Barkley Endocrine Exam PRACTICE
QUESTIONS |ORIGINAL QUESTIONS &
ANSWERS |DETAILED RATIONALES
|HINTED COMPLETE EXAM PREP GRADED
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1. A 52-year-old patient has polyuria, polydipsia, and an HbA1c of
7.2%. Which finding is sufficient to establish a diagnosis of diabetes
mellitus in an asymptomatic patient if confirmed on repeat testing?
A. Fasting glucose of 110 mg/dL
B. Random glucose of 160 mg/dL
C. HbA1c of 6.0%
D. HbA1c of 6.5% or greater
Answer: D. HbA1c of 6.5% or greater
Rationale: An HbA1c ≥6.5% meets a diagnostic criterion for diabetes.
In an asymptomatic patient, an abnormal diagnostic test should
generally be confirmed on another day unless unequivocal
hyperglycemia is present.
2. Which fasting plasma glucose level is diagnostic of diabetes
mellitus?
A. ≥100 mg/dL
B. ≥110 mg/dL
C. ≥126 mg/dL
D. ≥140 mg/dL
Answer: C. ≥126 mg/dL
,Rationale: A fasting plasma glucose ≥126 mg/dL (7.0 mmol/L) is
diagnostic of diabetes when confirmed appropriately.
3. A patient has a 2-hour plasma glucose of 205 mg/dL during a 75-g
oral glucose tolerance test. How should this result be interpreted?
A. Normal glucose tolerance
B. Prediabetes
C. Diabetes mellitus
D. Reactive hypoglycemia
Answer: C. Diabetes mellitus
Rationale: A 2-hour glucose ≥200 mg/dL during a 75-g oral glucose
tolerance test meets the diagnostic threshold for diabetes.
4. Which HbA1c value is most consistent with prediabetes?
A. 5.2%
B. 5.7%
C. 6.7%
D. 7.1%
Answer: B. 5.7%
Rationale: Prediabetes is generally defined by an HbA1c of 5.7%–
6.4%.
5. Which patient has the strongest indication for screening for type 2
diabetes?
A. A 22-year-old with BMI 19 kg/m² and no risk factors
B. A 35-year-old with obesity and a first-degree relative with diabetes
C. A 28-year-old endurance athlete without risk factors
D. A 30-year-old with normal BMI and no family history
,Answer: B. A 35-year-old with obesity and a first-degree relative
with diabetes
Rationale: Overweight/obesity combined with additional risk factors
such as a first-degree family history substantially increases diabetes
risk and warrants screening.
6. Which symptom is most characteristic of hyperglycemia?
A. Polyuria
B. Bradycardia
C. Hypothermia
D. Miosis
Answer: A. Polyuria
Rationale: Glucosuria causes osmotic diuresis, producing polyuria and
often compensatory polydipsia.
7. A patient with type 1 diabetes develops nausea, vomiting,
abdominal pain, and deep rapid respirations. Which complication
should be suspected?
A. Hyperosmolar hyperglycemic state
B. Diabetic ketoacidosis
C. Hypothyroidism
D. SIADH
Answer: B. Diabetic ketoacidosis
Rationale: DKA classically presents with hyperglycemia, ketosis,
metabolic acidosis, dehydration, gastrointestinal symptoms, and
compensatory Kussmaul respirations.
, 8. Which laboratory abnormality is most characteristic of diabetic
ketoacidosis?
A. Metabolic alkalosis
B. Elevated anion gap metabolic acidosis
C. Respiratory alkalosis without ketosis
D. Normal serum ketones
Answer: B. Elevated anion gap metabolic acidosis
Rationale: Accumulation of ketoacids produces an elevated anion gap
metabolic acidosis.
9. Which patient is most likely to develop hyperosmolar
hyperglycemic state (HHS)?
A. A young adult with new-onset type 1 diabetes
B. An older adult with poorly controlled type 2 diabetes
C. A healthy adolescent athlete
D. A patient with isolated hypothyroidism
Answer: B. An older adult with poorly controlled type 2 diabetes
Rationale: HHS typically occurs in older adults with type 2 diabetes
and features profound hyperglycemia, hyperosmolarity, and
dehydration with minimal or absent ketoacidosis.
