AADE Practice Test Exam Questions and
Answers Verified 2024
62-year-old patient with type 2 diabetes has noticed a 30-pound weight gain over the
past 2 years. Which of the following drugs would most likely worsen her weight gain?
Pramlintide
Exenatide
Rosiglitazone
Saxagliptin - ANSWER-C - Rosiglitazone is correct. Thiazolidinediones (pioglitazone
and rosiglitazone) activate PPAR-gamma receptors in the body. Activation of these
receptors results in mobilization of visceral fat and promotes deposition in subcutaneous
adipose tissue. Pramlintide and exenatide (Answers A and B) tend to promote weight
loss, while saxagliptin (Answer D) is weight neutral.
A 28-year-old woman with Type 1 diabetes for 10 years needs to re-calculate a
correction bolus based on her new insulin regimen. Her current total daily dose (TDD) of
insulin is 60 units. Which of the following best estimates the amount 1 unit of insulin will
lower her blood glucose level?
3 mg/dL
8 mg/dL
25 mg/dL
30 mg/dL - ANSWER-D - 30 mg/dL is correct. The Rule of 1800 (some providers
recommend 1700 for patients on insulin pumps, or 1500 for patients injecting regular
insulin) estimates the amount 1 unit of insulin will lower her blood glucose level. This
patient takes a total daily dose (TDD) of 60 units (1800 divided by 60 units = 30 mg/dL).
A general rule of thumb is that 1 unit of insulin will lower the blood glucose by 50 mg/dL.
A 28-year-old woman with Type 1 diabetes for 10 years presents for follow-up. Recent
laboratory tests showed fasting plasma glucose of 194 mg/dl and a hemoglobin A1C of
10.3%. A spot urine was positive for microalbumin at 58. Blood pressure today is 118/64
without symptoms and all other laboratory values were within normal limits. Which of the
following is the most appropriate blood pressure goal for this patient based on the 2016
ADA Standards of Care?
< 140/90 mmHg
< 140/80 mmHg
< 130/80 mmHg
< 120/75 mmHg - ANSWER-C - <130/80 mmHg is correct. The 2016 ADA guidelines
recommend a blood pressure goal of <140/90 mmHg for most adults with diabetes.
However, lower blood pressure targets are considered appropriate for younger patients
whose potential duration of disease is longer; those with albuminuria suggesting
presence of sustained kidney damage; and those in whom the burden of treatment is
minimal. This young patient with type 1 diabetes would certainly be able to withstand
the treatment burden and will likely reap benefits during her lifetime from tighter blood
pressure control.
, A 28-year-old woman with type 2 diabetes plans to get pregnant. Which of the following
drugs should be discontinued prior to getting pregnant?
Metformin
Detemir
Atorvastatin
Clonidine - ANSWER-C - Atorvastatin is correct. Statins, angiotensin converting enzyme
inhibitors and angiotensin receptor blockers are common therapies for patients with type
2 diabetes but may cause fetal damage and are contraindicated during pregnancy.
About 50% of the metformin dose crosses the placenta but is not associated with
adverse effects on the fetus (Answer A). Recombinant human NPH insulin is preferred
during pregnancy; however, if insulin analogs are desired, then lispro, aspart or detemir
(Answer B) are FDA Pregnancy Category B.
A 35-year-old patient with type 2 diabetes presents for follow-up of her glycemic control.
Her current medications include: metformin 1g twice daily and glargine 46 units at
bedtime with a recent A1C of 7.7% (goal <7%). She eats a granola bar for breakfast,
has a sandwich and water at lunch, then a large evening meal. She denies symptoms of
hypoglycemia. She weighs 156 pounds (BMI 26 kg/m^2) and her average preprandial
self-monitored blood glucose levels are: 152 mg/dL at 8AM, 160 mg/dL at noon, 146
mg/dL at 6 PM, and 220 mg/dL at 10 PM. Her provider decides to start glulisine before
the evening meal (at 6 PM). Which of the following would be the most appropriate
recommendation for this patient?
1 unit
5 units
15 units
20 units - ANSWER-B - 5 units is correct. Both the ADA and AACE guidelines
recommend adding bolus insulin at a dose of either 10% of the current basal dose, or
0.1 units/kg, or 5 units. Subsequent dose adjustments can be made in 1 to 2 unit
increments or 10% to 15% of the dose.
A 45-year-old man with type 2 diabetes recently started atorvastatin 40mg daily to lower
his cholesterol. Which of the following is the most appropriate frequency to recheck the
fasting lipid profile?
1 to 3 weeks
4 to 12 weeks
6 to 9 months
Yearly - ANSWER-B - 4 to 12 weeks is correct. The 2013 ACC/AHA Cholesterol
Guidelines for ASCVD Risk Reduction in Adults recommends that a repeat fasting lipid
panel be checked within 4 to 12 months after statin initiation or dose adjustment. Once
patients the dose is stabilized, then follow-up can be set to every 3 to 12 months
thereafter.
A 52-year-old male with diabetes, CAD, hypertension and dyslipidemia presents to clinic
to follow-up on his fasting laboratory values (see labs below). His medical history is
significant for MI (2009, 2011, 2014), PTCA (2009, 2014), and CABG (2011). His
Answers Verified 2024
62-year-old patient with type 2 diabetes has noticed a 30-pound weight gain over the
past 2 years. Which of the following drugs would most likely worsen her weight gain?
