ACE Self-Assessment Program (ASAP): Sample Questions

The ASAP online self-assessment tool provides learners with case-based questions and answers designed to challenge clinical thought processes in recall, interpretation, and problem-solving skills in the evaluation, diagnosis, treatment, and management of endocrine diseases.

ASAP features patient cases with case histories, images, lab results and other pertinent information. After completing each topic-based question set, participants are presented with rationales and references for further learning.

Learn more about ASAP and how it helps you meet your CME/MOC needs by clicking here .

ASAP Challenge: Hypertension

A 45 year-old Caucasian woman presents to your office for a health physical. She has a family history of heart disease. Her father had a myocardial infarction (MI) at age 60. She does not smoke. She works at a local bank as a manager and is often stressed with work and her two kids. She tries to exercise regularly by going for a walk with her family, but admits she does not always succeed. She and her husband each have two glasses of wine after dinner regularly. She tries to watch her diet by limiting her saturated fat intake. Upon physical examination, her blood pressure (BP) is 138/87 mm Hg; her weight is 72 kg, and her body mass index (BMI) is 28 kg/m2 (normal, 18.5 to 24.9 kg/m2). No edema or murmur is noted. She does not have an abdominal bruit. Her laboratory work up shows normal range electrolytes. Her creatinine is 0.9 mg/dL (normal, 0.84-1.21 mg/dL), and her low density lipoprotein cholesterol (LDL-C) is 149 mg/dL (desirable, <100 mg/dL). Her BP was 134/86 mm Hg one year ago, according to her chart.

ASAP Challenge: Bone

A 76 year-old woman is referred for evaluation of multiple non-traumatic vertebral compression fractures developing over the past year. She was initially diagnosed with osteoporosis at age 58 years, with her lowest T-score of -3.2 at her lumbar spine. She was treated with alendronate for one year, but because of significant gastroesophageal irritation, she switched to intravenous zoledronic acid once a year for the next three years without symptoms, followed by a 6-year drug holiday. Once her bone density began to decrease after 6 years off treatment, she received a second three-year course of intravenous zoledronic acid, again without symptoms.  After completing her second course of zoledronic acid, her bone density did not increase as much as it did with her first course, and her primary care physician switched her to denosumab 60 mg subcutaneously every six months. Because her bone density increased significantly after four years of denosumab treatment, her physician discontinued denosumab. One year after her last dose of denosumab, she developed severe back pain without a fall or other injury, and her spine films showed new vertebral compression fractures at L1, L3, and L4.

ASAP Challenge: Diabetes

A 21 year-old man with a 7-year history of type 2 diabetes mellitus (T2DM) presents for follow-up. He was diagnosed with T2DM at age 14 years. At that time, his body mass index (BMI) was in the 99th percentile for his age. His mother has a history of gestational diabetes mellitus during her pregnancy with him and was diagnosed with T2DM in her early forties, when he was ten years old. His current BMI is 41 kg/m2 (normal, 18.5 to 24.9 kg/m2). He has been treated with metformin and insulin analogues, but he has not been taking the insulin recently because he feels unwell after he exercises with symptoms of shakiness, sweatiness, and hunger. His glycated hemoglobin (HbA1c) is 9.2% (normal, <5.7%). He wants to know more about diabetes mellitus and asks if there are other medication options for him.