Differential Diagnosis in Primary Care Exam Preparation Guide
Course Introduction
This course focuses on the systematic approach to differential diagnosis in the context of primary care. Students will learn to evaluate patient presentations, collect relevant history, conduct physical examinations, and utilize appropriate diagnostic tests to distinguish between common and potentially serious conditions seen in the primary care setting. Emphasis is placed on clinical reasoning, evidence-based decision making, and the development of diagnostic acumen applicable to diverse patient populations. The course prepares future primary care practitioners to efficiently and accurately identify the underlying causes of symptoms, ensuring timely interventions and optimal patient outcomes.
Recommended Textbook
Advanced Assessment Interpreting Findings and Formulating Differential Diagnoses 3rd Edition
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20 Chapters
571 Verified Questions
571 Flashcards
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2
Chapter 1: Assessment and Clinical Decision-Making:
Overview
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) Which of the following clinical reasoning tools is defined as evidence-based resource based on mathematical modeling to express the likelihood of a condition in select situations,settings,and/or patients?
A) Clinical practice guideline
B) Clinical decision rule
C) Clinical algorithm
D) Clinical recommendation
Answer: B
Q2) The following is the least reliable source of information for diagnostic statistics:
A) Evidence-based investigations
B) Primary reports of research
C) Estimation based on a provider's experience
D) Published meta-analyses
Answer: C
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3
Chapter 2: An Overview of Genetic Assessment
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22 Flashcards
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Sample Questions
Q1) A woman affected with an X-linked recessive disorder:
A) Has one X chromosome affected by the mutation
B) Will transmit the disorder to all of her children
C) Will transmit the disorder to all of her sons
D) Will not transmit the mutation to any of her daughters
Answer: C
Q2) To illustrate two family members in an adoptive relationship in a pedigree:
A) Arrows are drawn pointing to the male and female
B) Brackets are drawn around the male and female
C) Double horizontal lines are drawn between the male and female
D) Circles are drawn around the male and female
Answer: B
Q3) A woman with an X-linked dominant disorder will:
A) Not be affected by the disorder herself
B) Transmit the disorder to 50 % of her offspring (male or female)
C) Not transmit the disorder to her daughters
D) Transmit the disorder to only her daughters
Answer: B
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Chapter 3: Skin
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) A patient presents complaining of recent onset of aching and malaise followed by the development of a generalized rash.He denies previous rash although he does admit that about a month ago he had an open sore on his right hand that was nonpainful.The exam reveals a maculopapular rash and lymphadenopathy.This presentation is most consistent with:
A) Pityriasis rosea
B) Secondary syphilis
C) Herpetic whitlow
D) Pyogenic granuloma
Answer: B
Q2) Which of the following skin disorders is associated with diabetes?
A) Acanthosis nigricans
B) Vitiligo
C) Impetigo
D) Folliculitis
Answer: A
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Chapter 4: Head,face,and Neck
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) Inflammation of the parotid gland can cause which of the following conditions?
A) Trigeminal neuralgia
B) Bruxism
C) Mumps
D) Temporomandibular joint syndrome
Q2) One of the most common signs of Epstein-Barr viral infection (infectious mononucleosis)is:
A) Swelling of the face
B) Parotitis
C) Cervical lymphadenopathy
D) Thyroid enlargement
Q3) When obtaining a health history focusing on the patient's head,face,and neck,which of the following is particularly important in regard to risk of disease?
A) Past dental work
B) Use of alcohol and tobacco
C) History of tension headaches
D) Use of aspirin
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Chapter 5: The Eye
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25 Flashcards
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Sample Questions
Q1) The most common cause of eye redness is:
A) Conjunctivitis
B) Acute glaucoma
C) Head trauma
D) Corneal abrasion
Q2) Ptosis is commonly the first sign of:
A) Stevens-Johnson syndrome
B) Hyperthyroidism
C) Temporal arteritis
D) Myasthenia gravis
Q3) An Amsler grid is used to evaluate which of the following conditions?
