NR511 Differential diagnosis and primary
care management Final Exam guide with
Comprehensive 180 Questions and Answers
Document focuses on mastering foundational clinical definitions, precise diagnostic tests, and
direct empirical treatments.
Table of contents
1. Gastrointestinal and Abdominal Pathologies (Questions 1–30)
2.Musculoskeletal and Orthopedic Conditions (Questions 31–60)
3.Endocrine and Metabolic Disorders (Questions 61–90)
4.Hematology, Gynecology, and Urogynecology (Questions 91–120)
5.Toxicology, ENT, and Dermatological Emergencies (Questions 151–180)
Gastrointestinal and Abdominal Pathologies
(Questions 1–30)
1. Question: What is the most specific initial laboratory test for acute pancreatitis?
Answer: Serum lipase.
2. Question: What is the gold standard diagnostic imaging modality for mesenteric
infarction?
Answer: Abdominal arteriogram or CT angiography.
3. Question: What physical exam finding is classically present in mesenteric ischemia
where pain out of proportion to exam occurs?
Answer: Mid-epigastric or LUQ pain radiating to the back, worse when lying supine,
with minimal localized tenderness.
4. Question: What radiological sign on an upright abdominal X-ray confirms intestinal
perforation?
Answer: Free air under the diaphragm (pneumoperitoneum).
5. Question: Which bowel sound pattern is typically heard early in a mechanical intestinal
obstruction?
Answer: Hyperactive, high-pitched or tinkling bowel sounds.
6. Question: Which bowel sound pattern is typically heard late in a mechanical intestinal
obstruction or with peritonitis?
Answer: Hypoactive or absent bowel sounds.
, 7. Question: What is the hallmark pain description for renal colic (kidney stones)?
Answer: Colicky flank pain progressing to constant, severe pain radiating to the groin.
8. Question: What primary diagnostic tests should be ordered for suspected nephrolithiasis?
Answer: Urinalysis, IV pyelogram (IVP), and renal ultrasound.
9. Question: What physical sign is elicited by tapping over the flank in renal pathologies?
Answer: Costovertebral angle (CVA) tenderness.
10. Question: What urinalysis finding is most common in acute renal colic?
Answer: Hematuria.
11. Question: Which abdominal condition presents with severe, diffuse parietal pain,
guarding, rebound tenderness, and relief from lying completely still?
Answer: Intestinal perforation.
12. Question: What position typically relieves the abdominal pain of acute pancreatitis?
Answer: Leaning forward or the fetal position.
13. Question: What position typically worsens the pain of mesenteric infarction?
Answer: Lying supine.
14. Question: What term describes the clinical presentation of an inability to pass stool or
flatus due to obstruction?
Answer: Obstipation.
15. Question: What imaging study is the first-line choice for evaluating acute right lower
quadrant pain suspected to be appendicitis in adults?
Answer: Computed tomography (CT) of the abdomen and pelvis with contrast.
16. Question: What test is preferred over CT for imaging suspected appendicitis in pregnant
patients and children?
Answer: Graded compression abdominal ultrasound.
17. Question: What clinical sign involves pain in the right lower quadrant upon internal
rotation of the right flexed hip?
Answer: Obturator sign.
18. Question: What clinical sign involves right lower quadrant pain upon passive extension
of the right hip?
Answer: Psoas sign.
19. Question: What sign involves deep palpation of the left lower quadrant eliciting pain in
the right lower quadrant?
Answer: Rovsing's sign.
20. Question: What name is given to point tenderness located one-third of the distance from
the anterior superior iliac spine to the umbilicus?
Answer: McBurney's point.
21. Question: What bacteria is most frequently isolated in spontaneous bacterial peritonitis
(SBP)?
Answer: Escherichia coli.
22. Question: What diagnostic procedure is required to confirm spontaneous bacterial
peritonitis in a patient with ascites?
Answer: Diagnostic paracentesis with ascitic fluid analysis (neutrophil count ≥
250 cells/𝜇L).
23. Question: What is the primary medical treatment choice for uncomplicated
Clostridioides difficile infection?
