CLINICAL EXAM SCENARIOS ACTUAL EVALUATION QUESTIONS
WITH SOLUTIONS A+ 2025/2026
✔✔A 41-year-old man presents to the emergency room with sudden onset of blurry
vision one hour ago. He states that he was resting at home when he noticed he had
difficulty reading. Currently, he is also starting to see double, and is seeing two images
on top of each other. Earlier today, he felt ill with nausea, vomiting, and watery diarrhea,
which he attributed to food he had eaten at a picnic the day before. When asked which
foods he ate, he lists potato salad, a hamburger, deviled eggs, and pickles made by his
neighbor. He also heard that his friend who went to the picnic with him has developed
similar symptoms and was seen in another hospital earlier. While in the emergency
room, the patient's temperature is 98.4°F (36.9°C), pulse is 75/min, blood pressure is
122/84 mmHg, and respirations are 13/min. Cranial nerve exam is notable for fixed
pupillary dilation, and difficulty depressing both eyes. The remainder of hi -
✔✔Decreased acetylcholine release
✔✔A 40-year-old man presents to a hospital after flying from sub-Saharan Africa. He
had been on a safari and had sustained multiple mosquito bites. He had not gotten his
necessary vaccines, as the trip was planned last-minute. For the past 2 days, he has
had fevers, chills, myalgias, and some vomiting. After landing, he had an episode of
bloody vomiting. On physical exam, he has a high fever. He also has gingival bleeding,
jaundice, and scleral icterus. On abdominal exam, he has hepatosplenomegaly. He is
admitted for supportive care and close monitoring. What is the most likely Dx? -
✔✔Yellow Fever
✔✔A 10-year-old boy presents to the emergency room for lightheadedness, fever, and
diarrhea. His dad recently traveled to Vietnam on business and returned a few days
ago. Since then, the boy has had a low-grade fever, chills, malaise, anorexia, and non-
bloody diarrhea. On further questioning, the dad remembered a recent bout of diarrhea,
for which he had not been treated. On physical exam, the boy has rose spots on his
trunk. He also has abdominal tenderness and hepatomegaly. He is started on
intravenous fluids and antibiotics. What is the most likely Dx? - ✔✔Typhoid Fever
✔✔A 40-year-old man presents to a local emergency room. He is currently on a medical
mission in India. He reports sudden-onset nausea, vomiting, and copious amounts of
watery diarrhea. His blood pressure is 93/65 mmHg and pulse is 114/min. On physical
exam, he has sunken eyes, decreased skin turgor, and dry mucous membranes. He is
given intravenous rehydration with the goal of rapid rehydration. What is the most likely
Dx? - ✔✔Cholera (V. cholerae)
✔✔A 13-year-old boy in rural Asia presents to a local hospital after a dog bite. The dog
did not belong to anybody and is often seen running around the area. His parents report
that this occurred a few weeks ago, but that they weren't concerned until the boy started
having low-grade fever and chills. While the physician explains that they can administer
WITH SOLUTIONS A+ 2025/2026
✔✔A 41-year-old man presents to the emergency room with sudden onset of blurry
vision one hour ago. He states that he was resting at home when he noticed he had
difficulty reading. Currently, he is also starting to see double, and is seeing two images
on top of each other. Earlier today, he felt ill with nausea, vomiting, and watery diarrhea,
which he attributed to food he had eaten at a picnic the day before. When asked which
foods he ate, he lists potato salad, a hamburger, deviled eggs, and pickles made by his
neighbor. He also heard that his friend who went to the picnic with him has developed
similar symptoms and was seen in another hospital earlier. While in the emergency
room, the patient's temperature is 98.4°F (36.9°C), pulse is 75/min, blood pressure is
122/84 mmHg, and respirations are 13/min. Cranial nerve exam is notable for fixed
pupillary dilation, and difficulty depressing both eyes. The remainder of hi -
✔✔Decreased acetylcholine release
✔✔A 40-year-old man presents to a hospital after flying from sub-Saharan Africa. He
had been on a safari and had sustained multiple mosquito bites. He had not gotten his
necessary vaccines, as the trip was planned last-minute. For the past 2 days, he has
had fevers, chills, myalgias, and some vomiting. After landing, he had an episode of
bloody vomiting. On physical exam, he has a high fever. He also has gingival bleeding,
jaundice, and scleral icterus. On abdominal exam, he has hepatosplenomegaly. He is
admitted for supportive care and close monitoring. What is the most likely Dx? -
✔✔Yellow Fever
✔✔A 10-year-old boy presents to the emergency room for lightheadedness, fever, and
diarrhea. His dad recently traveled to Vietnam on business and returned a few days
ago. Since then, the boy has had a low-grade fever, chills, malaise, anorexia, and non-
bloody diarrhea. On further questioning, the dad remembered a recent bout of diarrhea,
for which he had not been treated. On physical exam, the boy has rose spots on his
trunk. He also has abdominal tenderness and hepatomegaly. He is started on
intravenous fluids and antibiotics. What is the most likely Dx? - ✔✔Typhoid Fever
✔✔A 40-year-old man presents to a local emergency room. He is currently on a medical
mission in India. He reports sudden-onset nausea, vomiting, and copious amounts of
watery diarrhea. His blood pressure is 93/65 mmHg and pulse is 114/min. On physical
exam, he has sunken eyes, decreased skin turgor, and dry mucous membranes. He is
given intravenous rehydration with the goal of rapid rehydration. What is the most likely
Dx? - ✔✔Cholera (V. cholerae)
✔✔A 13-year-old boy in rural Asia presents to a local hospital after a dog bite. The dog
did not belong to anybody and is often seen running around the area. His parents report
that this occurred a few weeks ago, but that they weren't concerned until the boy started
having low-grade fever and chills. While the physician explains that they can administer
