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Exam Review

Key Facts: CME Endocrinología Exam

31 Jan 2026

Examination date

CME Convocatoria 2026

CEAT-UNAM

Venue (Tlatelolco, Mexico City)

CME Convocatoria 2026

08:00–12:00

Theoretical exam schedule (4 hours)

CME Convocatoria 2026

7.0 / 10

Passing grade to advance to ECOE

CME Convocatoria 2026

9 stations

ECOE clinical stations (min pass 8.0/station)

CME Convocatoria 2026

MXN 5,000

Certification examination fee

CME Convocatoria 2026

The CME certification exam is the CONACEM-recognized endocrinology board exam in Mexico: a 4-hour written MCQ exam (grade 7.0/10 to advance) followed by a 9-station ECOE in which each station needs 8.0.

Sample CME Endocrinología Practice Questions

Try these sample questions to review concepts for the CME Endocrinología exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 48-year-old asymptomatic man undergoes a routine health evaluation. His body mass index is 31.4 kg/m2. Laboratory testing reveals a fasting plasma glucose of 132 mg/dL. He has no prior history of diabetes. In accordance with the ADA Standards of Care, what is the most appropriate next step to confirm the diagnosis of diabetes mellitus?
A.Initiate immediate dual therapy with metformin and an SGLT2 inhibitor without further testing
B.Repeat the fasting plasma glucose or measure HbA1c from a new blood sample to confirm the result
C.Perform an immediate 24-hour continuous glucose monitoring profile
D.Classify the patient as having impaired fasting glucose and recheck in one year
Explanation: In an asymptomatic patient without unequivocal hyperglycemia (such as random glucose >=200 mg/dL with polyuria, polydipsia, or unexplained weight loss), a single abnormal fasting plasma glucose (>=126 mg/dL) requires confirmation. The diagnosis of diabetes mellitus is confirmed by repeating the same test or a different diagnostic test (such as HbA1c >=6.5% or a 75-g oral glucose tolerance test with 2-hour glucose >=200 mg/dL) either from a new blood specimen or, under current ADA criteria, as two different abnormal tests from the same sample.
2A 23-year-old female with known type 1 diabetes mellitus presents to the emergency department with abdominal pain, vomiting, and Kussmaul respirations. Laboratory evaluation demonstrates: plasma glucose 490 mg/dL, arterial pH 7.14, serum bicarbonate 10 mEq/L, anion gap 24 mEq/L, and serum potassium 5.1 mEq/L. What is the mandatory initial step in the pharmacological and fluid management of this patient?
A.Administer an intravenous bolus of 50 mEq of sodium bicarbonate over 30 minutes
B.Start an intravenous regular insulin infusion at 0.1 units/kg/hr immediately without IV fluids
C.Begin rapid intravenous volume resuscitation with isotonic crystalloid (0.9% NaCl) at 1,000 mL/hr
D.Administer 20 mEq of oral potassium chloride before any intravenous access is established
Explanation: Fluid resuscitation is the first priority in diabetic ketoacidosis. The 2024 ADA/EASD/JBDS/AACE/DTS consensus on hyperglycemic crises recommends isotonic saline or a balanced crystalloid at 500–1,000 mL/h during the first 2–4 hours, adjusted for age, heart and kidney function. Fluids restore circulating volume, improve renal perfusion, promote glucosuria and lower counter-regulatory hormones. The insulin infusion follows or accompanies volume expansion, provided serum potassium is at least 3.5 mmol/L (mEq/L).
3A 28-year-old male with type 1 diabetes is admitted with severe diabetic ketoacidosis. Initial blood tests reveal plasma glucose 540 mg/dL, arterial pH 7.08, serum bicarbonate 8 mEq/L, and serum potassium 3.0 mEq/L. What is the critical rule regarding insulin administration in this scenario?
A.Withhold insulin infusion and replete potassium intravenously until serum potassium is above 3.5 mEq/L
B.Double the standard regular insulin infusion rate to 0.2 units/kg/hr to correct the acidosis faster
C.Give a subcutaneous glargine dose immediately while keeping the patient fasting
