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100+ Free Título em Endocrinologia e Metabologia Practice Questions

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Key Facts: Título em Endocrinologia e Metabologia Exam

Two components

The TEEM is delivered as a Prova Objetiva and a Prova de Casos Clínicos, published separately by the SBEM

Portal SBEM — TEEM

Set by edital

SBEM publishes the paper structure, cut score and fee in a numbered edital for each edition; no standing figures are published

Edital TEEM — SBEM

2 Stages

Examination Phases (Prova Teórica + Prova Teórico-Prática)

Comissão de Título de Especialista SBEM

Set by edital

SBEM publishes the paper structure, cut score and fee in a numbered edital for each edition; no standing figures are published

Edital TEEM — SBEM

RQE Definitivo

Permanent Specialist Board Certification Recognized by CFM

Resolução CFM nº 2.330/2023

Set by edital

SBEM publishes the paper structure, cut score and fee in a numbered edital for each edition; no standing figures are published

Edital TEEM — SBEM

The Título de Especialista em Endocrinologia e Metabologia (TEEM) is the official national board certification for Brazilian endocrinologists, granted by SBEM and AMB. It assesses comprehensive theoretical knowledge and practical diagnostic competence across diabetes, thyroid disorders, obesity, neuroendocrinology, adrenal diseases, and bone metabolism. This resource is an English-language study adaptation.

