,SECTION 1: FOUNDATIONS OF DIFFERENTIAL DIAGNOSIS & PRIMARY
CARE (Questions 1-80)
Ques on 1
A 45-year-old woman presents with fa gue, weight gain, and cold intolerance. Which of the
following should be included in the differen al diagnosis?
A) Hypothyroidism
B) Depression
C) Iron deficiency anemia
D) All of the above
Correct Answer: D
Ra onale: Fa gue, weight gain, and cold intolerance can be caused by mul ple condi ons.
Hypothyroidism classically presents with these symptoms, but depression can also cause fa gue
and changes in appe te/weight, and anemia can cause fa gue and cold intolerance. A
comprehensive differen al diagnosis must consider mul ple possibili es. Diagnos c reasoning
requires con nually ques oning whether key diagnoses are being overlooked .
Ques on 2
A 58-year-old man with chronic hepa s C asks why his provider uses guidelines instead of
personal experience alone. You explain that guidelines are based on research, expert consensus,
and pa ent-centered considera ons. This explana on best describes which concept?
A) Pathophysiology
B) Evidence-based clinical prac ce guidelines
C) SOAP documenta on
D) Insurance policy
Correct Answer: B
Ra onale: Clinical prac ce guidelines synthesize best research evidence, expert opinion, and
prac cal considera ons to give standardized recommenda ons for care within an evidence-
based prac ce framework .
,Ques on 3
A 22-year-old student presents with sore throat. You ask about onset, fever, cough, exposure
history, and associated rash. You also consider whether there is an opportunity for vaccina on
update and smoking cessa on counseling. This illustrates which point from the study guide?
A) Visits focus only on the chief complaint
B) Every visit is also an opportunity for preven on and screening
C) Only specialists handle preven on
D) Preven ve care is separate from illness care
Correct Answer: B
Ra onale: The guide emphasizes that besides solving the current problem, each visit should
also be used to screen for high-risk problems, prevent disease, and promote health .
Ques on 4
A 22-year-old woman with IBS-D experiences severe diarrhea episodes only during stressful
weeks. She has no fever or blood in stool. Which pharmacologic op on is appropriate for
SHORT-TERM severe episodes?
A) Daily long-term opioid use
B) Loperamide as needed
C) Metronidazole for 10 days
D) High-dose cor costeroids
Correct Answer: B
Ra onale: The guide recommends short-term use of an diarrheals such as loperamide for
severe IBS-related diarrhea, while avoiding chronic use and reserving an bio cs for specific
bacterial causes .
Ques on 5
A 54-year-old woman with suspected GERD requests "every test possible." Before ordering, you
consider cost, convenience, sensi vity, specificity, and the risk of missing a serious condi on.
According to the study guide, what are you evalua ng?
A) Insurance coverage
B) Appropriateness of diagnos c tes ng
, C) E&M coding level
D) Func onal status
Correct Answer: B
Ra onale: The guide highlights considering cost, convenience, sensi vity, specificity, and
predic ve value before ordering diagnos c tests .
Ques on 6
A 36-year-old man presents with acute onset nausea, vomi ng, watery diarrhea, and diffuse
crampy abdominal pain a er a buffet meal. Several coworkers are ill. Which pathogen type is
MOST likely?
A) Viral
B) Fungal
C) Parasi c
D) Helminthic
Correct Answer: A
Ra onale: Acute gastroenteri s is most o en viral in origin, with norovirus being the leading
cause of acute diarrhea in adults, especially in outbreak se ngs .
Ques on 7
A 23-year-old woman has mild AGE with no fever or blood in the stool. She asks for an an bio c
"just in case." What is the most appropriate response?
A) Start ciprofloxacin immediately
B) Start metronidazole empirically
C) Recommend oral rehydra on and symptoma c care
D) Order a full set of stool cultures and O&P
Correct Answer: C
Ra onale: Most viral gastroenteri s cases are self-limited and treated with fluids and diet;
an bio cs are reserved for specific bacterial causes and are not indicated in uncomplicated
afebrile diarrhea .
