Barkley Endocrine Practice ACTUAL
EXAM ALL QUESTIONS AND ANSWERS
ALREADY GRADED A+. 100% VERIFIED
SOLUTIONS | UPDATED PER LATEST
GUIDELINES | GRADED A+
Diabetes Mellitus (Questions 1-30)
Question 1
What are the diagnostic criteria for diabetes mellitus based on fasting blood glucose?
A. Fasting blood glucose ≥110 mg/dL on one occasion
B. Fasting blood glucose ≥126 mg/dL on more than one occasion
C. Fasting blood glucose ≥140 mg/dL on one occasion
D. Fasting blood glucose ≥100 mg/dL on more than one occasion
Correct Answer: B
Rationale: The diagnostic criteria for diabetes mellitus include a fasting blood glucose of ≥126
mg/dL on more than one occasion, or a glycated hemoglobin (A1C) ≥6.5% .
Question 2
Glutamic acid decarboxylase (GAD-65) antibodies are found in what percentage of patients with
Type 1 Diabetes Mellitus?
A. 40%
B. 60%
C. 80%
D. 95%
Correct Answer: C
,Rationale: GAD-65 antibodies are autoimmune markers found in approximately 80% of patients
with Type 1 Diabetes Mellitus, making it a useful diagnostic tool for distinguishing Type 1 from
Type 2 diabetes .
Question 3
A patient with diabetes has a blood glucose of 60 mg/dL at 3:00 AM but 210 mg/dL at 7:00 AM.
What is the most likely diagnosis?
A. Dawn Phenomenon
B. Somogyi Effect
C. Insulin resistance
D. Brittle diabetes
Correct Answer: B
Rationale: The Somogyi Effect is rebound hyperglycemia caused by an undetected hypoglycemic
event during the night. The patient is hypoglycemic at 0300 but rebounds with an elevated
blood glucose at 0700. Management involves reducing or omitting bedtime insulin .
Question 4
A patient with diabetes has progressively elevated blood glucose throughout the night. What is
the most likely diagnosis?
A. Somogyi Effect
B. Dawn Phenomenon
C. Insulin resistance
D. Hyperosmolar hyperglycemic state
Correct Answer: B
Rationale: The Dawn Phenomenon is characterized by progressively elevated blood glucose
throughout the night due to the normal early-morning release of growth hormone and cortisol.
Management involves adding or increasing the bedtime dose of insulin .
Question 5
Which of the following is NOT a common early sign/symptom of Type 2 Diabetes Mellitus?
A. Recurrent vaginitis in women
B. Chronic skin infections
,C. Weight loss despite increased appetite
D. Pruritus
Correct Answer: C
Rationale: Early signs and symptoms of Type 2 Diabetes Mellitus include recurrent vaginitis in
women, chronic skin infections including pruritus, and polyuria/polydipsia. Weight loss despite
increased appetite is more characteristic of Type 1 Diabetes Mellitus .
Question 6
What is the black box warning for metformin?
A. Hepatotoxicity
B. Lactic acidosis
C. Nephrotoxicity
D. Cardiotoxicity
Correct Answer: B
Rationale: Metformin carries a black box warning for lactic acidosis, which presents with acute
muscle pain. Lactic acidosis is a rare but potentially fatal complication, particularly in patients
with renal impairment or acute illness .
Question 7
When should metformin be discontinued in a patient receiving iodinated radiocontrast
medium?
A. Immediately before the procedure
B. 1-2 days before the procedure
C. 4-6 hours before the procedure
D. No need to discontinue
Correct Answer: B
Rationale: Metformin should be discontinued 1-2 days before receiving iodinated radiocontrast
medium to reduce the risk of contrast-induced nephropathy and subsequent lactic acidosis. It
can be restarted 48 hours after the procedure once renal function is confirmed to be normal .
Question 8
Which of the following is a GLP-1 receptor agonist?
, A. Metformin
B. Glipizide
C. Semaglutide (Ozempic)
D. Pioglitazone
Correct Answer: C
Rationale: Semaglutide (Ozempic, Rybelsus) is a GLP-1 receptor agonist. Other examples include
dulaglutide (Trulicity). These medications stimulate insulin secretion, suppress glucagon, and
delay gastric emptying .
Question 9
What is the black box warning for GLP-1 receptor agonists?
A. Pancreatitis
B. Heart failure
C. Thyroid cancer
D. Lactic acidosis
Correct Answer: C
Rationale: GLP-1 receptor agonists carry a black box warning for thyroid cancer (medullary
thyroid carcinoma). They should not be used in patients with a personal or family history of
medullary thyroid cancer or multiple endocrine neoplasia syndrome type 2 .
Question 10
What is the REMS program monitoring requirement for GLP-1 receptor agonists?
A. Liver function tests
B. Pancreatitis monitoring
C. Renal function
D. Cardiac monitoring
Correct Answer: B
Rationale: GLP-1 receptor agonists require monitoring for pancreatitis through the REMS (Risk
Evaluation and Mitigation Strategy) program. Patients should be counseled to report severe
abdominal pain, which may indicate pancreatitis .