Sample Título em Endocrinologia e Metabologia Practice Questions

Try these sample questions to test your Título em Endocrinologia e Metabologia exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 58-year-old male with a 7-year history of type 2 diabetes mellitus (T2DM), established coronary artery disease (post-CABG 3 years ago), and stage G3a diabetic kidney disease (eGFR 52 mL/min/1.73m², urine albumin-to-creatinine ratio [RAC] 180 mg/g) presents for routine follow-up. His current medications include metformin 1,000 mg twice daily, atorvastatin 40 mg, enalapril 20 mg daily, and carvedilol 25 mg twice daily. His HbA1c is 7.4% and blood pressure is 128/78 mmHg. According to the Sociedade Brasileira de Diabetes (SBD) and ADA/EASD consensus guidelines, what is the most appropriate next step in his glycemic and cardiorenal management?
A.Add glimepiride 2 mg daily to achieve an HbA1c target below 6.5%.
B.Add an SGLT2 inhibitor (e.g., empagliflozin or dapagliflozin) or a GLP-1 receptor agonist with proven cardiorenal benefit, independent of baseline HbA1c.
C.Discontinue metformin due to stage G3a CKD and initiate basal insulin glargine at bedtime.
D.Add saxagliptin 5 mg daily as a DPP-4 inhibitor has proven superior cardiorenal mortality reduction.
Explanation: According to the Diretrizes da Sociedade Brasileira de Diabetes (SBD) and international consensus, patients with type 2 diabetes and established atherosclerotic cardiovascular disease (ASCVD) or chronic kidney disease (CKD) should receive an SGLT2 inhibitor (ISGLT2) and/or a GLP-1 receptor agonist (AR-GLP1) with proven cardiovascular and renal outcome benefits (e.g., empagliflozin, dapagliflozin, semaglutide, dulaglutide). This recommendation is independent of baseline HbA1c or individualized glycemic targets. Metformin is safe and indicated down to an eGFR of 30 mL/min/1.73m² (with dose adjustment below 45 mL/min/1.73m²).
2A 22-year-old female with type 1 diabetes mellitus (T1DM) is admitted to the emergency department with severe diabetic ketoacidosis (cetoacidose diabética - CAD). Initial labs revealed blood glucose 480 mg/dL, arterial pH 7.12, serum bicarbonate 10 mEq/L, and anion gap 24 mEq/L. She is treated with intravenous normal saline, potassium replacement, and continuous regular insulin infusion. After 14 hours of infusion, her capillary glucose is 180 mg/dL, venous pH is 7.34, serum bicarbonate is 19 mEq/L, and calculated anion gap is 10 mEq/L. She is alert, nausea has resolved, and she requests lunch. According to SBEM and SBD protocols, what is the most appropriate management at this stage?
A.Administer subcutaneous basal insulin along with prandial rapid-acting insulin 1 to 2 hours before stopping the intravenous insulin infusion.
B.Immediately turn off the intravenous insulin infusion and start oral metformin plus NPH insulin.
C.Discontinue intravenous fluids and insulin immediately, allowing the patient to eat regular meals while monitoring blood glucose every 6 hours.
D.Continue intravenous insulin infusion at the same rate and withhold all oral intake until the serum bicarbonate exceeds 24 mEq/L.
Explanation: Criteria for CAD resolution are met when blood glucose is < 200-250 mg/dL accompanied by at least two of the following: serum bicarbonate >= 18 mEq/L, venous pH > 7.30, and normalization of the anion gap (<= 12 mEq/L), along with clinical tolerance for oral intake. To avoid rebound ketoacidosis due to the short half-life of intravenous insulin, subcutaneous basal insulin (or basal-bolus) must be administered 1 to 2 hours before stopping the intravenous insulin infusion.
