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ENDOCRINOLOGY MKSAP QUESTIONS AND ANSWERS
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ENDOCRINOLOGY MKSAP QUESTIONS AND ANSWERS
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ENDOCRINOLOGY MKSAP QUESTIONS ANDANSWERS
Frequency of A1c screening in patients with normal A1c - Answers -Every 3 years
What are the 4 ways to diagnose diabetes? - Answers -1) A1c > 6.5%
2) A random glucose > 200
3) A fasting glucose > 126
4) 2h glucose during OGTT > 200
A random glucose is tested in an asymptomatic person is 300. What do you do next? -
Answers -A random glucose > 200 is consistent with diabetes. This person is
asymptomatic.
Answer: Repeat the test in > 2h
GAD65 and IA2 autoantibodies are associated with ___ - Answers -Type 1 diabetes
(70% of pts with newly dx T1DM will have +GAD65/IA2 antibodies)
These SHOULD be checked on every new presumed dx T1DM to confirm dx
Should patients begin insulin use during their "honeymoon period" after diagnosis? -
Answers -Yes - even though Beta cells will continue to produce insulin, their production
decreases and use of exogenous insulin reduces the strain on the remaining Beta cells
Diagnosis of acanthosis nigricans should prompt evaluation for diabetes and ___ -
Answers -malignancy
Acute acanthosis nigricans can be associated with malignancy
Of all the available meds to treat diabetes, which is the one that should be started first?
- Answers -Metformin (REGARDLESS of anything else)
Should metformin be started in patients with pre-diabetes? - Answers -YES. Metformin
reduces the risk of developing T2DM by up to 10 years. Prescribe it in pre-diabetes!
From the text: "Metformin is recommended for type 2 diabetes mellitus prevention in
individuals with prediabetes"
A woman is diagnosed with diabetes at 12 weeks GA. Another is diagnosed at 24
weeks GA. What is the difference? - Answers -Diabetes during pregnancy < 24 weeks:
T2DM
Diabetes during pregnancy > 24 weeks: GDM
, Lifelong screening for women with GDM: Is it necessary? - Answers -Yes - women w hx
GDM should. be screened for diabetes q1-3 yrs even if their post-partum sugars
normalize
For patients with hypoglycemia unawareness, what is their A1c goal? - Answers -A1C <
8%
Whereas the rest of the world aims for A1c < 6.5%, in these patients their goal is < 8%
In pts with diagnosed T2DM, their A1c goal is < 7%
In patients with life expectancy < 10 yrs or age > 80, what is their A1c goal? - Answers -
They don't have an A1c goal - ADA recommends "avoiding an A1c goal" in these
patients 2/2 risk>benefit
All patients with CVD + T2DM should be on _____ (medication) - Answers -
Empagliflozin
What's the eGFR cutoff to start Metformin? - Answers -eGFR > 45 required to start
Metformin
Metformin is contraindicated in patients with eGFR < ____ - Answers -eGFR < 30
Do SGLT2 inhibitors need to be renally dosed? - Answers -Yes
All patients with T2DM + ASCVD should be on _____ - Answers -SGLT2 inhibitor or
GLP1 agonist
Is tight glycemic control the goal during hospitalization? - Answers -No - associated w
increased mortality
Goal should be random glucose > 140 or so
Euglycemic DKA has been described in patients taking ____ (class of medications) -
Answers -SGLT2 inhibitor
"All pts diagnosed with T2DM should get eye exam at time of diagnosis." T of F? -
Answers -True
1) How to screen for nephropathy in T2DM
2) How often to screen for nephropathy in T2DM - Answers -1) Screen with eGFR and
urine albumin:Cr ratio
2) Screen annually
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