AG-ACNP Endocrine Actual Exam
2025/2026 Questions with Verified
Solutions || Already Graded A+
<Recent Version>
1. What is the pathology of diabetes mellitus? - ANSWER ✓ Metabolic disease
resulting from a breakdown in the body's ability to produce or utilize insulin
causing hyperglycemia.
2. Explain the pathology of DM Type 1. - ANSWER ✓ Insulin DEPENDENT.
Total destruction of beta cells.
Islet cell antibodies - 90% of patients
Ketone development occurs
3. What are the signs and symptoms of DM Type I? - ANSWER ✓ Polyphagia
Polydypsia
Polyuria
Weight loss
4. What is the pathology of Diabetic Ketoacidosis (DKA)? - ANSWER ✓
Intracellular dehydration as a result of hyperglycemia.
5. What are the cardinal signs and symptoms of DKA? - ANSWER ✓
Kussmaul breathing
Altered LOC
Fruity breath
Poor skin turgor, dehydration
6. What are the diagnostics associated with DKA? - ANSWER ✓ BG > 250
mg/dL
Ketonemia, ketonuria
Metabolic Acidosis - pH < 7.3, low HCO3
Hyperkalemia
Leukocytosis
, Hyperosmolality
7. Explain the management of DKA. - ANSWER ✓ Protect airway, oxygen
First Hour: Isotonic NS IVF 1-2 L, then 500 ml/hr.
Glucose falls <250 mg/dL: Start D51/2NS to prevent hypoglycemia
0.1 units/kg Regular insulin IV bolus, followed by 0.1 units/kg/hr Regular insulin
gtts.
Glucose does not fall 10% in first hour, repeat 0.1 units/kg Regular insulin
IV bolus.
Hourly UPO monitoring
8. Explain the pathology of Hyperosmolar Hyperglycemic Non-Ketosis
(HHNK). - ANSWER ✓ Intracellular dehydration as a result of elevated
blood glucose. Patients cannot produce enough insulin to prevent severe
hyperglycemia, osmotic diuresis, and extracellular fluid depletion.
9. Primary Adrenal insuffiency - ANSWER ✓ adrenal glands are damaged and
cannot produce enough cortisol
10.Secondary adrenal insuffiency - ANSWER ✓ When pituitary gland fails to
produce enough adrenocorticotropin (ACTH) that stimulates the adrenal
gland
11.s/s of adrenal insuffiency - ANSWER ✓ Hyperpigmentation in buccal
mucosa and Skin creases (especially knuckles, nail beds, nipples, palmar,
creases and posterior neck)
12.Tests for adrenal insufficiency - ANSWER ✓ ACTH simulation test, insulin
hypoglycemia test, plasma cortisol, cosyntropin
13.S/s addisonian crisis - ANSWER ✓ Pain in lower back, abdomen or legs
Severe vomiting and diarrhea, leading to dehydration
Low blood pressure
Loss of consciousness
Hyperkalemia
14.Outpatient mangement - ANSWER ✓ Hydrocortisone, gludrocortisone
acetate
,15.Inpatient management addisions - ANSWER ✓ Hydrocortisone, dextrose,
treat underlying infection/cause
16.What are the hallmark signs and symptoms of HHNK? - ANSWER ✓
Dehydration
Hypotension
Changes in LOC
17.What are the diagnostics associated with HHNK? - ANSWER ✓ Blood
glucose > 600 mg/dL; often > 1000 mg/dL.
Hyperosmolality > 310 mOsm/L
Elevated BUN/Cr - dehydration
Normal pH
Normal anion gap
18.Explain the management of HHNK. - ANSWER ✓ Protect airway, O2.
