Page 1 of 100
A4M WRITTEN EXAM/ 4M001 ENDOCRINOLOGY,
CARDIOLOGY & NEUROLOGY – AMERICAN
ACADEMY OF ANTI-AGING MEDICINE***
QUESTIONS AND ANSWERS | VERIFIED AND
WELL DETAILED ANSWERS | DOWNLOAD AND
PASS | LATEST EXAM UPDATE 2026/2027
What is HOMA-IR?
❖HOMA-IR is a homeostatic model for insulin
resistance based on plasma levels of fasting insulin
and glucose that is used to assess insulin sensitivity.
How do supra-physiologic doses of T affect insulin levels in
a patient with diabetes?
❖Although T replacement may decrease insulin
resistance; replacing with supra-physiologic doses
INCREASES insulin resistance
,Page 2 of 100
What is adiponectin?
❖Adiponectin is an adipose derived protein (adipokine)
that is protective against atherosclerosis. It
moderates fat tissue, promotes insulin sensitivity; and
decreases hepatic glucose and lipid production.
T or F: Stage 1 Insulin resistance is associated with
declining adiponectin levels; normal to slightly elevated
HOMA-IR; normal glucose; normal A1c; normal insulin
and normal pro-insulin.
❖T
Features of stage 2 IR (insulin resistance)
❖Decreased adiponectin; increasing insulin; normal
pro-insulin; high normal HOMA-IR; elevated insulin;
high post-prandial glucose. Beta cell impairment may
be present.
,Page 3 of 100
Features of stage 3 IR.
❖Elevated pro-insulin; elevated HOMA-IR; elevated
adiponectin; elevated insulin; high A1c and high
glucose.
At what age does sarcopenia begin
❖Sarcopenia begins at age 50, and progressively
worsens, affecting 30% of people over 60 and 50% of
those > 80
Supplements that may help combat sarcopenia
❖Vitamin D; glucosamine; creatine; colostrum; whey
protein; amino acids; HMB; carnitine; omega 3 fatty
acids; HRT; trace elements; human growth hormone
, Page 4 of 100
Optimal level of homocysteine
❖<10; also do not want it too low as this reflects over-
methylation
Changes observed in lung parenchyma with aging
❖Reduced elastic recoil and progressive reduction in
compliance due to stiffening of chest wall lead to
decreased vital capacity and increased residual
volume. Total lung capacity remains constant. FEV1
decreases.
Supplements that lower homocysteine
❖Vitamins B12, B6, folate, MTHF, TMG, garlic, SAME,
beets, broccoli
A4M WRITTEN EXAM/ 4M001 ENDOCRINOLOGY,
CARDIOLOGY & NEUROLOGY – AMERICAN
ACADEMY OF ANTI-AGING MEDICINE***
QUESTIONS AND ANSWERS | VERIFIED AND
WELL DETAILED ANSWERS | DOWNLOAD AND
PASS | LATEST EXAM UPDATE 2026/2027
What is HOMA-IR?
❖HOMA-IR is a homeostatic model for insulin
resistance based on plasma levels of fasting insulin
and glucose that is used to assess insulin sensitivity.
How do supra-physiologic doses of T affect insulin levels in
a patient with diabetes?
❖Although T replacement may decrease insulin
resistance; replacing with supra-physiologic doses
INCREASES insulin resistance
,Page 2 of 100
What is adiponectin?
❖Adiponectin is an adipose derived protein (adipokine)
that is protective against atherosclerosis. It
moderates fat tissue, promotes insulin sensitivity; and
decreases hepatic glucose and lipid production.
T or F: Stage 1 Insulin resistance is associated with
declining adiponectin levels; normal to slightly elevated
HOMA-IR; normal glucose; normal A1c; normal insulin
and normal pro-insulin.
❖T
Features of stage 2 IR (insulin resistance)
❖Decreased adiponectin; increasing insulin; normal
pro-insulin; high normal HOMA-IR; elevated insulin;
high post-prandial glucose. Beta cell impairment may
be present.
,Page 3 of 100
Features of stage 3 IR.
❖Elevated pro-insulin; elevated HOMA-IR; elevated
adiponectin; elevated insulin; high A1c and high
glucose.
At what age does sarcopenia begin
❖Sarcopenia begins at age 50, and progressively
worsens, affecting 30% of people over 60 and 50% of
those > 80
Supplements that may help combat sarcopenia
❖Vitamin D; glucosamine; creatine; colostrum; whey
protein; amino acids; HMB; carnitine; omega 3 fatty
acids; HRT; trace elements; human growth hormone
, Page 4 of 100
Optimal level of homocysteine
❖<10; also do not want it too low as this reflects over-
methylation
Changes observed in lung parenchyma with aging
❖Reduced elastic recoil and progressive reduction in
compliance due to stiffening of chest wall lead to
decreased vital capacity and increased residual
volume. Total lung capacity remains constant. FEV1
decreases.
Supplements that lower homocysteine
❖Vitamins B12, B6, folate, MTHF, TMG, garlic, SAME,
beets, broccoli
