,1. A 35-year-old male sees you for a routine health maintenance visit. He has gained a few
pounds over the past few years. He is 173 cm (68 in) tall and weighs 82 kg (181 lb), giving him
a BMI of 27 kg/m2.According to current American Diabetes Association guidelines, which one of
the following additional factors would warrant screening him for prediabetes and diabetes? -
CORRECT ANSWERS -E. Physical inactivity
2. An obese 58-year-old male comes to your office with a 2-week history of fatigue associated
with polyuria, polydipsia, and weight loss. You suspect he has type 2 diabetes. This diagnosis
would be corroborated by a random glucose level greater than or equal to a threshold of -
CORRECT ANSWERS -D. 200 mg/dL
3. A 66-year-old male who was hospitalized because of a TIA 3 months ago sees you for a
follow-up visit. His past medical history is notable for impaired fasting glucose and hypertension.
His current medications include valsartan (Diovan), 160 mg daily; rosuvastatin (Crestor), 20 mg
daily; and aspirin, 81 mg daily. On examination his BMI is 30 kg/m2, his blood pressure is
134/86 mm Hg, and he has brown, velvety, hyperkeratotic plaques on the back of his neck and
in his axillae. Laboratory studies are notable for an LDL-cholesterol level of 85 mg/dL, an HDL-
cholesterol level of 35 mg/dL, and a serum triglyceride level of 174 mg/dL. His hemoglobin A1c
is 7.1%.
Which one of the following agents may reduce his risk for stroke and myocardial infarction? -
CORRECT ANSWERS -D. Pioglitazone (Actos)
4. A 71-year-old male is hospitalized for an infected foot ulcer. His medical history is notable for
type 2 diabetes, hypertension, and chronic pancreatitis. His medications on admission include
pancrelipase (Creon), 72,000 units with each meal; extended-release metformin (Glucophage
XR), 500 mg four times daily; extended-release glipizide (Glucotrol XL), 5 mg daily; and
benazepril (Lotensin), 40 mg daily. Insulin therapy is initiated for hyperglycemia with persistent
blood glucose levels ≥200 mg/dL.
Based on American Diabetes Association guidelines, which one of the following would be the
most appropriate glycemic target for this patient during his hospitalization? - CORRECT
ANSWERS -C. 140-180 mg/dL
5. An obese 53-year-old male with a history of type 2 diabetes sees you for the first time. He
tells you that his previous physician had him see a dietician and started him on metformin
(Glucophage), 500 mg twice daily. A copy of his most recent laboratory tests shows a
hemoglobin A1c of 7.7%. He tells you that he has always been sedentary and asks if it would be
worthwhile for him to join an exercise facility and begin an exercise program.
Which one of the following statements would be accurate advice? - CORRECT ANSWERS -C.
Combined aerobic and resistance training results in greater glycemic improvement than either
method alone
, 6. An overweight, sedentary 71-year-old male presents with a 4-month history of burning pain in
the soles of his feet that is most noticeable at night when he is lying in bed. His medical history
includes a long history of type 2 diabetes, hypertension, and hypercholesterolemia. His current
medications include metformin (Glucophage), 850 mg twice daily; exenatide (Bydureon), 2 mg
subcutaneously weekly; valsartan (Diovan), 360 mg daily; hydrochlorothiazide, 25 mg daily; and
rosuvastatin (Crestor), 10 mg daily. He quit smoking 40 years ago and does not drink alcohol. A
physical examination is unremarkable except for some hyperesthesia of both feet, as well as
reduced vibratory sensation. His protective sensation is intact in both feet and his pedal pulses
are normal.
Which one of the following would be LEAST effective for treating this patient's pain syndrome? -
CORRECT ANSWERS -B. SSRIs
7. A 71-year-old male presents early on a Saturday morning to the urgent care clinic you are
staffing. He describes a 1-week history of episodic sweating, feelings of hunger, and tremor that
are relieved by eating. He reports that he has type 2 diabetes and has taken metformin
(Glucophage) for years, and that his physician recently added a new diabetes medication
because his hemoglobin A1c rose above 7.5%. He did not bring his medications with him and
you are unable to access his records because the electronic medical record system is
undergoing routine maintenance and an update.
Which one of the following diabetes medications would be most likely to cause this patient's
symptoms? - CORRECT ANSWERS -C. Glyburide
8. A 55-year-old male with type 2 diabetes presents with a history of reduced libido and erectile
dysfunction. He has not seen a physician for many years. On examination you note bronze-
colored skin, hepatomegaly, and mild testicular atrophy. A nonfasting laboratory workup reveals
the following serum levels:
Glucose............250 mg/dL
AST............260 U/L (N 10-40)
ALT............210 U/L (N 10-55)
FSH............5.0 mIU/mL (N 1.0-12.0)
LH............8.1 mIU/mL (N 2.0-12.0)
Testosterone............180 ng/mL (N 280-1250)
Which one of the following is the most likely diagnosis? - CORRECT ANSWERS -D.