CARE (Questions 1-80)
Ques on 1
A 45-year-old woman presents with fa gue, weight gain, and cold intolerance. Which of the
following should be included in the differen al diagnosis?
A) Hypothyroidism
B) Depression
C) Iron deficiency anemia
D) All of the above
Correct Answer: D
Ra onale: Fa gue, weight gain, and cold intolerance can be caused by mul ple condi ons.
Hypothyroidism classically presents with these symptoms, but depression can also cause fa gue
and changes in appe te/weight, and anemia can cause fa gue and cold intolerance. A
comprehensive differen al diagnosis must consider mul ple possibili es. Diagnos c reasoning
requires con nually ques oning whether key diagnoses are being overlooked .
Ques on 2
A 58-year-old man with chronic hepa s C asks why his provider uses guidelines instead of
personal experience alone. You explain that guidelines are based on research, expert consensus,
and pa ent-centered considera ons. This explana on best describes which concept?
A) Pathophysiology
B) Evidence-based clinical prac ce guidelines
C) SOAP documenta on
D) Insurance policy
Correct Answer: B
Ra onale: Clinical prac ce guidelines synthesize best research evidence, expert opinion, and
prac cal considera ons to give standardized recommenda ons for care within an evidence-
based prac ce framework .
,Ques on 3
A 22-year-old student presents with sore throat. You ask about onset, fever, cough, exposure
history, and associated rash. You also consider whether there is an opportunity for vaccina on
update and smoking cessa on counseling. This illustrates which point from the study guide?
A) Visits focus only on the chief complaint
B) Every visit is also an opportunity for preven on and screening
C) Only specialists handle preven on
D) Preven ve care is separate from illness care
Correct Answer: B
Ra onale: The guide emphasizes that besides solving the current problem, each visit should
also be used to screen for high-risk problems, prevent disease, and promote health .
Ques on 4
A 22-year-old woman with IBS-D experiences severe diarrhea episodes only during stressful
weeks. She has no fever or blood in stool. Which pharmacologic op on is appropriate for
SHORT-TERM severe episodes?
A) Daily long-term opioid use
B) Loperamide as needed
C) Metronidazole for 10 days
D) High-dose cor costeroids
Correct Answer: B
Ra onale: The guide recommends short-term use of an diarrheals such as loperamide for
severe IBS-related diarrhea, while avoiding chronic use and reserving an bio cs for specific
bacterial causes .
Ques on 5
A 54-year-old woman with suspected GERD requests "every test possible." Before ordering, you
consider cost, convenience, sensi vity, specificity, and the risk of missing a serious condi on.
According to the study guide, what are you evalua ng?
A) Insurance coverage
B) Appropriateness of diagnos c tes ng
, C) E&M coding level
D) Func onal status
Correct Answer: B
Ra onale: The guide highlights considering cost, convenience, sensi vity, specificity, and
predic ve value before ordering diagnos c tests .
Ques on 6
A 36-year-old man presents with acute onset nausea, vomi ng, watery diarrhea, and diffuse
crampy abdominal pain a er a buffet meal. Several coworkers are ill. Which pathogen type is
MOST likely?
A) Viral
B) Fungal
C) Parasi c
D) Helminthic
Correct Answer: A
Ra onale: Acute gastroenteri s is most o en viral in origin, with norovirus being the leading
cause of acute diarrhea in adults, especially in outbreak se ngs .
Ques on 7
A 23-year-old woman has mild AGE with no fever or blood in the stool. She asks for an an bio c
"just in case." What is the most appropriate response?
A) Start ciprofloxacin immediately
B) Start metronidazole empirically
C) Recommend oral rehydra on and symptoma c care
D) Order a full set of stool cultures and O&P
Correct Answer: C
Ra onale: Most viral gastroenteri s cases are self-limited and treated with fluids and diet;
an bio cs are reserved for specific bacterial causes and are not indicated in uncomplicated
afebrile diarrhea .
