All Practice Exams
100+ Free Cert Endocrinology(SA) Phys Practice Questions
CMSA Sub-specialty Certificate in Endocrinology and Metabolism practice questions are available now; exam metadata is being verified.
✓ No registration✓ No credit card✓ No hidden fees✓ Start practicing immediately
100+ Questions
100% Free
Loading practice questions...
Same family resources
Explore More CMSA Sub-specialty Certificate Examinations (South Africa)
Continue into nearby exams from the same family. Each card keeps practice questions, study guides, flashcards, videos, and articles in one place.
2026 Statistics
Key Facts: Cert Endocrinology(SA) Phys Exam
2 components
Written + oral/OSCE
CMSA Regulations
50% each
Subminimum per component
CMSA Regulations
R24 650
Exam Fee
CMSA Sub-specialty Fee Schedule
50% overall
Pass Mark
CMSA Regulations
College of Physicians
Exam Body
Colleges of Medicine of South Africa
The Cert Endocrinology(SA) Phys is a rigorous two-component exit examination (written short-answer papers plus an oral/OSCE/clinical component, each 50%) validating specialist competence in clinical endocrinology, diabetes, and metabolic medicine in South Africa.
Sample Cert Endocrinology(SA) Phys Practice Questions
Try these sample questions to test your Cert Endocrinology(SA) Phys exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.
1According to the 2024 SEMDSA guidelines for type 2 diabetes mellitus, which pharmacological class is recommended as first-line add-on therapy to metformin in a patient with established atherosclerotic cardiovascular disease (ASCVD), regardless of baseline HbA1c?
A.GLP-1 receptor agonist with proven CV benefit or SGLT2 inhibitor
B.Dipeptidyl peptidase-4 (DPP-4) inhibitor
C.Thiazolidinedione (e.g., pioglitazone)
D.Second-generation sulfonylurea (e.g., gliclazide MR)
Explanation: Both SEMDSA and ADA/EASD guidelines recommend that patients with type 2 diabetes and established ASCVD (or high cardiovascular risk) be prescribed a GLP-1 receptor agonist with proven cardiovascular benefit or an SGLT2 inhibitor independent of baseline HbA1c or individualized HbA1c target.
2A 45-year-old asymptomatic man undergoes routine health screening. His fasting plasma glucose is 7.4 mmol/L. Repeat testing 3 days later reveals a fasting plasma glucose of 7.2 mmol/L. What is the correct diagnostic categorization?
A.Impaired Glucose Tolerance (IGT)
B.Impaired Fasting Glucose (IFG)
C.Normal Fasting Glucose
D.Diabetes Mellitus
Explanation: Diabetes mellitus is diagnosed when fasting plasma glucose (FPG) is >= 7.0 mmol/L on two separate occasions in an asymptomatic individual. FPG values of 6.1-6.9 mmol/L represent Impaired Fasting Glucose.
3When should screening for diabetic retinopathy and diabetic nephropathy initially be performed in a newly diagnosed adult patient with Type 2 Diabetes Mellitus?
A.5 years after diagnosis
B.Only when symptoms of visual loss or proteinuria develop
C.At the time of diabetes diagnosis
D.3 years after diagnosis
Explanation: In Type 2 Diabetes Mellitus, subclinical microvascular complications may already be present at diagnosis because the exact onset of hyperglycemia often precedes clinical diagnosis by several years. Screening for retinopathy (dilated eye exam) and nephropathy (UACR and eGFR) must occur at diagnosis.
4What is the primary physiological mechanism by which SGLT2 inhibitors lower blood glucose levels?
A.Inhibition of sodium-glucose cotransporter 2 in the renal proximal convoluted tubule, inducing glucosuria
B.Enhancement of peripheral insulin sensitivity in skeletal muscle via PPAR-gamma activation
C.Inhibition of hepatic gluconeogenesis via AMP-activated protein kinase activation
D.Stimulation of insulin secretion from pancreatic beta cells in a glucose-dependent manner
Explanation: SGLT2 inhibitors selective inhibit sodium-glucose cotransporter 2 in the S1 segment of the renal proximal convoluted tubule. This reduces renal glucose reabsorption, lowering the renal threshold for glucose and promoting urinary glucose excretion (glucosuria).
5In a non-pregnant adult with Type 1 Diabetes Mellitus utilizing continuous glucose monitoring (CGM), what is the standardized international target for Time in Range (TIR, 3.9–10.0 mmol/L)?