3A 74-year-old male is brought to the emergency department with profound lethargy, severe dehydration, and obtundation. Laboratory evaluation reveals: plasma glucose 940 mg/dL, serum sodium 152 mEq/L, potassium 4.8 mEq/L, bicarbonate 20 mEq/L, arterial pH 7.36, serum creatinine 2.4 mg/dL (baseline 1.0 mg/dL), and calculated effective serum osmolality 342 mOsm/kg. Urine dipstick shows trace ketones. A diagnosis of Hyperosmolar Hyperglycemic State (Estado Hiperosmolar Hiperglicêmico - EHH) is established. What is the initial priority in the resuscitation of this patient?
A.Immediate intravenous bolus of regular insulin at 0.4 units/kg before any fluid administration.
B.Intravenous infusion of sodium bicarbonate to correct mild metabolic acidosis.
C.Aggressive fluid resuscitation with isotonic 0.9% NaCl (1,000–1,500 mL in the first hour) to restore intravascular volume, followed by reassessment of corrected sodium.
D.Initiation of intravenous potassium chloride bolus without fluids because total body potassium is severely depleted.
Explanation: In Hyperosmolar Hyperglycemic State (EHH), the primary therapeutic priority is aggressive volume replacement. Fluid deficits typically range from 100 to 200 mL/kg (8–12 L total). Initial therapy begins with 0.9% NaCl at 1,000–1,500 mL/hr during the first hour to restore hemodynamic stability and renal perfusion. Insulin should not be started if severe hypovolemia is uncorrected, as insulin drives water into cells and can worsen circulatory collapse.
4A 16-year-old adolescent with newly diagnosed type 1 diabetes mellitus (T1DM) was discharged on a total daily insulin dose of 0.6 units/kg/day. Three months later, his mother reports frequent mild hypoglycemic episodes. Over the past 4 weeks, his required total daily insulin dose has dropped to 0.18 units/kg/day while maintaining fasting glucose between 80–115 mg/dL and postprandial glucose < 140 mg/dL. His HbA1c is 5.8%. Diagnostic autoantibody panel was positive for anti-GAD65 and anti-ZnT8. What clinical phenomenon best explains his current status?
A.Misdiagnosis of T1DM; the patient has Maturity-Onset Diabetes of the Young (MODY 2).
B.Development of adrenal insufficiency (Schmidt syndrome) causing sudden insulin hypersensitivity.
C.Spontaneous permanent remission of autoimmune insulitis with complete beta-cell regeneration.
D.The 'honeymoon period' (fase de lua de mel), characterized by transient endogenous beta-cell recovery following the correction of initial glucotoxicity.
Explanation: The 'honeymoon period' (fase de lua de mel) occurs in up to 60-80% of children and adolescents shortly after starting insulin therapy for T1DM. Correction of initial severe glucotoxicity and metabolic stress allows surviving pancreatic beta-cells to transiently recover endogenous insulin secretion, markedly reducing exogenous insulin requirements (often < 0.2-0.3 units/kg/day) for several months to over a year before progressive autoimmune destruction resumes.
5A 52-year-old woman with type 2 diabetes treated with dapagliflozin 10 mg and metformin 1,000 mg twice daily undergoes elective laparoscopic cholecystectomy. Forty-eight hours postoperatively, she develops tachypnea, nausea, vomiting, and diffuse abdominal pain. Capillary blood glucose is 158 mg/dL. Arterial blood gas demonstrates pH 7.18, pCO2 22 mmHg, HCO3 8 mEq/L, and serum anion gap of 22 mEq/L. Blood beta-hydroxybutyrate is elevated at 4.8 mmol/L. What is the diagnosis and what is the key preventive measure recommended by SBEM/SBD regarding SGLT2 inhibitors?
A.Euglycemic Diabetic Ketoacidosis (CAD euglicêmica); SGLT2 inhibitors must be withheld at least 3 to 4 days prior to elective major surgery.
B.Metformin-associated lactic acidosis (MALA); metformin should have been replaced with a sulfonylurea preoperatively.
C.Acute post-cholecystectomy pancreatitis; SGLT2 inhibitors can be safely continued throughout the perioperative period.
D.Secondary adrenal insufficiency precipitated by surgical stress; SGLT2 inhibitors have no impact on perioperative ketoacidosis.