A) Optic neuritis
B) Macular degeneration
C) Amaurosis fugax
D) Retinal detachment
Q4) A Marcus-Gunn effect involves:
A) Abnormal pupillary responses
B) Abnormal visual acuity
C) Abnormal funduscopic findings
D) All of the above
Page 7
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Chapter 6: Ear, nose, mouth, and Throat
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29 Verified Questions
29 Flashcards
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Sample Questions
Q1) A patient complains of fever,fatigue,and pharyngitis.On physical examination there is pronounced cervical lymphadenopathy.Which of the following diagnostic tests should be considered?
A) Mono spot
B) Strep test
C) Throat culture
D) All of the above
Q2) With inspection of the mouth and buccal mucosa,Stensen's duct can be seen on the:
A) Underside of the tongue
B) Buccal mucosa opposite the lower molars
C) Buccal mucosa opposite the upper molars
D) Soft palate
Q3) Nasal discharge of green-yellow mucus,pharyngitis,and otitis media commonly indicate:
A) Allergic rhinitis
B) Viral infection
C) Bacterial infection
D) Nasal polyps
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8
Chapter 7: Cardiac and Peripheral Vascular Systems
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57 Verified Questions
57 Flashcards
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Sample Questions
Q1) The pain associated with pericarditis is .
A) Crushing and squeezing
B) Constant
C) Worse with inspiration
D) Only present with fever
Q2) A 23-year-old patient presents the emergency department with high fever,chills,extreme fatigue,and arthralgias.Your physical examination reveals grade II heart murmur heard loudest over the fourth intercostal space left sternal border.The arms of the patient reveal past intravenous drug abuse.The clinician should recognize these are signs and symptoms of:
A) Pulmonary embolism
B) Right ventricular failure
C) Functional heart murmur
D) Bacterial endocarditis
Q3) The pain of pancreatitis is described as:
A) Abdominal sharp and piercing pain in the left upper quadrant
B) Dull and cramping pain in the right upper quadrant
C) Severe,epigastric pain radiating straight into the back
D) Sharp pain radiating to the shoulder
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Page 9
Chapter 8: Respiratory System
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25 Flashcards
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Sample Questions
Q1) Your patient has just returned from a 6-month missionary trip to Southeast Asia.He reports unremitting cough,hemoptysis,and an unintentional weight loss of 10 pounds over the last month.These symptoms should prompt the clinician to suspect:
A) Legionaire's disease
B) Malaria
C) Tuberculosis
D) Pneumonia
Q2) Your patient with community-acquired pneumonia shows a pleural effusion on chest x-ray,indicating the need for:
A) Immediate endotracheal intubation
B) Broad spectrum intravenous antibiotics
C) Thoracentesis to rule out empyema
D) Gram stain and culture of sputum
Q3) Which of the following details are NOT considered while staging asthma?
A) Nighttime awakenings
B) Long-acting beta agonist usage
C) Frequency of symptoms
D) Spirometry findings
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Chapter 9: Breasts
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15 Flashcards
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Sample Questions
Q1) A 62-year-old female presents with a singular,hard,1 cm,non-tender,non-mobile mass in the right breast.There are no nipple or skin changes,however,you palpate an enlarged right-sided supraclavicular lymph node.The clinician should recognize these are signs of:
A) Fibroadenoma
B) Breast cyst
C) Malignancy
D) Paget's disease
Q2) Your patient is a 64-year-old female who presents with complaints of a red,scaly rash on her nipple and areola of one breast.It has been present for a few months.There is no mass or nipple discharge.You should be suspicious of:
A) Contact dermatitis
B) Mastitis
C) Paget's disease
D) Eczema
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11
Chapter 10: Abdomen
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44 Flashcards
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Sample Questions
Q1) The most common cause of acute pancreatitis is:
A) Trauma
B) Hepatitis virus A
C) Hyperlipidemia
D) Alcohol abuse
Q2) When ruptured ectopic pregnancy is suspected,the following procedure is most important:
A) Culdocentesis
B) CT scan
C) Abdominal x-ray
D) Digital rectal examination