D.Administer insulin infusion concurrently with IV calcium gluconate to stabilize the myocardium
Explanation: Under the 2024 ADA/EASD/JBDS/AACE/DTS hyperglycemic crises consensus, if serum potassium is below 3.5 mmol/L (mEq/L) at presentation, insulin is postponed while intravenous potassium is given (about 10–20 mEq/h) until potassium rises above 3.5. The 2009 ADA statement used a 3.3 mEq/L cut-off. Administering insulin drives potassium into cells, which can trigger life-threatening ventricular arrhythmias, cardiac arrest, or respiratory muscle paralysis.
4A 72-year-old woman with a history of dementia and type 2 diabetes presents with profound lethargy and severe dehydration. Laboratory results show: serum glucose 980 mg/dL, serum sodium 152 mEq/L, serum potassium 4.6 mEq/L, arterial pH 7.36, serum bicarbonate 22 mEq/L, effective serum osmolality 342 mOsm/kg, and negative urine ketones. She receives 0.9% NaCl with a positive fluid balance and a low-dose insulin infusion. Four hours later her glucose has fallen to 620 mg/dL, her measured sodium has risen to 156 mEq/L, and her calculated osmolality is falling by about 4 mOsm/kg per hour. What is the most appropriate fluid management now?
A.Switch to hypertonic 3% sodium chloride
B.Switch immediately to 0.45% sodium chloride because the serum sodium has risen
C.Give a rapid bolus of 5% dextrose in water to correct the hypernatremia
D.Continue isotonic crystalloid and monitor osmolality; hypotonic saline is reserved for osmolality that stops falling
Explanation: This is hyperglycemic hyperosmolar state (HHS): glucose ≥600 mg/dL, effective osmolality >300 mOsm/kg (2024 consensus criterion), pH ≥7.30, bicarbonate ≥15 and minimal ketosis. As glucose falls, water shifts into cells and the measured sodium rises (about 1.6 mEq/L for each 100 mg/dL drop in glucose). The 2024 ADA/EASD/JBDS/AACE/DTS consensus states that this initial rise in sodium is not an indication for hypotonic fluids. 0.45% NaCl is indicated only if osmolality is not declining despite an adequate positive fluid balance and appropriate insulin. The target is a fall in osmolality of 3–8 mOsm/kg/h and in sodium of no more than 10 mEq/L in 24 h. Here osmolality is falling at a safe rate, so isotonic fluid continues.
5A 52-year-old man with newly diagnosed type 2 diabetes has an HbA1c of 7.8%. His eGFR is 84 mL/min/1.73 m2, liver enzymes are normal, and he has no history of heart failure or renal disease. In accordance with international consensus (ADA/EASD), what is the recommended initial first-line pharmacological agent alongside lifestyle modification?
A.Pioglitazone
B.Metformin
C.Glimepiride
D.Acarbose
Explanation: Metformin remains the foundational first-line pharmacological agent for patients with newly diagnosed type 2 diabetes mellitus when not contraindicated (eGFR >=30 mL/min/1.73 m2). It provides potent glycemic efficacy, weight neutrality or modest reduction, low hypoglycemia risk, and established long-term cardiovascular safety data.
6A 61-year-old male with type 2 diabetes and a history of myocardial infarction 3 years ago has an HbA1c of 8.2% despite maximal metformin monotherapy. His eGFR is 52 mL/min/1.73 m2 and urine albumin-to-creatinine ratio is 180 mg/g. Which class of antihyperglycemic medication provides proven organ-protective benefits in reducing heart failure hospitalization and slowing CKD progression?
A.Dipeptidyl peptidase-4 (DPP-4) inhibitors
B.Meglitinides
C.Sodium-glucose cotransporter 2 (SGLT2) inhibitors
D.Thiazolidinediones
Explanation: SGLT2 inhibitors (such as empagliflozin, dapagliflozin, and canagliflozin) have demonstrated robust reductions in heart failure hospitalizations, cardiovascular mortality, and chronic kidney disease progression in patients with type 2 diabetes and established cardiovascular disease or CKD. Guidelines strongly recommend an SGLT2 inhibitor in this clinical scenario independent of baseline HbA1c.
