and Formulating Differential Diagnoses, 5th Edition, Mary Jo
Goolsby, Laurie Grubbs Chapter 1 - 22 | Complete
,Chaptert1.tAssessmenttandtClinicaltDecision-Making:tOverview
MultipletChoice
Identifytthetchoicetthattbesttcompletestthetstatementtortanswerstthetquestion.
t 1. Whichttypetoftclinicaltdecision-makingtistmosttreliable?
A. Intuitive
B. Analytical
C. Experiential
D. Augenblick
t 2. Whichtoftthetfollowingtistfalse?tTotobtaintadequatethistory,thealth-caretproviderstmusttbe:
A. Methodicaltandtsystematic
B. Attentivettotthetpatient’stverbaltandtnonverbaltlanguage
C. Ablettotaccuratelytinterprettthetpatient’stresponses
D. Adepttattreadingtintotthetpatient’ststatements
t 3. Essentialtpartstoftathealththistorytincludetalltoftthetfollowingtexcept:
A. Chieftcomplaint
B. Historytoftthetpresenttillness
C. Currenttvitaltsigns
D. Alltoftthetabovetaretessentialthistorytcomponents
t 4. Whichtoftthetfollowingtistfalse?tWhiletperformingtthetphysicaltexamination,tthetexaminertmusttbetablet
to:
A. Differentiatetbetweentnormaltandtabnormaltfindings
B. Recalltknowledgetoftatrangetoftconditionstandttheirtassociatedtsignstandtsymptoms
C. Recognizethowtcertaintconditionstaffecttthetresponsettotothertconditions
D. Foreseetunpredictabletfindings
t 5. Thetfollowingtistthetleasttreliabletsourcetoftinformationtfortdiagnostictstatistics:
A. Evidence-basedtinvestigations
B. Primarytreportstoftresearch
C. Estimationtbasedtontatprovider’stexperience
D. Publishedtmeta-analyses
t 6. Thetfollowingtcantbetusedttotassisttintsoundtclinicaltdecision-making:
A. Algorithmtpublishedtintatpeer-reviewedtjournaltarticle
B. Clinicaltpracticetguidelines
C. Evidence-basedtresearch
D. Alltoftthetabove
t 7. Iftatdiagnostictstudythasthightsensitivity,tthistindicatesta:
A. Hightpercentagetoftpersonstwithtthetgiventconditiontwillthavetantabnormaltresult
B. Lowtpercentagetoftpersonstwithtthetgiventconditiontwillthavetantabnormaltresult
C. Lowtlikelihoodtoftnormaltresulttintpersonstwithouttatgiventcondition
D. Nonetoftthetabove
,t 8. Iftatdiagnostictstudythasthightspecificity,tthistindicatesta:
A. Lowtpercentagetofthealthytindividualstwilltshowtatnormaltresult
B. Hightpercentagetofthealthytindividualstwilltshowtatnormaltresult
C. Hightpercentagetoftindividualstwithtatdisordertwilltshowtatnormaltresult
D. Lowtpercentagetoftindividualstwithtatdisordertwilltshowtantabnormaltresult
t 9. Atlikelihoodtratiotabovet1tindicatestthattatdiagnosticttesttshowingta:
A. Positivetresulttiststronglytassociatedtwithtthetdisease
B. Negativetresulttiststronglytassociatedtwithtabsencetoftthetdisease
C. Positivetresulttistweaklytassociatedtwithtthetdisease
D. Negativetresulttistweaklytassociatedtwithtabsencetoftthetdisease
t 10.tWhichtoftthetfollowingtclinicaltreasoningttoolstistdefinedtastevidence-
basedtresourcetbasedtontmathematicaltmodelingttotexpresstthetlikelihoodtoftatconditiontintselecttsituat
ions,tsettings,tand/ortpatients?
A. Clinicaltpracticetguideline
B. Clinicaltdecisiontrule
C. Clinicaltalgorithm
D. Clinicaltrecommendation
, Chaptert1.tAssessmenttandtClinicaltDecision-Making:tOverview
AnswertSection
MULTIPLEtCHOICE
1. ANS:t B
Croskerryt(2009)tdescribesttwotmajorttypestoftclinicaltdiagnostictdecision-
making:tintuitivetandtanalytical.tIntuitivetdecision-makingt(similarttotAugenblinktdecision-
making)tistbasedtontthetexperiencetandtintuitiontoftthetcliniciantandtistlesstreliabletandtpairedtwithtfairl
ytcommonterrors.tIntcontrast,tanalyticaltdecision-
makingtistbasedtontcarefultconsiderationtandthastgreatertreliabilitytwithtrareterrors.
PTS: 1
2. ANS:t D
Totobtaintadequatethistory,tproviderstmusttbetwelltorganized,tattentivettotthetpatient’stverbaltandtnonve
rbaltlanguage,tandtablettotaccuratelytinterprettthetpatient’stresponsesttotquestions.tRathertthantreadingt
intotthetpatient’ststatements,ttheytclarifytanytareastoftuncertainty.
PTS: 1
3. ANS:t C
Vitaltsignstaretparttoftthetphysicaltexaminationtportiontoftpatienttassessment,tnottparttoftthethealththistor
y.
PTS: 1
4. ANS:t D
Whiletperformingtthetphysicaltexamination,tthetexaminertmusttbetablettotdifferentiatetbetweentnormalt
andtabnormaltfindings,trecalltknowledgetoftatrangetoftconditions,tincludingttheirtassociatedtsignstandt
symptoms,trecognizethowtcertaintconditionstaffecttthetresponsettotothertconditions,tandtdistinguishtth
etrelevancetoftvariedtabnormaltfindings.
PTS: 1
5. ANS:t C
Sourcestfortdiagnostictstatisticstincludettextbooks,tprimarytreportstoftresearch,tandtpublishedtmeta-
analyses.tAnothertsourcetoftstatistics,tthetonetthatthastbeentmosttwidelytusedtandtavailabletfortapplica
tionttotthetreasoningtprocess,tistthetestimationtbasedtontatprovider’stexperience,talthoughtthesetaretrar
elytaccurate.tOvertthetpasttdecade,tthetavailabilitytoftevidencetontwhichttotbasetclinicaltreasoningtisti
mproving,tandttheretistantincreasingtexpectationtthattclinicaltreasoningtbetbasedtontscientifictevidenc
e.tEvidence-
basedtstatisticstaretalsotincreasinglytbeingtusedttotdeveloptresourcesttotfacilitatetclinicaltdecision-
making.
PTS: 1
6. ANS:t D
Totassisttintclinicaltdecision-making,tatnumbertoftevidence-
basedtresourcesthavetbeentdevelopedttotassisttthetclinician.tResources,tsuchtastalgorithmstandtclinicalt
practicetguidelines,tassisttintclinicaltreasoningtwhentproperlytapplied.
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