10. Which finding best distinguishes HHS from DKA?
A. Severe dehydration
B. Hyperglycemia
C. Altered mental status with minimal ketosis
D. Increased serum osmolality
Answer: C. Altered mental status with minimal ketosis
QUESTIONS |ORIGINAL QUESTIONS &
ANSWERS |DETAILED RATIONALES
|HINTED COMPLETE EXAM PREP GRADED
A+*INSTANT DOWNLOAD PDF
1. A 52-year-old patient has polyuria, polydipsia, and an HbA1c of
7.2%. Which finding is sufficient to establish a diagnosis of diabetes
mellitus in an asymptomatic patient if confirmed on repeat testing?
A. Fasting glucose of 110 mg/dL
B. Random glucose of 160 mg/dL
C. HbA1c of 6.0%
D. HbA1c of 6.5% or greater
Answer: D. HbA1c of 6.5% or greater
Rationale: An HbA1c ≥6.5% meets a diagnostic criterion for diabetes.
In an asymptomatic patient, an abnormal diagnostic test should
generally be confirmed on another day unless unequivocal
hyperglycemia is present.
2. Which fasting plasma glucose level is diagnostic of diabetes
mellitus?
A. ≥100 mg/dL
B. ≥110 mg/dL
C. ≥126 mg/dL
D. ≥140 mg/dL
Answer: C. ≥126 mg/dL
,Rationale: A fasting plasma glucose ≥126 mg/dL (7.0 mmol/L) is
diagnostic of diabetes when confirmed appropriately.
3. A patient has a 2-hour plasma glucose of 205 mg/dL during a 75-g
oral glucose tolerance test. How should this result be interpreted?
A. Normal glucose tolerance
B. Prediabetes
C. Diabetes mellitus
D. Reactive hypoglycemia
Answer: C. Diabetes mellitus
Rationale: A 2-hour glucose ≥200 mg/dL during a 75-g oral glucose
tolerance test meets the diagnostic threshold for diabetes.
4. Which HbA1c value is most consistent with prediabetes?
A. 5.2%
B. 5.7%
C. 6.7%
D. 7.1%
Answer: B. 5.7%
Rationale: Prediabetes is generally defined by an HbA1c of 5.7%–
6.4%.
5. Which patient has the strongest indication for screening for type 2
diabetes?
A. A 22-year-old with BMI 19 kg/m² and no risk factors
B. A 35-year-old with obesity and a first-degree relative with diabetes
C. A 28-year-old endurance athlete without risk factors
D. A 30-year-old with normal BMI and no family history
,Answer: B. A 35-year-old with obesity and a first-degree relative
with diabetes
Rationale: Overweight/obesity combined with additional risk factors
such as a first-degree family history substantially increases diabetes
risk and warrants screening.
6. Which symptom is most characteristic of hyperglycemia?
A. Polyuria
B. Bradycardia
C. Hypothermia
D. Miosis
Answer: A. Polyuria
Rationale: Glucosuria causes osmotic diuresis, producing polyuria and
often compensatory polydipsia.
7. A patient with type 1 diabetes develops nausea, vomiting,
abdominal pain, and deep rapid respirations. Which complication
should be suspected?
A. Hyperosmolar hyperglycemic state
B. Diabetic ketoacidosis
C. Hypothyroidism
D. SIADH
Answer: B. Diabetic ketoacidosis
Rationale: DKA classically presents with hyperglycemia, ketosis,
metabolic acidosis, dehydration, gastrointestinal symptoms, and
compensatory Kussmaul respirations.
, 8. Which laboratory abnormality is most characteristic of diabetic
ketoacidosis?
A. Metabolic alkalosis
B. Elevated anion gap metabolic acidosis
C. Respiratory alkalosis without ketosis
D. Normal serum ketones
Answer: B. Elevated anion gap metabolic acidosis
Rationale: Accumulation of ketoacids produces an elevated anion gap
metabolic acidosis.
9. Which patient is most likely to develop hyperosmolar
hyperglycemic state (HHS)?
A. A young adult with new-onset type 1 diabetes
B. An older adult with poorly controlled type 2 diabetes
C. A healthy adolescent athlete
D. A patient with isolated hypothyroidism
Answer: B. An older adult with poorly controlled type 2 diabetes
Rationale: HHS typically occurs in older adults with type 2 diabetes
and features profound hyperglycemia, hyperosmolarity, and
dehydration with minimal or absent ketoacidosis.
10. Which finding best distinguishes HHS from DKA?
A. Severe dehydration
B. Hyperglycemia
C. Altered mental status with minimal ketosis
D. Increased serum osmolality
Answer: C. Altered mental status with minimal ketosis