Explanation: SGLT2 inhibitors promote persistent urinary glucose excretion, which lowers plasma glucose and suppresses endogenous insulin secretion while stimulating glucagon release. Under surgical stress, reduced oral intake, or infection, this altered insulin-to-glucagon ratio triggers profound lipolysis and ketogenesis with near-normal or mildly elevated glycemia (< 200-250 mg/dL), termed Euglycemic DKA. SBEM, SBD, and regulatory agencies mandate discontinuing SGLT2 inhibitors 3 to 4 days prior to scheduled major surgical procedures.
6A 28-year-old female with type 1 diabetes utilizes a continuous glucose monitoring (CGM / MGC) sensor. Over the past 14 days, her sensor active time was 98%. Her Ambulatory Glucose Profile (AGP) report displays: Time in Range (TIR, 70–180 mg/dL) = 74%, Time Above Range (TAR, > 180 mg/dL) = 21%, Time Below Range (TBR, < 70 mg/dL) = 5% (with 1.8% < 54 mg/dL), and Coefficient of Variation (%CV) = 38%. According to international and SBD consensus on CGM targets for non-pregnant adults with T1DM, which parameter fails to meet the recommended clinical target?
A.Time in Range (TIR 70–180 mg/dL), which must exceed 85%.
B.Time Below Range (TBR < 70 mg/dL and < 54 mg/dL) and Glucose Variability (%CV), which exceed safe thresholds.
C.Time Above Range (TAR > 180 mg/dL), which must be strictly 0%.
D.Sensor active time, which is below the valid analytical threshold of 99%.
Explanation: Standard consensus targets for CGM in non-pregnant adults with T1DM/T2DM are: Time in Range (TIR 70–180 mg/dL) > 70%, Time Below Range (TBR < 70 mg/dL) < 4%, Very Low TBR (< 54 mg/dL) < 1%, Time Above Range (TAR > 180 mg/dL) < 25%, and Coefficient of Variation (%CV) <= 36%. In this patient, TBR < 70 mg/dL is 5% (> 4%), TBR < 54 mg/dL is 1.8% (> 1%), and %CV is 38% (> 36%), indicating excessive hypoglycemia exposure and high glycemic variability.
7A 63-year-old male with a 12-year history of T2DM, hypertension, and stage G3bA3 diabetic kidney disease (eGFR 38 mL/min/1.73m², persistent urinary albumin-to-creatinine ratio [RAC] 420 mg/g) is evaluated. He is currently on maximally tolerated doses of dapagliflozin 10 mg, losartan 100 mg daily, and linagliptin 5 mg. His serum potassium is 4.3 mEq/L and blood pressure is 132/82 mmHg. Based on the FIDELIO-DKD and FIGARO-DKD landmark clinical trials and recent SBD/KDIGO guidelines, what pharmacological agent should be added to further reduce the risk of CKD progression and cardiovascular events?
A.Spironolactone 50 mg daily, as all mineralocorticoid receptor antagonists have identical renal outcome benefits.
B.Aliskiren 150 mg daily, to achieve dual renin-angiotensin-aldosterone system inhibition.
C.Finerenone (a non-steroidal selective mineralocorticoid receptor antagonist) 20 mg daily, with regular potassium monitoring.
D.Triple therapy with enalapril added to losartan to completely arrest albuminuria.
Explanation: Finerenone is a novel, non-steroidal, selective mineralocorticoid receptor antagonist (ns-MRA) that significantly reduces CKD progression and cardiovascular events in patients with T2DM and persistent albuminuria (RAC >= 30 mg/g) already on maximally tolerated RAAS inhibitors and SGLT2 inhibitors, as demonstrated in the FIDELIO-DKD and FIGARO-DKD trials. It has a favorable safety profile regarding hyperkalemia compared to steroidal MRAs like spironolactone.
8A 29-year-old primigravida at 26 weeks of gestation undergoes a standard 75g oral glucose tolerance test (TOTG-75g) for gestational diabetes mellitus (DMG) screening. Her first-trimester fasting plasma glucose was 84 mg/dL. Her current TOTG-75g results are: Fasting = 89 mg/dL; 1-hour post-load = 184 mg/dL; 2-hour post-load = 148 mg/dL. According to the criteria adopted by the Sociedade Brasileira de Diabetes (SBD), FEBRASGO, and IADPSG, how should this patient be classified?
