Section 1: Endocrine
1. A patient has FPG 128 mg/dL and A1c 6.4%. Next step?
A. Diagnose diabetes
B. Repeat testing
C. Start metformin
D. Order OGTT
2. Which medication is contraindicated if eGFR <30?
A. GLP-1 agonist
B. Insulin
C. Metformin
D. DPP-4 inhibitor
3. A patient on SGLT2 inhibitor presents with nausea, abdominal pain, and normal glucose. What
is the diagnosis?
A. Hypoglycemia
B. Euglycemic DKA
C. Lactic acidosis
D. HHS
4. Which drug provides both cardiovascular and renal protection in T2DM?
A. Sulfonylureas
B. SGLT2 inhibitors
C. TZDs
D. DPP-4 inhibitors
5. A patient with A1c 10.5% and weight loss should start:
A. Metformin only
B. GLP-1 agonist
C. Basal insulin
D. DPP-4 inhibitor
, 6. Which physical finding suggests insulin resistance?
A. Goiter
B. Acanthosis nigricans
C. Pretibial edema
D. Bradycardia
7. A patient has ↑TSH and normal T4. Next step?
A. Immediate treatment
B. Diagnose hyperthyroidism
C. Monitor or treat if symptomatic
D. Start PTU
8. Which medication should be avoided within 4 hours of levothyroxine?
A. Vitamin C
B. Calcium
C. Magnesium
D. Potassium
9. First-line treatment for hyperthyroidism in pregnancy (1st trimester):
A. Methimazole
B. PTU
C. Radioiodine
D. Surgery
10. Which symptom is MOST specific to Graves disease?
A. Weight loss
B. Tremor
C. Ophthalmopathy
D. Tachycardia
Section 2: GI
11. GERD patient with dysphagia—next step?
A. Start PPI
B. Endoscopy