NS IVF 6-12 L, then 1/2 NS, then D51/2NS
15 units Regular insulin, followed by 10-15 units Regular insulin SQ
immediatley
19.What are the classic signs and symptoms of Hyperthyroidism? - ANSWER
✓ Increased sweating
Tachycardia
Hyperthermia
Heat intolerance
Weight loss
Exopthalmos
Emotionally labile
Atrial Fibrillation
20.What is the most sensitive test in diagnosing hyperthyroidism? - ANSWER
✓ TSH assay. Hyperthyroidism - TSH low, T3 high
21.In hyperthyroidism, the T3 is: - ANSWER ✓ Elevated T3 (80-230 ng/dL)
22.A low thyroid radioactive iodine uptake is associated with what etiology of
hyperthyroidism? - ANSWER ✓ Subacute thyroiditis
, 23.What age group is primarily affected in DM Type 1? - ANSWER ✓ Young
people and early adulthood
24.What antigens are strongly associated with DMI? - ANSWER ✓ HLA-DR3
or HLA-DR4 (human leukocye antigens)
25.What antibodies are found in 90% of patients within the first year of dx of
DM1? - ANSWER ✓ Islet cell antibodies
26.What is the hallmark difference between DM1 and DM2? - ANSWER ✓
development of ketones in DM1
27.What are s/s of DM? - ANSWER ✓ polyuria
polydipsia
polyphagia
28.What s/s of DM are primarily found in type 1 DM? - ANSWER ✓ nocturnal
emesis
weight loss
weakness/fatigue
29.What s/s of DM are primarily found in type 2 DM? - ANSWER ✓ onset is
insidious
recurrent vaginitis or other chronic skin infxn
blurred vision
peripheral neuropathies
30.What lab values are typically assc w/Impaired glucose tolerance? -
ANSWER ✓ FBG >/100 and </125
31.If a serum fasting glucose is >? 126 can you diagnose a person w/DM? -
ANSWER ✓ No, the fasting glucose needs to be >/126 on two separate
occasions, or a non-fasting blood glucose>/ 200 w/the 3 p's
32.Would the BUN/cr be elevated in a DM pt? - ANSWER ✓ Yes, ,due to
dehydration
2025/2026 Questions with Verified
Solutions || Already Graded A+
<Recent Version>
1. What is the pathology of diabetes mellitus? - ANSWER ✓ Metabolic disease
resulting from a breakdown in the body's ability to produce or utilize insulin
causing hyperglycemia.
2. Explain the pathology of DM Type 1. - ANSWER ✓ Insulin DEPENDENT.
Total destruction of beta cells.
Islet cell antibodies - 90% of patients
Ketone development occurs
3. What are the signs and symptoms of DM Type I? - ANSWER ✓ Polyphagia
Polydypsia
Polyuria
Weight loss
4. What is the pathology of Diabetic Ketoacidosis (DKA)? - ANSWER ✓
Intracellular dehydration as a result of hyperglycemia.
5. What are the cardinal signs and symptoms of DKA? - ANSWER ✓
Kussmaul breathing
Altered LOC
Fruity breath
Poor skin turgor, dehydration
6. What are the diagnostics associated with DKA? - ANSWER ✓ BG > 250
mg/dL
Ketonemia, ketonuria
Metabolic Acidosis - pH < 7.3, low HCO3
Hyperkalemia
Leukocytosis
, Hyperosmolality
7. Explain the management of DKA. - ANSWER ✓ Protect airway, oxygen
First Hour: Isotonic NS IVF 1-2 L, then 500 ml/hr.
Glucose falls <250 mg/dL: Start D51/2NS to prevent hypoglycemia
0.1 units/kg Regular insulin IV bolus, followed by 0.1 units/kg/hr Regular insulin
gtts.
Glucose does not fall 10% in first hour, repeat 0.1 units/kg Regular insulin
IV bolus.
Hourly UPO monitoring
8. Explain the pathology of Hyperosmolar Hyperglycemic Non-Ketosis
(HHNK). - ANSWER ✓ Intracellular dehydration as a result of elevated
blood glucose. Patients cannot produce enough insulin to prevent severe
hyperglycemia, osmotic diuresis, and extracellular fluid depletion.
