary MRI shows a 3 mm equivocal lesion. What test best distinguishes pituitary from ectopic ACTH when imaging is uncertain?

A
B
C
D
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2026 Statistics

Key Facts: SCE Endocrinology and Diabetes Exam

11 Nov 2026

2026 Endocrinology and Diabetes SCE date

Federation exam dates and fees page

22 Jul-19 Aug 2026

2026 application period

Federation Endocrinology and Diabetes page

200 questions

Official SCE exam length

SCE/ESE Regulations April 2026

2 x 3 hours

Paper timing

SCE/ESE Regulations April 2026

GBP 700

UK examination fee

Federation exam dates and fees page

462

Published pass score until next standards review

2025 SCE Endocrinology selected metrics report

58.6%

2025 UK resident doctors pass rate

2025 SCE Endocrinology selected metrics report

100

Free practice questions here

OpenExamPrep

The 2026 SCE in Endocrinology and Diabetes is scheduled for 11 November 2026, with applications open 22 July to 19 August 2026 at 8:00am UK local time. Current SCE regulations describe an in-centre CBT format with two 3-hour papers of 100 best-of-five questions each and a one-hour break. The Federation lists fees of GBP 700 for UK sittings and GBP 875 for international sittings. The 2025 Endocrinology metrics report gives a pass mark of 462, equivalent to 62% or 124/200, and reports pass rates of 58.6% for UK resident doctors and 40.1% for all candidates.

Sample SCE Endocrinology and Diabetes Practice Questions

Try these sample questions to test your SCE Endocrinology and Diabetes exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 54-year-old man has osmotic symptoms. His HbA1c is 68 mmol/mol and a repeat fasting plasma glucose is 8.1 mmol/L. What is the most appropriate diagnosis?
A.Prediabetes
B.Diabetes mellitus
C.Stress hyperglycaemia only
D.Impaired fasting glucose without diabetes
Explanation: An HbA1c of 48 mmol/mol or higher, or fasting plasma glucose of 7.0 mmol/L or higher on appropriate testing, supports diabetes. Osmotic symptoms make the clinical diagnosis even stronger and should trigger classification and cardiovascular risk assessment.
2A patient with type 1 diabetes has DKA. Glucose is 29 mmol/L, pH 7.12, bicarbonate 8 mmol/L and potassium 3.1 mmol/L. What should happen before starting IV insulin?
A.Give IV bicarbonate routinely
B.Replace potassium and delay insulin until potassium is safer
C.Start a sulfonylurea
D.Stop fluids to avoid cerebral oedema
Explanation: Insulin shifts potassium into cells and can precipitate dangerous hypokalaemia. In DKA with potassium below about 3.3 mmol/L, potassium replacement is the immediate priority before insulin infusion.
3A newly diagnosed patient with type 2 diabetes has HbA1c 61 mmol/mol, BMI 31 kg/m2 and eGFR 78 mL/min/1.73 m2. There is no acute illness or contraindication. Which drug is the usual first-line glucose-lowering therapy?
A.Metformin
B.Gliclazide for all patients
C.Basal insulin for all patients
D.Pioglitazone before lifestyle advice
Explanation: Metformin remains the usual first-line drug for type 2 diabetes when renal function and tolerance allow. It should be combined with lifestyle, weight, blood pressure and cardiovascular risk management.
4A conscious adult with diabetes is sweaty and confused. Capillary glucose is 2.8 mmol/L and they can swallow safely. What is the immediate treatment?
A.Give 15-20 g of fast-acting carbohydrate and recheck glucose
B.Inject long-acting insulin
C.Give only protein because carbohydrate rebounds
D.Wait for spontaneous recovery
Explanation: Conscious hypoglycaemia is treated promptly with fast-acting carbohydrate, followed by reassessment and longer-acting carbohydrate if needed. The priority is rapid restoration of safe glucose before searching for the precipitant.
5Which advice is safest for a patient taking an SGLT2 inhibitor who develops vomiting, poor oral intake and dehydration?
A.Continue the SGLT2 inhibitor because glucose is normal
B.Temporarily stop the SGLT2 inhibitor and seek ketone/clinical advice
C.Double the dose to prevent ketosis
D.Stop all fluids until glucose rises
Explanation: SGLT2 inhibitors should be withheld during significant acute illness, dehydration, fasting or perioperative stress because of euglycaemic DKA risk. Patients need hydration, carbohydrate if able, ketone testing where appropriate and clear escalation advice.
6A man with longstanding diabetes attends annual review. Which bedside test is most appropriate for detecting loss of protective sensation in the feet?
A.10 g monofilament testing
B.Tinel test at the wrist
C.Fundus fluorescein angiography
D.Peak expiratory flow
Explanation: A 10 g monofilament is used to assess protective sensation and stratify diabetic foot risk. It should be combined with pulse assessment, inspection for deformity, skin breaks and footwear review.
7A 43-year-old with type 2 diabetes asks why retinal screening is needed despite normal vision. What is the best answer?
A.Sight-threatening retinopathy can be asymptomatic until advanced
B.Retinal screening mainly detects cataract
C.Normal visual acuity excludes maculopathy
D.Only patients on insulin need screening
Explanation: Diabetic retinopathy and maculopathy may be silent until vision is threatened. Regular retinal screening detects treatable disease before irreversible visual loss.
8A patient with diabetes has persistent albuminuria and hypertension. Which treatment most directly reduces renal and cardiovascular risk if tolerated?
A.ACE inhibitor or angiotensin receptor blocker
B.Loop diuretic as sole renoprotective therapy
C.Calcium supplement
D.Short course of antibiotics
Explanation: ACE inhibitors or ARBs reduce intraglomerular pressure and are used in diabetes with hypertension and albuminuria if tolerated. Monitor creatinine and potassium after initiation and dose changes.
9A 29-year-old has weight loss, tremor, diffuse goitre and positive TSH receptor antibodies. TSH is suppressed and free T4 is high. What is the most likely diagnosis?
A.Subacute thyroiditis
B.Graves disease
C.Primary hypothyroidism
D.Non-thyroidal illness
Explanation: Suppressed TSH, high free T4, diffuse goitre and positive TSH receptor antibodies are typical of Graves disease. Eye signs or pretibial myxoedema would further support the diagnosis.
10A patient at 9 weeks gestation has symptomatic Graves thyrotoxicosis requiring antithyroid medication. Which drug is generally preferred in the first trimester?
A.Carbimazole or methimazole
B.Propylthiouracil
C.Radioiodine
D.High-dose iodine alone for the whole pregnancy
Explanation: Propylthiouracil is generally preferred in the first trimester because methimazole/carbimazole exposure is associated with embryopathy. Many patients are switched back after the first trimester because propylthiouracil has hepatotoxicity risk.

