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1. what is the sensitivity of the Prostate Specific Antigen (PSA) for detecting
prostate cancer?: # men with prostate cancer
# men with positive PSA
160
# men with negative PSA
40
total
200
The correct answer is 160/200. Sensitivity is the proportion of patients with the disease that have a positive result; it is
the number of true positives divided by the total number of patients who have the disease.
2. A diagnostic test is used in a sample of 1000 patients. 500 of these patients
have the disease, while 500 do not. Of those 500 patients without the disease,
30 test positive, and 470 test negative. What is the specificity of the test?: The
correct answer is 470/500.
Specificity is the proportion of patients who test negative out of the total number of patients who do not have the
disease; it is the number of true negatives overall negatives. In this example, 500/1000 patients have the disease. Of
those 500 patients without the disease, 30 test positive, and 470 test negative.
3. The Positive Predictive Value (PPV) of a test refers to which of the following?-
: the proportion of patients with a positive test who have the disease.
4. Which of the following depends on the prevalence of the disease?: positive
predictive value.
Predictive values depend on the prevalence of disease in the population whereas sensitivity and specificity are intrinsic
properties of the test. Reliability refers to the consistency or stability of a measure.
5. A low pretest probability of disease may lead to which of the following?: low
positive predictive value and more false-positive results.
Positive predictive value increases with prevalence; therefore, a low prevalence value yields a low positive predictive
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value and implies a high false-positive rate. Negative predictive value decreases with prevalence, and sensitivity and
specificity do not vary with prevalence.
6. If you strongly suspect that a patient is positive for a specific condition but
tests negative, the negative result may be:: false-negative test results due to a low negative
predictive value.
At the individual level, your clinical suspicion is equivalent to pre-test probability and high prevalence at the population
level. Negative predictive value is inversely correlated with prevalence; therefore, your clinical suspicion translates to a
low negative predictive value, suggesting a false-negative test result.
7. Which test(s) provide data relevant to the chief complaint: Fever: CBC
Check CBC with differential for neutrophil shift in suspected infection
8. Which test(s) provide data relevant to the chief complaint: Unexplained bruis-
ing: CBC
Check platelet count
9. Which test(s) provide data relevant to the chief complaint: Fatigue: Both CBC and
CMP
Check RBC, Hgb and Hct for anemia, CMP for potential liver or kidney abnormalities
10. Which test(s) provide data relevant to the chief complaint: Cardiac dysrhyth-
mias: CMP
Monitor electrolytes for abnormalities
11. Which test(s) provide data relevant to the chief complaint: Unexplained
weight loss: Both CBC and CMP
Check WBC for inflammation or possible cancer, CMP for glucose, liver or kidney abnormalities
12. Which test(s) provide data relevant to the chief complaint: Edema: CMP
Check for kidney function
13. What is SNAPPS?: Summarize the history and findings
Narrow the differential diagnosis to two or three possibilities
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Analyze the differential by comparing and contrasting the possibilities
Probe the preceptor by asking questions about alternative approaches or uncertainties
Plan the management of the client's health issues
Select an issue from the case for self-directed learning
14. a 13 year old presents to the clinic complaining of severe left side sore throat
and pain with swallowing for 1
day. upon exam, the patient appears uncomfortable and febrile. Cervical
adenopathy is present on left side,
difficulty opening and closing mouth. What should you do?: Refer to the ER
15. a 37 year old female presents for her annual visit. She mentions that her 13
year old daughter has had to
recent infestions of lice. She asks what she can do to prevent this?: After 2 days of no
head lice, her bedding is lice free
16. Which of the following is the appropriate treatment for giardia: quin.hydr.
17. Your client, a 72-year-old smoker of 50 years, is at the office today for
a routine physical. During your inspection of the oral mucosa, you discover
a white lesion on the lateral surface of the tongue that you suspect to be
cancerous. You document your finding as:: A white, painless, firm, ulcerated lesion with indurated
borders
18. Maryann, age 28, presents to the clinic because of a rapid onset of patchy
hair loss. The skin within these oval patches of hair loss is very smooth. Tapered
hairs that resemble exclamation points are seen at the margin of a patch of hair
loss. Based on these findings, you suspect Maryann has:: Alopecia areata The findings are
consistent with alopecia areata, ie, nonscarring hair loss of rapid onset,
the pattern of which is most commonly sharply defined round or oval patches.
19. Which of the following is not a complication of group a strep
hemolytic anemia
glomerular nephritis:
20. Which of the following is an example of conductive hearing loss?: Serous OM