For Question of the week, QoW, test takers usually choose the correct answer 70-80% of the time. However, for one question of the week, about 55% of respondents chose the correct answer.

So, we thought this would be a perfect opportunity for another answer rationale. We’ll explore this question and the best answer in more detail and throw in some test-taking tips along the way. Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer below:

Question of the week:

JR has noticed that over the past few weeks blood glucose levels have been steadily climbing, even though his eating and medication dose have been stable. Which of the following issues is most likely contributing to hyperglycemia?

Answer Choices:

1. Periodontitis
2. Sudden case of acanthosis nigricans
3. Insulin reactive disease
4. Recurrent symogi effect

As shown above, the most common choice was option 1, the second most common answer was option 4, then option 3, and finally option 2.

Congratulations! The majority of participants got this question right!

Option 1 is the correct answer. We know that periodontitis (inflammation of the gums and supporting structures of the teeth) and hyperglycemia are co-associated. When blood glucose levels rise, risk of periodontitis increases. When there is periodontitis, blood glucose levels rise. As a matter of fact, periodontitis is often called the 6th complication of diabetes. (see SciElo for more details).

Option 2 is incorrect because acanthosis nigricans is a skin condition where skin typically thickens and darkens due to insulin resistance, but the scenario in this question doesn’t mention anything about the skin of JR. We also know acanthosis nigricans isn’t associated with sudden hyperglycemia. It develops over time, so a “sudden case of” helps us to remove it as a possible answer by process of elimination.

Option 3 is incorrect because “insulin reactive disease” is not a recognized diagnosis or condition. This answer was included because “reactive” can look a lot like “resistance”. It is considered a juicy answer because it sounds right.

Finally, Option 4 is incorrect because the recurrent symogi effect indicates hypoglycemia which leads to hyperglycemia on specific occasions, not contributing to overall hyperglycemia. So, this was another option included to encourage careful reading of the question.

We hope you appreciate this week’s rationale and keep studying hard! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!

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