A.Normal glucose tolerance during pregnancy, because two out of three values are strictly normal.
B.Impaired glucose tolerance (pré-diabetes gestacional), requiring re-testing at 34 weeks.
C.Overt diabetes in pregnancy (diabetes manifesto), requiring immediate initiation of prandial and basal insulin.
D.Gestational Diabetes Mellitus (Diabetes Mellitus Gestacional - DMG), as a single abnormal value on the 75g OGTT is sufficient for diagnosis.
Explanation: Under the SBD, FEBRASGO, and IADPSG criteria, a 75g OGTT performed between 24 and 28 weeks of gestation confirms Gestational Diabetes Mellitus (DMG) if AT LEAST ONE value is equal to or greater than the established cutoffs: Fasting >= 92 mg/dL; 1-hour >= 180 mg/dL; 2-hour >= 153 mg/dL. Here, the 1-hour value is 184 mg/dL (>= 180 mg/dL), establishing the diagnosis of DMG.
9A 56-year-old male with a 15-year history of T2DM complains of severe postprandial fullness, early satiety, recurrent nausea, and persistent lightheadedness when standing up from a seated position. Physical exam shows a supine blood pressure of 142/86 mmHg with heart rate 76 bpm; upon standing for 3 minutes, his blood pressure drops to 110/68 mmHg without any compensatory change in heart rate (78 bpm). Neurological exam demonstrates resting sinus tachycardia, absent Achilles reflexes bilaterally, and loss of 10g monofilament sensation in a stocking distribution. Which diagnostic combination best confirms his underlying condition?
A.Electromyography showing pure motor demyelinating polyradiculopathy.
B.Gastric emptying scintigraphy with solid meals demonstrating delayed retention and Cardiovascular Autonomic Reflex Tests (CARTs / Testes de Ewing).
C.24-hour urinary free cortisol and plasma renin-to-aldosterone ratio to evaluate secondary adrenal failure.
D.Upper GI endoscopy confirming peptic ulcer perforation.
Explanation: The clinical presentation is characteristic of Diabetic Autonomic Neuropathy (DAN), involving both Diabetic Gastroparesis (nausea, postprandial fullness, early satiety) and Cardiac Autonomic Neuropathy (CAN - orthostatic hypotension with fixed heart rate / loss of heart rate variability). Diagnosis of gastroparesis is confirmed by gastric emptying scintigraphy (cintilografia de esvaziamento gástrico) using a radiolabeled solid meal (retention > 10% at 4 hours). CAN is evaluated using standardized Cardiovascular Autonomic Reflex Tests (Ewing battery: deep breathing, Valsalva maneuver, active standing).
10A 24-year-old male with T1DM weighing 70 kg is practicing advanced carbohydrate counting. His total daily insulin dose (TDD) is 42 units/day (basal-bolus regimen: 21 units glargine + 21 units lispro split across meals). His pre-meal target blood glucose is 100 mg/dL. Using the standard 'Rule of 500' for Carbohydrate-to-Insulin Ratio (Relação Carboidrato/Insulina - RCI) and the 'Rule of 1800' for Insulin Sensitivity Factor (Fator de Sensibilidade - FS), how much rapid-acting insulin lispro should he inject before a meal containing 60 g of carbohydrates if his preprandial blood glucose is 220 mg/dL?
A.8.0 units (5.0 units for meal carbs + 3.0 units for glycemic correction).
B.4.0 units (2.0 units for meal carbs + 2.0 units for glycemic correction).
C.12.0 units (8.0 units for meal carbs + 4.0 units for glycemic correction).
D.15.0 units (10.0 units for meal carbs + 5.0 units for glycemic correction).
Explanation: Calculations: (1) RCI = 500 / TDD = 500 / 42 ≈ 12 g of carbohydrate per unit of insulin. For a 60 g carb meal: 60 / 12 = 5.0 units of bolus insulin. (2) FS = 1800 / TDD = 1800 / 42 ≈ 43 mg/dL drop per unit of insulin. The correction dose = (Current Glucose - Target Glucose) / FS = (220 - 100) / 43 = 120 / 43 ≈ 2.8 (rounded to 3.0 units). Total pre-meal bolus = 5.0 + 3.0 = 8.0 units.