About the SCE Endocrinology and Diabetes Exam

The Specialty Certificate Examination in Endocrinology and Diabetes is a Federation/MRCP(UK) knowledge assessment for physicians. It tests the UK specialty curriculum and blueprint across diabetes diagnosis and management, diabetic emergencies, complications, hypothalamus and pituitary, thyroid, adrenal, gonadal, parathyroid/calcium and other endocrine or metabolic disorders. For UK trainees it is a required knowledge-based assessment for CCT in the listed specialty pathway; international physicians can use it as a professional benchmark against the UK specialty standard.

Assessment

Computer-based in-centre SCE with Paper 1 in the morning and Paper 2 in the afternoon.

Time Limit

Two 3-hour papers with a one-hour break between papers

Passing Score

462 scaled score; 2025 report states 62% or 124/200, in use until standards are reviewed

Exam Fee

UK: GBP 700; International: GBP 875 (Federation of the Royal Colleges of Physicians of the UK / MRCP(UK))

SCE Endocrinology and Diabetes Exam Content Outline

14% (28/200)

Diabetes mellitus diagnosis and general management

Diagnosis and classification of diabetes, individualised glycaemic targets, metformin, insulin, GLP-1 receptor agonists, SGLT2 inhibitors, diabetes technology, preconception counselling and safe delivery of care.

6% (12/200)

Diabetic emergencies and acute illness or surgery

DKA, HHS, severe hypoglycaemia, sick-day medication advice, perioperative insulin, steroid hyperglycaemia, pump failure and inpatient safety.

14% (28/200)

Complications of diabetes

Microvascular and macrovascular complications including retinopathy, nephropathy, neuropathy, foot disease, autonomic dysfunction, cardiovascular risk and DVLA-related safety decisions.

