Endocrinology (ABIM)
What is Pre-Diabetes? - correct answer ✔✔fasting BG 100-125, OGTT 140-199, HbA1c 5.7-6.4; prevent
progression-diet & exercise
What is Diabetes Mellitus Type 1? - correct answer ✔✔types- type1A (GAD65, 1A-2, thyroid, celiac), type
1B (asian, african), latent autoimmune diabetes of adulthood; (tx: longer-acting basal insulin + pre-
prandial insulin + correctional insulin
What are screening recommendations for chronic complications of diabetes? - correct answer ✔✔type 1
(begin 5yrs after diagnosis); type 2 (begin at time of diagnosis)
What is Panretinal laser photocoagulation therapy? - correct answer ✔✔retained central vision,
↓peripheral/↓night vision
What is Nonproliferative Diabetic Retinopathy? - correct answer ✔✔
What is Hyperglycemic Hyperosmolar Syndrome? - correct answer ✔✔↑BG, dry; dx-glucose >600,
plasma osmolality >320mOsm/kg; (tx-fluids, 0.9%NS, if Na too low or normal then use 0.45NS and when
BG 200→D5% + 0.45NS + K if <5.3; insulin, 1UK, when BG 200→0.01-0.05→ insulin SC basal-bolus
regiment)
What is Diabetic Ketoacidosis? - correct answer ✔✔
What is Diabetic Ketoacidosis? - correct answer ✔✔infection, abdominal pain; dx-BG >250, HCO3 <15,
AG↑, ⊕serum ketone; 0.9%NS, if Na too low or normal then use 0.45NS; BG <200→D5% + 0.45NS; K
>5.2, start insulin; K <3.3, start KCL for K level, 4-5; pH is <6.9,NaHCO3 + KCl
What is Diabetic Ketoacidosis: Subcutaneous Insulin Indication - correct answer ✔✔able to eat, glucose
< 200, anion gap < 12, serum HCO3 > 15; (tx-overlap SQ and IV by 2hrs)
,What are Diabetes Mellitus Type 2 Screening Criteria? - correct answer ✔✔fasting glucose (> 126mg/dL),
random glucose (>200 w/symptoms), 2-Hour Glucose during OGTT > 200mg/dL, HbA1c ≥ 6.5%;
asymptomatic patients + two tests with one abnormal, repeat
What are Diabetic Care Guidelines? - correct answer ✔✔A1c <7.0%, fasting BG (80-130), post prandial
BG (<180), BP <140/90 (ACE/ARB), statin, aspirin; yearly-spot urine/albumin, eye examination, foot
exam, smoking cessation
What is Diabetes Mellitus Type 2 Medication Algorithym? - correct answer ✔✔1. lifestyle
2. Step 1: metformin, dual therapy if A1c remains at 9% or above after 3 months of metformin
3. Step 2: Add a second drug (liraglutide) w. A1c >9%
4. Step 3: Add a third drug (metformin plus 2 drugs from step 2)
5. Step 4: Intensive insulin therapy + meformin (A1c >10%, BG > 250, random BG > 300, polyuria)
What is Maturity-onset diabetes of the young? - correct answer ✔✔adolescents-young adults, fx DM
Diabetic Oral Medications: What Medications are added to Metformin (eGFR <30)? - correct answer
✔✔liraglutide (GLP-1 agonist), glipizide (sulfonylurea); dual-therapy if A1c remains at 9% or above after
3 months of metformin
Diabetic Oral Medications: Help with Weight Loss - correct answer ✔✔liraglutide (GLP-1 agonist), 3-6mo
Diabetic Oral Medications: What Medications are 2nd line to Meformin (eGFR <30)? - correct answer
✔✔empagliflozin (SGLT2)
Diabetic Oral Medications: ASCVD Patients - correct answer ✔✔empagliflozin (SGLT2)
Diabetic Oral Medications: CKD Patients - correct answer ✔✔saxagliptin, (DPP4, ↑HF, pancreatitis)
What are Diabetic ketoacidosis Medications? - correct answer ✔✔empagliflozin (SGLT2)
, What are Diabetes Diagnostic Guidelines? - correct answer ✔✔>45yo; screen earlier if: BMI >25 + 1 risk
factor (1°relative with DM, PCOS, high risk ethnicity); target A1c-younger <7%, older 7-8%, BG 90-140
What are Hospitalized Diabetic Patient BG? - correct answer ✔✔140-180, avoid hypoglycemia; (tx-
scheduled basal insulin or basal insulin +correction for BG 140 to 180)
What is Diabetic Diarrhea? - correct answer ✔✔bloating, watery diarrhea ± at night, fecal incontinence;
complication-small intestinal bacterial overgrowth; dx-workup negative;
What is Basal-Bolus Insulin? - correct answer ✔✔total units 40 (1/2 basal 20, 1/2 bolus split into thirds
to be given prandially)
What is Diabetic Amyotrophy? - correct answer ✔✔LE pain-weakness, foot drop, autonomic failure; dx-
EMG-NCS; (tx-PT/OT, glycemic control)
What is Latent Autoimmune Diabetes of Adulthood? - correct answer ✔✔35yo-50yo, type 1 DM,
polyuria-fatigue, autoimmune disease; dx-anti-islet cell antibodies, anti-glutamic acid decarboxylase; (tx-
insulin)
What is Bariatric Surgery? - correct answer ✔✔BMI > 40 + DM, BMI of 35.0-39.9 not achieve weight loss
goals/improvement in comorbidities, w/Liraglutide; BMI 30.0 to 34.9 w. DM
What is Pregnancy Diabetes Mellitus? - correct answer ✔✔1hr glucose challenge test (24-28wks); 2hr
glucose challenge test (6-12wks postpartum); GDM Hx-1st trimester screening; (tx-insulin, A1c within 1%
of normal; fasting <95, 1-hour post prandial <140, 2hour post prandial <120)
What Pregnancy Anti-Hypertensive? - correct answer ✔✔methyldopa, B-blockers (except atenolol),
calcium channel blockers, hydralazine
What Medications Should be Stopped before pregnancy? - correct answer ✔✔ACE inhibitors, ARBs,
cholesterol lowering drugs