Pramlintide
Exenatide
Rosiglitazone
Saxagliptin - ANSWER-C - Rosiglitazone is correct. Thiazolidinediones (pioglitazone
and rosiglitazone) activate PPAR-gamma receptors in the body. Activation of these
receptors results in mobilization of visceral fat and promotes deposition in subcutaneous
adipose tissue. Pramlintide and exenatide (Answers A and B) tend to promote weight
loss, while saxagliptin (Answer D) is weight neutral.
A 28-year-old woman with Type 1 diabetes for 10 years needs to re-calculate a
correction bolus based on her new insulin regimen. Her current total daily dose (TDD) of
insulin is 60 units. Which of the following best estimates the amount 1 unit of insulin will
lower her blood glucose level?
3 mg/dL
8 mg/dL
25 mg/dL
30 mg/dL - ANSWER-D - 30 mg/dL is correct. The Rule of 1800 (some providers
recommend 1700 for patients on insulin pumps, or 1500 for patients injecting regular
insulin) estimates the amount 1 unit of insulin will lower her blood glucose level. This
patient takes a total daily dose (TDD) of 60 units (1800 divided by 60 units = 30 mg/dL).
A general rule of thumb is that 1 unit of insulin will lower the blood glucose by 50 mg/dL.
A 28-year-old woman with Type 1 diabetes for 10 years presents for follow-up. Recent
laboratory tests showed fasting plasma glucose of 194 mg/dl and a hemoglobin A1C of
10.3%. A spot urine was positive for microalbumin at 58. Blood pressure today is 118/64
without symptoms and all other laboratory values were within normal limits. Which of the
following is the most appropriate blood pressure goal for this patient based on the 2016
ADA Standards of Care?
< 140/90 mmHg
< 140/80 mmHg
< 130/80 mmHg
< 120/75 mmHg - ANSWER-C - <130/80 mmHg is correct. The 2016 ADA guidelines
recommend a blood pressure goal of <140/90 mmHg for most adults with diabetes.
However, lower blood pressure targets are considered appropriate for younger patients
whose potential duration of disease is longer; those with albuminuria suggesting
presence of sustained kidney damage; and those in whom the burden of treatment is
minimal. This young patient with type 1 diabetes would certainly be able to withstand
the treatment burden and will likely reap benefits during her lifetime from tighter blood
pressure control.
, A 28-year-old woman with type 2 diabetes plans to get pregnant. Which of the following
drugs should be discontinued prior to getting pregnant?
Metformin
Detemir
Atorvastatin
Clonidine - ANSWER-C - Atorvastatin is correct. Statins, angiotensin converting enzyme
inhibitors and angiotensin receptor blockers are common therapies for patients with type
2 diabetes but may cause fetal damage and are contraindicated during pregnancy.
About 50% of the metformin dose crosses the placenta but is not associated with
adverse effects on the fetus (Answer A). Recombinant human NPH insulin is preferred
during pregnancy; however, if insulin analogs are desired, then lispro, aspart or detemir
(Answer B) are FDA Pregnancy Category B.
A 35-year-old patient with type 2 diabetes presents for follow-up of her glycemic control.
Her current medications include: metformin 1g twice daily and glargine 46 units at
bedtime with a recent A1C of 7.7% (goal <7%). She eats a granola bar for breakfast,
has a sandwich and water at lunch, then a large evening meal. She denies symptoms of
hypoglycemia. She weighs 156 pounds (BMI 26 kg/m^2) and her average preprandial
self-monitored blood glucose levels are: 152 mg/dL at 8AM, 160 mg/dL at noon, 146
mg/dL at 6 PM, and 220 mg/dL at 10 PM. Her provider decides to start glulisine before
the evening meal (at 6 PM). Which of the following would be the most appropriate
recommendation for this patient?
1 unit
5 units
15 units
20 units - ANSWER-B - 5 units is correct. Both the ADA and AACE guidelines
recommend adding bolus insulin at a dose of either 10% of the current basal dose, or
0.1 units/kg, or 5 units. Subsequent dose adjustments can be made in 1 to 2 unit
increments or 10% to 15% of the dose.
A 45-year-old man with type 2 diabetes recently started atorvastatin 40mg daily to lower
his cholesterol. Which of the following is the most appropriate frequency to recheck the
fasting lipid profile?
1 to 3 weeks
4 to 12 weeks
6 to 9 months
Yearly - ANSWER-B - 4 to 12 weeks is correct. The 2013 ACC/AHA Cholesterol
Guidelines for ASCVD Risk Reduction in Adults recommends that a repeat fasting lipid
panel be checked within 4 to 12 months after statin initiation or dose adjustment. Once
patients the dose is stabilized, then follow-up can be set to every 3 to 12 months
thereafter.
A 52-year-old male with diabetes, CAD, hypertension and dyslipidemia presents to clinic
to follow-up on his fasting laboratory values (see labs below). His medical history is
significant for MI (2009, 2011, 2014), PTCA (2009, 2014), and CABG (2011). His