10% (20/200)

Hypothalamus and pituitary

Prolactinoma, acromegaly, Cushing disease, nonfunctioning adenomas, hypopituitarism, pituitary apoplexy, diabetes insipidus, SIADH and replacement sequencing.

18% (36/200)

Thyroid

Thyrotoxicosis, Graves disease, thyroiditis, hypothyroidism, myxoedema coma, thyroid storm, thyroid nodules, thyroid cancer, amiodarone thyroid disease and pregnancy thyroid care.

10% (20/200)

Adrenal

Adrenal insufficiency and crisis, congenital adrenal hyperplasia, Cushing syndrome, primary aldosteronism, pheochromocytoma, adrenal incidentaloma and endocrine hypertension.

10% (20/200)

Gonads

PCOS, hypogonadism, infertility, premature ovarian insufficiency, menopause, hyperandrogenism, puberty presentations and testosterone monitoring.

8% (16/200)

Parathyroid and calcium

Primary and secondary hyperparathyroidism, familial hypocalciuric hypercalcaemia, hypoparathyroidism, vitamin D deficiency, osteoporosis, denosumab safety and hypercalcaemia of malignancy.

10% (20/200)

Other endocrine and metabolic disease

Obesity, appetite and weight disorders, genetic endocrine syndromes, lipid disease, insulinoma, miscellaneous endocrine presentations and patient-safety reasoning.

How to Pass the SCE Endocrinology and Diabetes Exam

What You Need to Know

  • Passing score: 462 scaled score; 2025 report states 62% or 124/200, in use until standards are reviewed
  • Assessment: Computer-based in-centre SCE with Paper 1 in the morning and Paper 2 in the afternoon.
  • Time limit: Two 3-hour papers with a one-hour break between papers
  • Exam fee: UK: GBP 700; International: GBP 875

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

SCE Endocrinology and Diabetes Study Tips from Top Performers

1Use the official blueprint as your revision map: diabetes topics account for 68 of 200 questions, and thyroid contributes the largest single endocrine system block at 36 of 200.
2Practise investigation sequencing: many SCE stems test what to do next rather than isolated recall of a diagnosis.
3Revise UK-specific practice points, including NICE/SIGN style management, DVLA guidance in diabetes, sick-day rules and pregnancy medication safety.
4Build fluency with endocrine emergencies such as DKA, HHS, adrenal crisis, thyroid storm, myxoedema coma, pituitary apoplexy and severe hypercalcaemia.
5For pituitary and adrenal questions, decide first whether the physiology is primary, secondary or tertiary; it usually determines the next test and safest treatment.
6Review every wrong answer by asking why it is plausible but less correct, because best-of-five SCE questions often separate close clinical options.

Frequently Asked Questions

When is the 2026 SCE in Endocrinology and Diabetes?

The Federation lists the 2026/01 Endocrinology and Diabetes SCE exam date as 11 November 2026. Applications open on 22 July 2026 and close on 19 August 2026 at 8:00am UK local time, with a reasonable adjustment deadline of 27 August 2026.

What is the SCE Endocrinology and Diabetes format?

The current SCE regulations describe an in-centre Computer-Based Testing format. The exam has two papers: Paper 1 in the morning and Paper 2 in the afternoon. Each paper is three hours and contains 100 best-of-five questions, with a one-hour break between papers.

How much does the SCE cost in 2026?

The Federation exam dates and fees page lists SCE fees as GBP 700 for UK sittings and GBP 875 for international sittings. Candidates transferring from a UK to an international location are liable for the difference.

What is the pass mark for SCE Endocrinology and Diabetes?

The 2025 selected examination metrics report states that the pass score increased from 432 to 462 after the February 2022 standards review and that future examinations will use 462 until standards are reviewed. The 2025 pass mark was 462, reported as 62% or 124/200.

Who can sit the SCE?

The specialty page states there are no entry requirements for the SCE in Endocrinology and Diabetes, although UK trainees normally take it in their penultimate year of training. The SCE FAQ adds that candidates must hold an M.D. or MBBS degree and do not need to have sat MRCP(UK) first.

What does the SCE Endocrinology blueprint cover?

The official blueprint totals 200 questions across diabetes diagnosis and management, diabetic emergencies, diabetes complications, hypothalamus and pituitary, thyroid, adrenal, gonads, parathyroid/calcium and other appetite, genetic or miscellaneous conditions.