Hemachromatosis
9. A 67-year-old male sees you 6 months after he was hospitalized with a non-ST-elevation
myocardial infarction. He also has a history of hypertension and type 2 diabetes. His current
pounds over the past few years. He is 173 cm (68 in) tall and weighs 82 kg (181 lb), giving him
a BMI of 27 kg/m2.According to current American Diabetes Association guidelines, which one of
the following additional factors would warrant screening him for prediabetes and diabetes? -
CORRECT ANSWERS -E. Physical inactivity
2. An obese 58-year-old male comes to your office with a 2-week history of fatigue associated
with polyuria, polydipsia, and weight loss. You suspect he has type 2 diabetes. This diagnosis
would be corroborated by a random glucose level greater than or equal to a threshold of -
CORRECT ANSWERS -D. 200 mg/dL
3. A 66-year-old male who was hospitalized because of a TIA 3 months ago sees you for a
follow-up visit. His past medical history is notable for impaired fasting glucose and hypertension.
His current medications include valsartan (Diovan), 160 mg daily; rosuvastatin (Crestor), 20 mg
daily; and aspirin, 81 mg daily. On examination his BMI is 30 kg/m2, his blood pressure is
134/86 mm Hg, and he has brown, velvety, hyperkeratotic plaques on the back of his neck and
in his axillae. Laboratory studies are notable for an LDL-cholesterol level of 85 mg/dL, an HDL-
cholesterol level of 35 mg/dL, and a serum triglyceride level of 174 mg/dL. His hemoglobin A1c
is 7.1%.
Which one of the following agents may reduce his risk for stroke and myocardial infarction? -
CORRECT ANSWERS -D. Pioglitazone (Actos)
4. A 71-year-old male is hospitalized for an infected foot ulcer. His medical history is notable for
type 2 diabetes, hypertension, and chronic pancreatitis. His medications on admission include
pancrelipase (Creon), 72,000 units with each meal; extended-release metformin (Glucophage
XR), 500 mg four times daily; extended-release glipizide (Glucotrol XL), 5 mg daily; and
benazepril (Lotensin), 40 mg daily. Insulin therapy is initiated for hyperglycemia with persistent
blood glucose levels ≥200 mg/dL.
Based on American Diabetes Association guidelines, which one of the following would be the
most appropriate glycemic target for this patient during his hospitalization? - CORRECT
ANSWERS -C. 140-180 mg/dL
5. An obese 53-year-old male with a history of type 2 diabetes sees you for the first time. He
tells you that his previous physician had him see a dietician and started him on metformin
(Glucophage), 500 mg twice daily. A copy of his most recent laboratory tests shows a
hemoglobin A1c of 7.7%. He tells you that he has always been sedentary and asks if it would be
worthwhile for him to join an exercise facility and begin an exercise program.
Which one of the following statements would be accurate advice? - CORRECT ANSWERS -C.
Combined aerobic and resistance training results in greater glycemic improvement than either
method alone
, 6. An overweight, sedentary 71-year-old male presents with a 4-month history of burning pain in
the soles of his feet that is most noticeable at night when he is lying in bed. His medical history
includes a long history of type 2 diabetes, hypertension, and hypercholesterolemia. His current
medications include metformin (Glucophage), 850 mg twice daily; exenatide (Bydureon), 2 mg
subcutaneously weekly; valsartan (Diovan), 360 mg daily; hydrochlorothiazide, 25 mg daily; and
rosuvastatin (Crestor), 10 mg daily. He quit smoking 40 years ago and does not drink alcohol. A
physical examination is unremarkable except for some hyperesthesia of both feet, as well as
reduced vibratory sensation. His protective sensation is intact in both feet and his pedal pulses
are normal.
Which one of the following would be LEAST effective for treating this patient's pain syndrome? -
CORRECT ANSWERS -B. SSRIs
7. A 71-year-old male presents early on a Saturday morning to the urgent care clinic you are
staffing. He describes a 1-week history of episodic sweating, feelings of hunger, and tremor that
are relieved by eating. He reports that he has type 2 diabetes and has taken metformin
(Glucophage) for years, and that his physician recently added a new diabetes medication
because his hemoglobin A1c rose above 7.5%. He did not bring his medications with him and
you are unable to access his records because the electronic medical record system is
undergoing routine maintenance and an update.
Which one of the following diabetes medications would be most likely to cause this patient's
symptoms? - CORRECT ANSWERS -C. Glyburide
8. A 55-year-old male with type 2 diabetes presents with a history of reduced libido and erectile
dysfunction. He has not seen a physician for many years. On examination you note bronze-
colored skin, hepatomegaly, and mild testicular atrophy. A nonfasting laboratory workup reveals
the following serum levels:
Glucose............250 mg/dL
AST............260 U/L (N 10-40)
ALT............210 U/L (N 10-55)
FSH............5.0 mIU/mL (N 1.0-12.0)
LH............8.1 mIU/mL (N 2.0-12.0)
Testosterone............180 ng/mL (N 280-1250)
Which one of the following is the most likely diagnosis? - CORRECT ANSWERS -D.
Hemachromatosis
9. A 67-year-old male sees you 6 months after he was hospitalized with a non-ST-elevation
myocardial infarction. He also has a history of hypertension and type 2 diabetes. His current