A.> 95%
B.> 85%
C.> 50%
D.> 70%
Explanation: International consensus on CGM metrics specifies that non-pregnant adults with T1D or T2D should achieve a Time in Range (TIR 3.9–10.0 mmol/L [70–180 mg/dL]) of > 70%, with Time Below Range (< 3.9 mmol/L) kept at < 4%.
6Which laboratory parameter most definitively distinguishes Hyperosmolar Hyperglycemic State (HHS) from classic Diabetic Ketoacidosis (DKA)?
A.Effective serum osmolality > 320 mOsm/kg with minimal/absent ketoacidosis
B.Blood glucose level > 15.0 mmol/L
C.Elevated serum lactate level > 4.0 mmol/L
D.Serum potassium level < 3.0 mmol/L
Explanation: HHS is characterized by profound hyperglycemia (often > 33.3 mmol/L), severe dehydration, and high effective serum osmolality (> 320 mOsm/kg), with minimal or absent ketoacidosis (arterial pH > 7.30, serum bicarbonate > 18 mmol/L, serum beta-hydroxybutyrate < 3.0 mmol/L). DKA requires ketoacidosis with high anion gap.
7What is the recommended initial intravenous fluid resuscitation protocol for an adult presenting with Diabetic Ketoacidosis (DKA) without cardiogenic shock?
A.Ringer's Lactate containing 50 mEq/L potassium chloride immediately
B.5% Dextrose in Water at 500 mL/h
C.0.45% Sodium Chloride at 2000 mL over the first hour
D.0.9% Sodium Chloride at 1000–1500 mL (15–20 mL/kg) over the first hour
Explanation: The initial step in DKA fluid resuscitation is expanding intravascular volume using 0.9% NaCl at 15–20 mL/kg/h (typically 1.0 to 1.5 L) over the first hour, followed by tailored fluid selection based on corrected serum sodium and hydration status.
8Which agent is recommended as a first-line pharmacological treatment for painful diabetic peripheral neuropathy?
A.Duloxetine
B.Pethidine
C.Indomethacin
D.Prednisone
Explanation: First-line agents for painful diabetic peripheral neuropathy include SNRI antidepressants (Duloxetine) or gabapentinoids (Pregabalin / Gabapentin) or tricyclic antidepressants (Amitriptyline).
9In clinical trials and continuous glucose monitoring guidelines, how is Level 2 (clinically significant) hypoglycemia defined?
A.Glucose < 3.0 mmol/L (< 54 mg/dL)
B.Glucose < 4.5 mmol/L (< 81 mg/dL)
C.Glucose < 3.9 mmol/L (< 70 mg/dL)
D.Severe cognitive impairment requiring external third-party assistance regardless of glucose level
Explanation: Level 1 hypoglycemia is defined as glucose < 3.9 mmol/L (70 mg/dL) but >= 3.0 mmol/L. Level 2 hypoglycemia is defined as glucose < 3.0 mmol/L (54 mg/dL), representing a threshold where neuroglycopenia begins. Level 3 is severe hypoglycemia requiring third-party assistance.
10A 38-year-old woman with T2DM treated with empagliflozin, metformin, and basal insulin presents with nausea, vomiting, abdominal pain, and deep sighing breathing. Laboratory investigation reveals arterial pH 7.22, serum bicarbonate 14 mmol/L, anion gap 18 mmol/L, serum beta-hydroxybutyrate 4.2 mmol/L, but plasma glucose is only 9.8 mmol/L. What is the immediate initial management strategy?
A.Increase empagliflozin dose and start oral antiemetics
B.Administer oral sodium bicarbonate and discharge on increased basal insulin dose
C.Discontinue empagliflozin immediately, start IV 0.9% saline infusion, IV dextrose 5–10%, and IV fixed-rate continuous insulin infusion
D.Administer IV glucagon 1 mg intramuscularly and hold insulin
Explanation: This patient has euglycemic DKA (euDKA) secondary to SGLT2 inhibitor therapy. Key management steps are immediate cessation of the SGLT2 inhibitor, IV volume expansion, IV insulin infusion to suppress lipolysis/ketogenesis, and co-administration of IV dextrose (5–10%) because plasma glucose is < 14 mmol/L.
About the Cert Endocrinology(SA) Phys Practice Questions
Verified exam format metadata for CMSA Sub-specialty Certificate in Endocrinology and Metabolism is pending. The practice questions above remain available while official exam length, timing, passing score, fee, and administrator details are reviewed.