9. Primary Adrenal insuffiency - ANSWER ✓ adrenal glands are damaged and
cannot produce enough cortisol
10.Secondary adrenal insuffiency - ANSWER ✓ When pituitary gland fails to
produce enough adrenocorticotropin (ACTH) that stimulates the adrenal
gland
11.s/s of adrenal insuffiency - ANSWER ✓ Hyperpigmentation in buccal
mucosa and Skin creases (especially knuckles, nail beds, nipples, palmar,
creases and posterior neck)
12.Tests for adrenal insufficiency - ANSWER ✓ ACTH simulation test, insulin
hypoglycemia test, plasma cortisol, cosyntropin
13.S/s addisonian crisis - ANSWER ✓ Pain in lower back, abdomen or legs
Severe vomiting and diarrhea, leading to dehydration
Low blood pressure
Loss of consciousness
Hyperkalemia
14.Outpatient mangement - ANSWER ✓ Hydrocortisone, gludrocortisone
acetate
,15.Inpatient management addisions - ANSWER ✓ Hydrocortisone, dextrose,
treat underlying infection/cause
16.What are the hallmark signs and symptoms of HHNK? - ANSWER ✓
Dehydration
Hypotension
Changes in LOC
17.What are the diagnostics associated with HHNK? - ANSWER ✓ Blood
glucose > 600 mg/dL; often > 1000 mg/dL.
Hyperosmolality > 310 mOsm/L
Elevated BUN/Cr - dehydration
Normal pH
Normal anion gap
18.Explain the management of HHNK. - ANSWER ✓ Protect airway, O2.
NS IVF 6-12 L, then 1/2 NS, then D51/2NS
15 units Regular insulin, followed by 10-15 units Regular insulin SQ
immediatley
19.What are the classic signs and symptoms of Hyperthyroidism? - ANSWER
✓ Increased sweating
Tachycardia
Hyperthermia
Heat intolerance
Weight loss
Exopthalmos
Emotionally labile
Atrial Fibrillation
20.What is the most sensitive test in diagnosing hyperthyroidism? - ANSWER
✓ TSH assay. Hyperthyroidism - TSH low, T3 high
21.In hyperthyroidism, the T3 is: - ANSWER ✓ Elevated T3 (80-230 ng/dL)
22.A low thyroid radioactive iodine uptake is associated with what etiology of
hyperthyroidism? - ANSWER ✓ Subacute thyroiditis
, 23.What age group is primarily affected in DM Type 1? - ANSWER ✓ Young
people and early adulthood
24.What antigens are strongly associated with DMI? - ANSWER ✓ HLA-DR3
or HLA-DR4 (human leukocye antigens)
25.What antibodies are found in 90% of patients within the first year of dx of
DM1? - ANSWER ✓ Islet cell antibodies
26.What is the hallmark difference between DM1 and DM2? - ANSWER ✓
development of ketones in DM1
27.What are s/s of DM? - ANSWER ✓ polyuria
polydipsia
polyphagia
28.What s/s of DM are primarily found in type 1 DM? - ANSWER ✓ nocturnal
emesis
weight loss
weakness/fatigue
29.What s/s of DM are primarily found in type 2 DM? - ANSWER ✓ onset is
insidious
recurrent vaginitis or other chronic skin infxn
blurred vision
peripheral neuropathies
30.What lab values are typically assc w/Impaired glucose tolerance? -
ANSWER ✓ FBG >/100 and </125
31.If a serum fasting glucose is >? 126 can you diagnose a person w/DM? -
ANSWER ✓ No, the fasting glucose needs to be >/126 on two separate
occasions, or a non-fasting blood glucose>/ 200 w/the 3 p's
32.Would the BUN/cr be elevated in a DM pt? - ANSWER ✓ Yes, ,due to
dehydration