7A 45-year-old woman with type 2 diabetes and obesity (BMI 36 kg/m2) is being considered for glucagon-like peptide-1 (GLP-1) receptor agonist therapy with dulaglutide. Which of the following conditions represents an absolute contraindication to this class of medication?
A.Non-alcoholic fatty liver disease (NAFLD)
B.Mild non-proliferative diabetic retinopathy
C.Moderate chronic kidney disease (eGFR 45 mL/min/1.73 m2)
D.Personal or family history of medullary thyroid carcinoma or MEN 2
Explanation: All GLP-1 receptor agonists carry a black-box warning and absolute contraindication in patients with a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), based on rodent models demonstrating thyroid C-cell hyperplasia and tumors via GLP-1 receptor activation.
8A 56-year-old female with type 2 diabetes treated with metformin and empagliflozin undergoes elective laparoscopic cholecystectomy. Forty-eight hours postoperatively, she develops malaise, nausea, tachypnea, and vomiting. Her fingerstick glucose is 168 mg/dL. Arterial blood gas shows: pH 7.22, pCO2 24 mmHg, HCO3 10 mEq/L, and serum beta-hydroxybutyrate is markedly elevated at 5.2 mmol/L. What is the diagnosis?
A.Euglycemic diabetic ketoacidosis (euDKA) triggered by SGLT2 inhibitor therapy
B.Metformin-associated lactic acidosis (MALA)
C.Acute postoperative hypovolemic shock with lactic acidosis
D.Hyperosmolar hyperglycemic state
Explanation: Euglycemic diabetic ketoacidosis (euDKA) is a recognized complication of SGLT2 inhibitors. It is characterized by high anion gap metabolic acidosis and significant ketonemia (beta-hydroxybutyrate >3.0 mmol/L) with normal or only modestly elevated blood glucose (<250 mg/dL). It is typically precipitated by physiologic stressors such as surgery, infection, acute illness, or reduced caloric/insulin intake.
9A 36-year-old non-obese woman (BMI 22.8 kg/m2) was diagnosed with type 2 diabetes 9 months ago. Despite adherence to metformin and glimepiride, her HbA1c has worsened from 8.0% to 10.8%, and she has experienced unexplained 6-kg weight loss. She has no family history of diabetes. Which diagnostic test is most informative to establish a diagnosis of Latent Autoimmune Diabetes in Adults (LADA)?
A.24-hour urinary free cortisol excretion
B.Serum autoantibodies to glutamic acid decarboxylase (anti-GAD65)
C.Measurement of glucagon-like peptide-1 after a mixed meal
D.Genetic sequencing for HNF1A mutations
Explanation: Latent Autoimmune Diabetes in Adults (LADA) shares genetic, immunological, and phenotypic features with type 1 diabetes, presenting in adults >=30 years who initially do not require insulin but experience rapid beta-cell failure. High-titer positivity for anti-glutamic acid decarboxylase 65 (anti-GAD65) autoantibodies, often accompanied by anti-IA2 or ZnT8, confirms the autoimmune etiology and dictates prompt initiation of insulin therapy.
10A 21-year-old lean male is found to have asymptomatic fasting hyperglycemia between 105 and 125 mg/dL during a routine pre-employment screen. His HbA1c is 6.2%. His mother and maternal grandfather have had lifelong mild asymptomatic fasting hyperglycemia without microvascular complications. Genetic testing confirms a heterozygous inactivating mutation in the glucokinase (GCK) gene, consistent with MODY 2. What is the recommended management?
A.Immediate initiation of basal-bolus insulin therapy
B.Low-dose sulfonylurea therapy (glipizide 2.5 mg daily)
C.Reassurance and clinical lifestyle follow-up without pharmacological intervention
D.Treatment with high-dose metformin to achieve fasting glucose <100 mg/dL
Explanation: GCK-MODY (MODY 2) is caused by heterozygous mutations in the glucokinase gene, which acts as the pancreatic beta-cell glucose sensor. This shifts the threshold for glucose-stimulated insulin release higher, resulting in lifelong, stable, mild fasting hyperglycemia (100–145 mg/dL) with normal or mildly elevated HbA1c. These patients do not develop microvascular complications and do not respond to or require pharmacological therapy, except during pregnancy when fetal genotype is discordant.