Q3) Your patient with pancreatitis has a Ranson rule score of 8.The clinician should recognize that this is a risk of:
A) Pleural involvement
B) Alcoholism
C) High mortality
D) Bile duct obstruction
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Chapter 11: Genitourinary System
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20 Flashcards
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Sample Questions
Q1) Your 77-year-old patient complains of frequent urination,hesitation in getting the stream started,and nocturnal frequency of urination that is bothersome.On DRE,there is an enlarged,firm,non-tender,smooth prostate.The clinician should recognize these as symptoms of:
A) Prostatitis
B) Prostate cancer
C) Urethritis
D) Benign prostatic hyperplasia
Q2) Your 24-year-old female patient complains of dysuria as well as frequency and urgency of urination that develops the day after she uses her diaphragm.Urine culture reveals a bacterial count of 100 CFU/mL.These signs and symptoms indicate:
A) Upper urinary tract infection
B) Lower urinary tract infection
C) Normal bacteriuria
D) Urethritis
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13
Chapter 12: Male Reproductive System
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25 Flashcards
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Sample Questions
Q1) A 12-year-old boy accompanied by his mother reports sudden severe pain in the right lower abdomen and scrotum.There is no history of trauma.Upon physical examination,the right scrotum is extremely tender to touch.These are signs of:
A) Fournier's disease
B) Testicular cancer
C) Testicular torsion
D) Varicocele of the testes
Q2) Which of the following is considered a risk factor for penile cancer?
A) Chlamydia infection
B) Condyloma acuminata
C) Epispadius
D) Circumcision
Q3) Your male patient is 456 pounds and complains of erectile dysfunction.On physical examination,you note gynecomastia,decreased pubic,facial,and axillary hair,as well as atrophic testes.This is due to:
A) Vascular disease that affects the testes
B) Conversion of testosterone in fatty tissue to estradiol
C) Androgen resistance of fatty tissue
D) All of the above
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Page 14
Chapter 13: Female Reproductive System
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44 Verified Questions
44 Flashcards
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Sample Questions
Q1) A 16-year-old female complains of sudden left-sided lower quadrant abdominal pain.Last menstrual period was 2 weeks ago.On physical examination,the abdomen is non-tender with no masses and no organomegaly.Bowel sounds are normal in 4 quadrants.Pelvic examination is within normal limits.Abdominal CT scan is negative.Pregnancy test is negative.These signs and symptoms are consistent with:
A) Ovarian cancer
B) Hydatidiform mole
C) Endometriosis
D) Follicular cyst
Q2) Your 61-year-old female patient complains of dyspareunia.On pelvic examination,you note atrophic vaginitis.The clinician should explain that these are most likely:
A) Signs of vaginismus
B) Postmenopausal symptoms
C) Signs of estrogen deficiency
D) B and C
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Chapter 14: Musculoskeletal System
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31 Verified Questions
31 Flashcards
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Sample Questions
Q1) A 43-year-old female was in a bicycling accident and complains of severe pain of the right foot.The patient limps into the emergency room.On physical examination,there is no point tenderness over the medial or lateral ankle malleolus.There is no foot tenderness except at the base of the fifth metatarsal bone.According to the Ottawa foot rules,should an x-ray of the feet be ordered?
A) Yes,there is tenderness over the fifth metatarsal
B) No,there is not tenderness over the navicular bone
C) Yes,the patient cannot bear weight on the foot
D) A and C
Q2) Your patient is a 43-year-old female golfer who complains of arm pain.On physical examination,there is point tenderness on the elbow and pain when the patient is asked to flex the wrist against the clinician's resistance.These are typical signs of:
A) Carpal tunnel syndrome
B) Osteoarthritis of the wrist
C) Epicondylitis
D) Cervical osteoarthritis
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Chapter 15: Neurological System
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) Which of the following microorganisms is a common cause of meningitis?