About the Título em Endocrinologia e Metabologia Exam

The Título de Especialista em Endocrinologia e Metabologia (TEEM) is the official board certification granted jointly by the Sociedade Brasileira de Endocrinologia e Metabologia (SBEM) and the Associação Médica Brasileira (AMB), under the regulatory oversight of the Conselho Federal de Medicina (CFM). Attaining this title grants physicians the official specialist status and allows registration of the Registro de Qualificação de Especialista (RQE) in Endocrinology and Metabolism in Brazil. The rigorous evaluation evaluates knowledge across diabetes mellitus, thyroid diseases, obesity, lipid metabolism, pituitary and adrenal disorders, bone and mineral disorders, and reproductive endocrinology. Please note that this practice question bank is an English-language study adaptation designed for board prep.

Assessment

TEEM — Exame de Suficiência para obtenção do Título de Especialista em Endocrinologia e Metabologia, run annually by the Sociedade Brasileira de Endocrinologia e Metabologia with the AMB, following CFM and CNRM guidance. The examination is delivered in two components published separately by the SBEM: a Prova Objetiva and a Prova de Casos Clínicos. Approval in both is required for the title.

Time Limit

Set by each annual edital

Passing Score

Set by each edition's edital

Exam Fee

Set annually by the society's edital and varies with society/AMB membership status; consult the current edital before budgeting (Sociedade Brasileira de Endocrinologia e Metabologia (SBEM) — Associação Médica Brasileira (AMB))

Título em Endocrinologia e Metabologia Exam Content Outline

25%

Diabetes Mellitus e Complicações Metabólicas

Pathophysiology, clinical diagnosis, classification (T1DM, T2DM, MODY, LADA, GDM), continuous glucose monitoring (AGP, Time in Range / TIR, Time Below Range / TBR, %CV), intensive insulin therapy (basal-bolus calculation, carbohydrate counting, insulin pump therapy), modern non-insulin antidiabetic agents (SGLT2 inhibitors, GLP-1 receptor agonists, dual GIP/GLP-1 agonists), acute decompensations (diabetic ketoacidosis / CAD, hyperosmolar hyperglycemic state / EHH, hypoglycemia unawareness), and chronic micro/macrovascular complications (diabetic kidney disease / DKD, diabetic retinopathy, distal symmetric and autonomic polyneuropathy, Charcot neuroarthropathy).

20%

Tireoide: Disfunções, Bócio, Nódulos e Neoplasias

Hypothyroidism (primary autoimmune Hashimoto's thyroiditis, central, subclinical hypothyroidism indications for levothyroxine, pregnancy-specific management), hyperthyroidism and thyrotoxicosis (Graves' disease TRAb, antithyroid drug therapy, radioactive iodine I-131, Graves' orbitopathy CAS score and pulse methylprednisolone, thyroid storm Burch-Wartofsky score and multi-drug regimen, subacute De Quervain thyroiditis, postpartum thyroiditis, amiodarone-induced thyrotoxicosis AIT-1 vs AIT-2), thyroid nodules (ACR TI-RADS / ATA sonographic risk stratification, FNA cytology), Bethesda System for Reporting Thyroid Cytopathology (AUS/FLUS, Follicular Neoplasm, Suspicious for Malignancy, Malignant), and thyroid carcinomas (papillary, follicular, medullary calcitonin/CEA/RET, anaplastic ATC targeted therapy, ATA recurrence risk staging, post-op radioiodine ablation, dynamic response assessment).

12%

Obesidade, Síndrome Metabólica e Dislipidemias

Neuroendocrine regulation of appetite and energy expenditure, obesity diagnosis and staging, lifestyle modification, modern anti-obesity pharmacotherapy (semaglutide 2.4 mg, tirzepatide, liraglutide 3.0 mg, naltrexone/bupropion, phentermine/topiramate), bariatric and metabolic surgery (CFM criteria, Roux-en-Y gastric bypass, sleeve gastrectomy, long-term micronutrient deficiencies), metabolic syndrome diagnostic criteria (IDF/NCEP/SBEM), primary and secondary dyslipidemias (SBC cardiovascular risk stratification and LDL-C targets), familial hypercholesterolemia (Dutch Lipid Clinic criteria, LDLR/APOB/PCSK9 genetics), severe hypertriglyceridemia and acute pancreatitis, PCSK9 monoclonal antibodies (evolocumab, alirocumab) and inclisiran, statin-associated muscle symptoms (SAMS), MASLD/MASH staging with FIB-4, lipodystrophy syndromes, and familial chylomicronemia syndrome.

13%

Hipófise e Neuroendocrinologia

Pituitary adenomas / pituitary neuroendocrine tumors (PitNETs), prolactinoma workup, hook effect, first-line medical therapy with dopamine agonists (cabergoline), acromegaly screening (serum IGF-1, OGTT GH nadir, somatostatin receptor ligands, pegvisomant), Cushing's disease (screening with 24h UFC, 1mg overnight DST, late-night salivary cortisol; high-dose DST and inferior petrosal sinus sampling / IPSS), hypopituitarism and hormone replacement sequence, pituitary apoplexy emergency management, central diabetes insipidus (arginine vasopressin deficiency, water deprivation test, desmopressin), syndrome of inappropriate antidiuresis (SIAD/SIADH euvolemic hyponatremia), craniopharyngiomas (adamantinomatous vs papillary), lymphocytic hypophysitis, and adult growth hormone deficiency.