About the CME Endocrinología Exam

Independent CME endocrinology certification study practice by OpenExamPrep. The Consejo Mexicano de Endocrinología, A.C., recognized by CONACEM, certifies endocrinologists through a written multiple-choice theoretical exam followed by a 9-station ECOE (objective structured clinical examination). The 2026 exam was held on 31 January 2026 at CEAT-UNAM in Mexico City, with the theoretical exam from 08:00 to 12:00. The official exam is in Spanish; this bank is an independent English-language MCQ study adaptation of the theoretical component built from current international guidelines and relevant Mexican NOMs. It is not an official translation or simulation, and the ECOE stations are not simulated.

Exam sponsor: Consejo Mexicano de Endocrinología, A.C. (CME). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

The certification process comprises two sequential stages: a 4-hour written theoretical multiple-choice examination (08:00–12:00) evaluating clinical knowledge and decision-making, followed by an Objective Structured Clinical Examination (ECOE) consisting of 9 clinical stations with expert examiners. A minimum score of 7.0 out of 10.0 on the written exam is required to proceed to the ECOE, where each station must be passed with a grade of 8.0 or higher.

Time Limit

4 hours (theoretical written exam session: 08:00 to 12:00 hrs)

Passing Score

Theoretical written exam: minimum grade of 7.0 / 10.0 required to advance to the ECOE; each of the 9 ECOE stations must be passed with 8.0 or higher for final board certification

Exam / Certification Fees

MXN 5,000 for initial certification (MXN 7,000 for recertification / renewal)

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

Core section (weight not published)

Diabetes Mellitus y Metabolismo de Lípidos

Classification (type 1, type 2, LADA, MODY), glycemic goals, oral and injectable antihyperglycemics (metformin, SGLT2i, GLP-1 RA, DPP-4i, insulin titration), acute metabolic decompensation (DKA, HHS fluid and electrolyte protocols), microvascular and macrovascular complications, and management of familial and acquired dyslipidemias

Core section (weight not published)

Patología Tiroidea y Cáncer de Tiroides

Etiology, clinical diagnosis, and treatment of hyperthyroidism (Graves disease, toxic multinodular goiter, thyroid storm scoring), hypothyroidism (Hashimoto disease, subclinical hypothyroidism, pregnancy recommendations, myxedema coma), fine-needle aspiration cytopathology (Bethesda system), and differentiated thyroid cancer risk stratification and radioactive iodine protocols

Core section (weight not published)

Hipófisis y Neuroendocrinología

Evaluation and management of pituitary adenomas (prolactinoma, acromegaly, Cushing disease, non-functioning tumors), hypopituitarism and hormone replacement, pituitary apoplexy, sellar pathology, and fluid-electrolyte syndromes including central diabetes insipidus, SIADH, and cerebral salt wasting

Core section (weight not published)

Glándula Suprarrenal e Hipertensión Endocrina

Primary adrenal insufficiency (Addison disease) and emergency crisis management, screening and confirmation of primary aldosteronism (aldosterone-to-renin ratio, adrenal venous sampling), pheochromocytoma and paraganglioma perioperative alpha- and beta-blockade, Cushing syndrome diagnostic algorithms, and adrenal incidentaloma workup

Core section (weight not published)

