questions
Differential Diagnosis & Primary Care
Practicum.
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Your 22 year old male patient states during his review of systems thathis scrotum is very
enlarged and feels like it is full a powerlifter and works as a trash collector. You suspect the
patient likely has which of the following diagnoses?
A -Varicocele
B -Meningocele
C -Rectocele
D -Hydrocele - CORRECT ANSWER -A -Varicocele
The point of maximum impulse (PMI) is MOST often palpable in healthy adults when
positioned in the supine or left lateral decubitus position. Which one of the following
locations is most commonly described as the PMI in a healthy adult?
A -Left 2nd intercostal space, midaxillary line
B -Left 5th intercostal space, midclavicular line
C -Right 4th intercostal space, midaxillary line
D -Right 2nd intercostal space, midclavicular line - CORRECT ANSWER -B -Left 5th
intercostal space, midclavicular line
A40 year old, female, African American patient presents for history and physical. Upon your
initial assessment, you notice she has severe exophthalmos as pictured below. Which one of
the following diagnoses below would be the highest on your differential diagnose of this
physical examination finding?
A -Bilateral conjunctivitis
B -Hyperthyroidism
C -hypothyroidism
D -Myexedma - CORRECT ANSWER -B -Hyperthyroidism
,Your patient with a suspected diagnosis of COPD has been seen by pulmonology and has
underwent a pulmonary function test (PFT) with spirometry. As the patient's primary
healthcare provider, you have been asked to explain the findings of the PFT to the patient in
afollow-up visit at which time the patient asks what the study was evaluating. To describe
the PFT to the patient in more useful terms, you state that the large inspiration of air to the
furthest extent they could reasonably accomplish followed by a full exhalation is referred to
as which of the following measurements during the PFT?
A -Forced Expiratory Volume over 1 second (FEV1)
B -Functional Reserve Capacity
C -Inspiratory Reserve
D -Forced Vital Capacity - CORRECT ANSWER -D -Forced vital capacity
Your patient has a diagnosis of Addison's disease. Which of the following might you expect
to find during examination?
A -Abdominal striae
B -Dowager hump
C -Low body temperature
D -Moon face - CORRECT ANSWER -B -Dowager hump
The nurse practitioner's evaluation of a patient with Diabetes Mellitus type 2 should include
which of the following while evaluating for end organ dysfunction of the disease?
A -Renal function panel
B -Urinalysis
C -Non-dilated eye exam
D -All of these are appropriate options - CORRECT ANSWER -D -All of these are appropriate
options
During your visit with a 19 year old patient for a college health physical, your health history
,includes a diagnosis of angioedema. What of the following parts of the body are were likely
involved?
A -Isolated to the colon
, B -Anywhere in the enteral tract
C -Chest
D -Face and Lips - CORRECT ANSWER -D -Face and Lips
Which of the following dermatologic lesions is precancerous and likely due to prolonged
exposure to UV-B?
A -Actinic Keratosis
B -Basal cell carcinoma
C -Verucca
D -Seborrheic dermatitis - CORRECT ANSWER -A -Actinic Keratosis
Based on your evaluation of ABCDE for melanoma, which of the following represents a
suspicous finding?
A -Irregular borders
B -Symmetrical nature
C -Brown color
D -Diameter of 0.4 cm - CORRECT ANSWER -A -Irregular borders
Your patient is complaining of hypersomnia, lack of motivation, weight gain, and anhedonia.
Suspecting a diagnosis of clinical depression, you anticipate the patient will benefit from
treating their underlying deficit of which of the following neurotransmitters?
A -GABA
B -Serotonin
C -Dobutamine
D -Glutamate - CORRECT ANSWER -B -Serotonin