12%

Adrenais e Hipertensão Endócrina

Primary aldosteronism (Conn syndrome, aldosterone-to-renin ratio / ARR, confirmatory saline suppression test, adrenal vein sampling / AVS for lateralization), pheochromocytoma and paraganglioma (plasma/urinary fractionated metanephrines, genetic syndromes RET/VHL/NF1/SDH, mandatory preoperative alpha-adrenergic blockade before beta-blockers), primary adrenal insufficiency (Addison's disease, autoimmune adrenalitis, cosyntropin stimulation test) and acute adrenal crisis resuscitation (immediate IV hydrocortisone and isotonic fluids), congenital adrenal hyperplasia (21-hydroxylase deficiency, 17-OHP, salt-wasting vs simple virilizing), adrenal incidentaloma workup (unenhanced CT HU attenuation, hormonal exclusion), adrenocortical carcinoma (Weiss criteria, mitotane), ectopic ACTH secretion, and glucocorticoid-induced HPA axis suppression.

8%

Metabolismo Ósseo e Mineral

Bone biology and remodeling, osteoporosis diagnosis by dual-energy X-ray absorptiometry (DXA T-score <= -2.5, Z-score <= -2.0), FRAX fracture risk calculation, antiresorptive medications (bisphosphonates, denosumab rebound fracture risk upon discontinuation) and osteoanabolic agents (teriparatide, romosozumab), primary hyperparathyroidism (hypercalcemia, intact PTH, asymptomatic surgery criteria), familial hypocalciuric hypercalcemia (CASR mutation, CCCR < 0.01), hypocalcemia and hypoparathyroidism, vitamin D deficiency and osteomalacia (Looser's zones), tumor-induced osteomalacia (FGF23-secreting tumors, burosumab), and Paget's disease of bone (alkaline phosphatase, zoledronic acid).

5%

Endocrinologia Feminina e Masculina

Polycystic ovary syndrome (Rotterdam diagnostic criteria, hyperandrogenism, metabolic syndrome association, lifestyle, combined oral contraceptives, metformin, letrozole), male hypogonadism (morning total testosterone, primary hypergonadotropic vs secondary hypogonadotropic, Klinefelter syndrome 47,XXY, testosterone replacement therapy contraindications and monitoring), menopausal hormone therapy (window of opportunity, estrogen plus progestogen for endometrial protection, transdermal route for cardiovascular safety), and secondary amenorrhea step-by-step diagnostic algorithm.

5%

Endocrinologia Pediátrica

Pediatric growth failure and short stature assessment (height velocity curves, Greulich-Pyle bone age, familial short stature vs constitutional delay of growth and puberty, GH stimulation testing), central precocious puberty (pubertal LH response to GnRH test, cranial MRI, depot GnRH analogs) vs peripheral precocious puberty (suppressed LH, McCune-Albright, testotoxicosis), neonatal congenital hypothyroidism screening (Teste do Pezinho, immediate levothyroxine replacement), and Turner syndrome (45,X, recombinant GH, puberty induction).

How to Pass the Título em Endocrinologia e Metabologia Exam

What You Need to Know

  • Passing score: Set by each edition's edital
  • Assessment: TEEM — Exame de Suficiência para obtenção do Título de Especialista em Endocrinologia e Metabologia, run annually by the Sociedade Brasileira de Endocrinologia e Metabologia with the AMB, following CFM and CNRM guidance. The examination is delivered in two components published separately by the SBEM: a Prova Objetiva and a Prova de Casos Clínicos. Approval in both is required for the title.
  • Time limit: Set by each annual edital
  • Exam fee: Set annually by the society's edital and varies with society/AMB membership status; consult the current edital before budgeting