A) Enterococcus
B) Haemophilus influenza
C) Influenza virus
D) Chlamydia
Q2) When carrying out a mental status exam on a non-English speaking patient,it is important to have a(n):
A) Patient's family member,who is bilingual,interpret for the patient
B) Objective interpreter ask the questions for the patient
C) Friend of the patient interpret the questions for the patient
D) Any of the above is acceptable
Q3) Your patient with a cervical herniated disc presents with a weakened biceps reflex.The biceps reflex is a test of the following spinal nerves:
A) C3 to C4
B) C4 to C5
C) C5 to C6
D) C7 to T1
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Chapter 16: Nonspecific Complaints
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Sample Questions
Q1) A 54-year-old male complains of loss of appetite,weakness,fatigue,and unintentional weight loss of 10 pounds over the last month.His wife recommended that he get a physical examination.On physical examination,you do not find significant signs of a specific disorder.The CBC with differential shows anemia.A serum metabolic panel has all normal findings.Which diagnostic test(s)would you recommend to obtain more information?
A) Cystoscopy
B) Digital rectal exam
C) Colonoscopy
D) B and C
Q2) A 44-year-old female comes in for a physical examination.She complains of "having trouble losing weight," excessive fatigue,sluggishness,and loss of excessive blood with menses.On physical examination,there are no significant findings except her BMI of 28 is in the overweight category.What other question(s)would assist in the diagnosis?
A) Is there a history of thyroid disorders in the family?
B) Do you feel excessively cold or hot when others are not ?
C) Have you had a recent upper respiratory infection?
D) A and B
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Chapter 17: Psychiatric Mental Health
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34 Flashcards
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Sample Questions
Q1) Eating disorders are driven by:
A) Perfectionism
B) Feelings of inadequacy
C) Obsessive-compulsive disorder
D) A and B
Q2) Which of the following statements is true regarding phobia?
A) The anxiety associated with phobia is out of proportion to the actual danger or threat in the situation
B) Diagnosis is based on the presence of symptoms for at least a 6-month duration
C) Persons with phobias have apprehension of a future attack,which is referred to as anticipatory anxiety
D) A and B
Q3) Depression can cause the following physiological changes:
A) Lack of appetite or overeating
B) Avolition or agitation
C) Insomnia or hypersomnia
D) All of the above
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19
Chapter 18: Pediatric Patients
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Sample Questions
Q1) At what age range should a mother begin feeding the child solid food,such as rice cereal?
A) 3to 4 months
B) 5 to 6 months
C) 6 to 7 months
D) 7 to 8 months
Q2) In infants and toddlers,it is recommended to perform the physical examination:
A) In head-to-toe sequence
B) In noninvasive-to-invasive sequence
C) On the parent's lap
D) B and C
Q3) What age is the child who is in the "do it myself" stage?
A) 18 months
B) 2 years old
C) 3 years old
D) 4 years old
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Page 20
Chapter 19: Pregnant Patients
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35 Flashcards
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Sample Questions
Q1) A pregnant woman with hyperemesis gravidarum should be checked for:
A) Multiple pregnancy
B) Hyperadrenalism
C) Hyperthyroidism
D) Fibroid tumor
Q2) The fetal heartbeat can be first heard using Doppler equipment at:
A) 2 weeks
B) 5 weeks
C) 10 weeks
D) 20 weeks
Q3) A reproductive history is recorded in terms of gravida and para,which indicates:
A) Number of times pregnant and the number of pregnancies beyond 20 weeks
B) Number of times pregnant and the number of spontaneous or medically-induced abortions
C) Number of live births and number of times pregnant
D) Number of times pregnant and number of vaginal births
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Chapter 20: Older Patients
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25 Flashcards
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Sample Questions
Q1) The functional reach test is a good predictor of:
A) Susceptibility to fall
B) Complete range of motion
C) Dependence in ADLs
D) A & C
Q2) For measuring weight in patients in long-term care facilities:
A) Always use same scale
B) Record the patient's clothing
C) Calculate the body mass index (BMI)
D) All the above
Q3) Prior to giving clearance for an older adult to take part in an exercise regimen,the assessment tool should be used by the clinician.
A) Get up and go
B) Tinetti scale
C) PARmed-X
D) PAR-Q
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