EXAM ALL QUESTIONS AND ANSWERS
ALREADY GRADED A+. 100% VERIFIED
SOLUTIONS | UPDATED PER LATEST
GUIDELINES | GRADED A+
Diabetes Mellitus (Questions 1-30)
Question 1
What are the diagnostic criteria for diabetes mellitus based on fasting blood glucose?
A. Fasting blood glucose ≥110 mg/dL on one occasion
B. Fasting blood glucose ≥126 mg/dL on more than one occasion
C. Fasting blood glucose ≥140 mg/dL on one occasion
D. Fasting blood glucose ≥100 mg/dL on more than one occasion
Correct Answer: B
Rationale: The diagnostic criteria for diabetes mellitus include a fasting blood glucose of ≥126
mg/dL on more than one occasion, or a glycated hemoglobin (A1C) ≥6.5% .
Question 2
Glutamic acid decarboxylase (GAD-65) antibodies are found in what percentage of patients with
Type 1 Diabetes Mellitus?
A. 40%
B. 60%
C. 80%
D. 95%
Correct Answer: C
,Rationale: GAD-65 antibodies are autoimmune markers found in approximately 80% of patients
with Type 1 Diabetes Mellitus, making it a useful diagnostic tool for distinguishing Type 1 from
Type 2 diabetes .
Question 3
A patient with diabetes has a blood glucose of 60 mg/dL at 3:00 AM but 210 mg/dL at 7:00 AM.
What is the most likely diagnosis?
A. Dawn Phenomenon
B. Somogyi Effect
C. Insulin resistance
D. Brittle diabetes
Correct Answer: B
Rationale: The Somogyi Effect is rebound hyperglycemia caused by an undetected hypoglycemic
event during the night. The patient is hypoglycemic at 0300 but rebounds with an elevated
blood glucose at 0700. Management involves reducing or omitting bedtime insulin .
Question 4
A patient with diabetes has progressively elevated blood glucose throughout the night. What is
the most likely diagnosis?
A. Somogyi Effect
B. Dawn Phenomenon
C. Insulin resistance
D. Hyperosmolar hyperglycemic state
Correct Answer: B
Rationale: The Dawn Phenomenon is characterized by progressively elevated blood glucose
throughout the night due to the normal early-morning release of growth hormone and cortisol.
Management involves adding or increasing the bedtime dose of insulin .
Question 5
Which of the following is NOT a common early sign/symptom of Type 2 Diabetes Mellitus?
A. Recurrent vaginitis in women
B. Chronic skin infections
,C. Weight loss despite increased appetite
D. Pruritus
Correct Answer: C
Rationale: Early signs and symptoms of Type 2 Diabetes Mellitus include recurrent vaginitis in
women, chronic skin infections including pruritus, and polyuria/polydipsia. Weight loss despite
increased appetite is more characteristic of Type 1 Diabetes Mellitus .
Question 6
What is the black box warning for metformin?
A. Hepatotoxicity
B. Lactic acidosis
C. Nephrotoxicity
D. Cardiotoxicity
Correct Answer: B
Rationale: Metformin carries a black box warning for lactic acidosis, which presents with acute
muscle pain. Lactic acidosis is a rare but potentially fatal complication, particularly in patients
with renal impairment or acute illness .
Question 7
When should metformin be discontinued in a patient receiving iodinated radiocontrast
medium?
A. Immediately before the procedure
B. 1-2 days before the procedure
C. 4-6 hours before the procedure
D. No need to discontinue
Correct Answer: B
Rationale: Metformin should be discontinued 1-2 days before receiving iodinated radiocontrast
medium to reduce the risk of contrast-induced nephropathy and subsequent lactic acidosis. It
can be restarted 48 hours after the procedure once renal function is confirmed to be normal .
Question 8
Which of the following is a GLP-1 receptor agonist?
, A. Metformin
B. Glipizide
C. Semaglutide (Ozempic)
D. Pioglitazone
Correct Answer: C
Rationale: Semaglutide (Ozempic, Rybelsus) is a GLP-1 receptor agonist. Other examples include
dulaglutide (Trulicity). These medications stimulate insulin secretion, suppress glucagon, and
delay gastric emptying .
Question 9
What is the black box warning for GLP-1 receptor agonists?
A. Pancreatitis
B. Heart failure
C. Thyroid cancer
D. Lactic acidosis
Correct Answer: C
Rationale: GLP-1 receptor agonists carry a black box warning for thyroid cancer (medullary
thyroid carcinoma). They should not be used in patients with a personal or family history of
medullary thyroid cancer or multiple endocrine neoplasia syndrome type 2 .
Question 10
What is the REMS program monitoring requirement for GLP-1 receptor agonists?
A. Liver function tests
B. Pancreatitis monitoring
C. Renal function
D. Cardiac monitoring
Correct Answer: B
Rationale: GLP-1 receptor agonists require monitoring for pancreatitis through the REMS (Risk
Evaluation and Mitigation Strategy) program. Patients should be counseled to report severe
abdominal pain, which may indicate pancreatitis .