Metabolismo Fosfocálcico, Hueso y Gónadas

Differential diagnosis of hypercalcemia (primary hyperparathyroidism vs humoral hypercalcemia of malignancy), hypocalcemia and hungry bone syndrome, diagnostic DEXA T-scores and pharmacological treatment of osteoporosis, male hypogonadism and testosterone replacement, and polycystic ovary syndrome (PCOS Rotterdam criteria)

Preparing for the CME Endocrinología Exam

What You Need to Know

  • Passing score: Theoretical written exam: minimum grade of 7.0 / 10.0 required to advance to the ECOE; each of the 9 ECOE stations must be passed with 8.0 or higher for final board certification
  • Assessment: The certification process comprises two sequential stages: a 4-hour written theoretical multiple-choice examination (08:00–12:00) evaluating clinical knowledge and decision-making, followed by an Objective Structured Clinical Examination (ECOE) consisting of 9 clinical stations with expert examiners. A minimum score of 7.0 out of 10.0 on the written exam is required to proceed to the ECOE, where each station must be passed with a grade of 8.0 or higher.
  • Time limit: 4 hours (theoretical written exam session: 08:00 to 12:00 hrs)
  • Exam / certification fees: MXN 5,000 for initial certification (MXN 7,000 for recertification / renewal) Official sources

Using Our Practice Resources

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

CME Endocrinología: Suggested Study Strategy

1Master diagnostic criteria and glycemic targets from the ADA Standards of Care, including individualized HbA1c goals, cardiovascular and kidney outcome evidence for SGLT2 inhibitors and GLP-1 receptor agonists, and basal insulin titration.
2Know the 2024 ADA/EASD/JBDS/AACE/DTS consensus on DKA and HHS: fluid rates, the potassium threshold of 3.5 mmol/L before insulin, when hypotonic fluids are justified in HHS, and resolution criteria.
3Review thyroid storm scoring (Burch-Wartofsky), antithyroid drug adverse effects, the ATA nodule ultrasound patterns and the 2023 Bethesda categories, and the 2025 ATA differentiated thyroid cancer guideline (four risk tiers and response-based TSH goals).
4Memorize dynamic testing cut-offs: OGTT for acromegaly, dexamethasone suppression tests for Cushing syndrome, the ARR (the 2025 Endocrine Society guideline suggests screening everyone with hypertension), and plasma free metanephrines for pheochromocytoma.
5Understand bone and mineral metabolism therapeutics: indications, renal function cutoffs, and mechanisms of action for antiresorptives (bisphosphonates, denosumab), bone anabolic agents (teriparatide, romosozumab), and hungry bone syndrome management.

Frequently Asked Questions

What is the Consejo Mexicano de Endocrinología certification exam?

The Examen de Certificación en Endocrinología is administered by the Consejo Mexicano de Endocrinología, A.C. (CME), the council recognized by CONACEM for the specialty. Certification is valid for 5 years and is renewed through recertification.

When and where is the 2026 CME examination held?

According to the official 2026 convocatoria, the examination is conducted on 31 January 2026 at the Centro de Evaluación y Adiestramiento Técnico (CEAT-UNAM) located in Tlatelolco, Mexico City. The theoretical written examination takes place from 08:00 to 12:00 hrs.

What is the examination structure and passing score?

Candidates first complete a 4-hour theoretical written multiple-choice test (08:00–12:00). A minimum grade of 7.0 out of 10.0 is required on the written test to qualify for the practical ECOE (Examen Clínico Objetivo Estructurado), which consists of 9 stations with clinical evaluators. Each ECOE station must be passed with a grade of 8.0 or higher.

What are the registration fees for the CME certification exam?

For the 2026 convocatoria, the initial certification fee is MXN 5,000, while the recertification (vigencia de certificación) fee is MXN 7,000, payable directly to the Consejo Mexicano de Endocrinología, A.C.

Why is this OpenExamPrep study bank written in English?

The official CME examination is conducted in Spanish. This bank is an independent English-language MCQ study adaptation of the theoretical component. It is not an official translation or simulation, and the practical ECOE stations are not simulated. Mexican clinical and regulatory terms are kept where useful.