Answer: Oral fidaxomicin or oral vancomycin.
care management Final Exam guide with
Comprehensive 180 Questions and Answers
Document focuses on mastering foundational clinical definitions, precise diagnostic tests, and
direct empirical treatments.
Table of contents
1. Gastrointestinal and Abdominal Pathologies (Questions 1–30)
2.Musculoskeletal and Orthopedic Conditions (Questions 31–60)
3.Endocrine and Metabolic Disorders (Questions 61–90)
4.Hematology, Gynecology, and Urogynecology (Questions 91–120)
5.Toxicology, ENT, and Dermatological Emergencies (Questions 151–180)
Gastrointestinal and Abdominal Pathologies
(Questions 1–30)
1. Question: What is the most specific initial laboratory test for acute pancreatitis?
Answer: Serum lipase.
2. Question: What is the gold standard diagnostic imaging modality for mesenteric
infarction?
Answer: Abdominal arteriogram or CT angiography.
3. Question: What physical exam finding is classically present in mesenteric ischemia
where pain out of proportion to exam occurs?
Answer: Mid-epigastric or LUQ pain radiating to the back, worse when lying supine,
with minimal localized tenderness.
4. Question: What radiological sign on an upright abdominal X-ray confirms intestinal
perforation?
Answer: Free air under the diaphragm (pneumoperitoneum).
5. Question: Which bowel sound pattern is typically heard early in a mechanical intestinal
obstruction?
Answer: Hyperactive, high-pitched or tinkling bowel sounds.
6. Question: Which bowel sound pattern is typically heard late in a mechanical intestinal
obstruction or with peritonitis?
Answer: Hypoactive or absent bowel sounds.
, 7. Question: What is the hallmark pain description for renal colic (kidney stones)?
Answer: Colicky flank pain progressing to constant, severe pain radiating to the groin.
8. Question: What primary diagnostic tests should be ordered for suspected nephrolithiasis?
Answer: Urinalysis, IV pyelogram (IVP), and renal ultrasound.
9. Question: What physical sign is elicited by tapping over the flank in renal pathologies?
Answer: Costovertebral angle (CVA) tenderness.
10. Question: What urinalysis finding is most common in acute renal colic?
Answer: Hematuria.
11. Question: Which abdominal condition presents with severe, diffuse parietal pain,
guarding, rebound tenderness, and relief from lying completely still?
Answer: Intestinal perforation.
12. Question: What position typically relieves the abdominal pain of acute pancreatitis?
Answer: Leaning forward or the fetal position.
13. Question: What position typically worsens the pain of mesenteric infarction?
Answer: Lying supine.
14. Question: What term describes the clinical presentation of an inability to pass stool or
flatus due to obstruction?
Answer: Obstipation.
15. Question: What imaging study is the first-line choice for evaluating acute right lower
quadrant pain suspected to be appendicitis in adults?
Answer: Computed tomography (CT) of the abdomen and pelvis with contrast.
16. Question: What test is preferred over CT for imaging suspected appendicitis in pregnant
patients and children?
Answer: Graded compression abdominal ultrasound.
17. Question: What clinical sign involves pain in the right lower quadrant upon internal
rotation of the right flexed hip?
Answer: Obturator sign.
18. Question: What clinical sign involves right lower quadrant pain upon passive extension
of the right hip?
Answer: Psoas sign.
19. Question: What sign involves deep palpation of the left lower quadrant eliciting pain in
the right lower quadrant?
Answer: Rovsing's sign.
20. Question: What name is given to point tenderness located one-third of the distance from
the anterior superior iliac spine to the umbilicus?
Answer: McBurney's point.
21. Question: What bacteria is most frequently isolated in spontaneous bacterial peritonitis
(SBP)?
Answer: Escherichia coli.
22. Question: What diagnostic procedure is required to confirm spontaneous bacterial
peritonitis in a patient with ascites?
Answer: Diagnostic paracentesis with ascitic fluid analysis (neutrophil count ≥
250 cells/𝜇L).
23. Question: What is the primary medical treatment choice for uncomplicated
Clostridioides difficile infection?
Answer: Oral fidaxomicin or oral vancomycin.