Keys to Passing

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

Título em Endocrinologia e Metabologia Study Tips from Top Performers

1Master Continuous Glucose Monitoring & Diabetes Technology: Understand Time in Range (TIR > 70%), Time Below Range (TBR < 4% for < 70 mg/dL, < 1% for < 54 mg/dL), Coefficient of Variation (%CV <= 36%), and insulin pump infusion failure management.
2Memorize Dynamic Endocrine Testing Protocols: Know cutoff values for 1mg dexamethasone suppression (< 1.8 ug/dL), cosyntropin stimulation (> 18 ug/dL), OGTT GH suppression (< 0.4-1.0 ng/mL), water deprivation test, and adrenal vein sampling lateralization ratios.
3Integrate Thyroid Imaging and Cytology Systems: Master ACR TI-RADS / ATA ultrasound risk patterns and the Bethesda Cytopathology categories (AUS/FLUS, Follicular Neoplasm, Suspicious for Malignancy, Malignant) and their specific surgical/molecular indications.
4Understand Modern Incretin & SGLT2i Cardiorenal Evidence: Review landmark clinical trials (EMPA-REG, DAPA-CKD, DECLARE, LEADER, SUSTAIN-6,阶段, SURPASS, SURMOUNT, FLOW) demonstrating cardiorenal protection in T2DM and CKD.
5Review Official Brazilian & International Guidelines: Study the Diretrizes da Sociedade Brasileira de Diabetes (SBD), Posicionamentos SBEM/ABESO on Obesity, Diretrizes Brasileiras de Dislipidemia (SBC), and ATA Thyroid Nodule/Cancer guidelines.
6Complete the 100 Practice Questions with Detailed Explanations: Thoroughly analyze both correct rationales and incorrect distractor explanations to solidify high-yield diagnostic and therapeutic nuances.

Frequently Asked Questions

What is the TEEM (Título de Especialista em Endocrinologia e Metabologia)?

The TEEM is the official medical specialist board certification awarded jointly by the Sociedade Brasileira de Endocrinologia e Metabologia (SBEM) and the Associação Médica Brasileira (AMB), recognized by the Conselho Federal de Medicina (CFM). It legally certifies a physician as an endocrinologist and metabologist in Brazil, enabling registration of the Registro de Qualificação de Especialista (RQE).

What are the eligibility requirements to sit for the SBEM specialist exam?

Candidates must hold an active registration with their Regional Medical Council (CRM), be in good ethical and professional standing, and have completed either: (a) an accredited Medical Residency (Residência Médica) in Endocrinologia e Metabologia recognized by CNRM/MEC, or (b) documented clinical practice and professional training in the specialty for the minimum period specified in the official annual Edital SBEM/AMB.

How is the SBEM specialist title exam structured?

The TEEM qualification certame is divided into two parts: (1) Prova Teórica, an objective multiple-choice examination assessing pathophysiology, clinical trials, and clinical practice guidelines across all endocrine domains; and (2) Prova Teórico-Prática, evaluating real-world clinical competence through case vignettes, dynamic endocrine testing curves, thyroid ultrasound images, cytopathology slides, and bone densitometry reports.

What is the passing score for the TEEM certification?

Candidates must achieve a minimum overall score of 70% (7.0 out of 10.0) according to the official certame announcement (Edital).

Which medical society administers the TEEM examination?

The examination is organized and administered by the Sociedade Brasileira de Endocrinologia e Metabologia (SBEM) in partnership with the Associação Médica Brasileira (AMB). SBEM is the official national body representing endocrinologists in Brazil (official portal: endocrino.org.br).

Why is this OpenExamPrep practice bank written in English?

This practice bank is an English-language study adaptation created for endocrinology fellows, residents, and international physicians preparing for board-level clinical certification. It maintains all authentic Brazilian clinical terminology (e.g., SBEM, SBD, ABESO, AMB, CFM, SUS, PCDT, cetoacidose diabética, nódulo tireoidiano, densitometria óssea) within standardized bilingual vignettes.