Final Exam 1 - NR511 / NR 511 (Latest 2024/
2025) : Differential Diagnosis & Primary
Care Practicum - Chamberlain
1. A 45-year-old female presents with fatigue, cold intolerance, and weight gain.
Physical exam reveals dry skin and bradycardia. What is the most likely
diagnosis?
Hypothyroidism
These are classic signs and symptoms of hypothyroidism. The slow
metabolism results in weight gain, fatigue, bradycardia, and cold
intolerance.
2. A 28-year-old male presents with right lower quadrant pain, fever, and
nausea. What is the most appropriate initial imaging study?
CT scan of the abdomen and pelvis with contrast
CT is the gold standard for diagnosing appendicitis in adults and
provides high sensitivity and specificity.
,3. A patient presents with a sore throat, fever, and tonsillar exudates. Which
clinical decision tool can best guide management?
Centor Criteria
The Centor Criteria help guide the diagnosis and treatment of
streptococcal pharyngitis and determine the need for antibiotics or
further testing.
4. A 66-year-old male with a 40-pack-year smoking history presents with
hemoptysis and unintentional weight loss. What is the next best step in
management?
Order a chest X-ray
Given the red flag symptoms and smoking history, lung cancer must be
ruled out. A chest X-ray is the appropriate initial diagnostic tool.
5. A 34-year-old woman presents with sudden onset of palpitations, anxiety,
and heat intolerance. Labs reveal low TSH and elevated T3/T4. What is the most
likely diagnosis?
Hyperthyroidism
These clinical findings and labs are consistent with hyperthyroidism. The
symptoms reflect a hypermetabolic state.
6. A 60-year-old female presents with new-onset unilateral headache, jaw
claudication, and visual disturbances. What is the most likely diagnosis?
, Temporal arteritis (Giant cell arteritis)
This is a classic presentation of temporal arteritis, especially in elderly
women. Prompt diagnosis and treatment with steroids are necessary to
prevent vision loss.
7. A 25-year-old female presents with urinary frequency, urgency, and dysuria.
What is the first-line treatment for uncomplicated UTI?
Nitrofurantoin 100 mg BID for 5 days
Nitrofurantoin is a first-line agent for uncomplicated UTIs in women,
with minimal resistance and good efficacy.
8. A patient presents with a painless, hard testicular mass. What is the next best
diagnostic step?
Scrotal ultrasound
A scrotal ultrasound is the imaging modality of choice to evaluate
testicular masses and differentiate between solid and cystic lesions.
9. A 70-year-old patient presents with fatigue, pallor, and black tarry stools.
What lab test would best confirm your suspicion of GI bleeding?
Hemoglobin and hematocrit
A low H&H supports blood loss. Black tarry stools (melena) are
consistent with upper GI bleeding.
2025) : Differential Diagnosis & Primary
Care Practicum - Chamberlain
1. A 45-year-old female presents with fatigue, cold intolerance, and weight gain.
Physical exam reveals dry skin and bradycardia. What is the most likely
diagnosis?
Hypothyroidism
These are classic signs and symptoms of hypothyroidism. The slow
metabolism results in weight gain, fatigue, bradycardia, and cold
intolerance.
2. A 28-year-old male presents with right lower quadrant pain, fever, and
nausea. What is the most appropriate initial imaging study?
CT scan of the abdomen and pelvis with contrast
CT is the gold standard for diagnosing appendicitis in adults and
provides high sensitivity and specificity.
,3. A patient presents with a sore throat, fever, and tonsillar exudates. Which
clinical decision tool can best guide management?
Centor Criteria
The Centor Criteria help guide the diagnosis and treatment of
streptococcal pharyngitis and determine the need for antibiotics or
further testing.
4. A 66-year-old male with a 40-pack-year smoking history presents with
hemoptysis and unintentional weight loss. What is the next best step in
management?
Order a chest X-ray
Given the red flag symptoms and smoking history, lung cancer must be
ruled out. A chest X-ray is the appropriate initial diagnostic tool.
5. A 34-year-old woman presents with sudden onset of palpitations, anxiety,
and heat intolerance. Labs reveal low TSH and elevated T3/T4. What is the most
likely diagnosis?
Hyperthyroidism
These clinical findings and labs are consistent with hyperthyroidism. The
symptoms reflect a hypermetabolic state.
6. A 60-year-old female presents with new-onset unilateral headache, jaw
claudication, and visual disturbances. What is the most likely diagnosis?
, Temporal arteritis (Giant cell arteritis)
This is a classic presentation of temporal arteritis, especially in elderly
women. Prompt diagnosis and treatment with steroids are necessary to
prevent vision loss.
7. A 25-year-old female presents with urinary frequency, urgency, and dysuria.
What is the first-line treatment for uncomplicated UTI?
Nitrofurantoin 100 mg BID for 5 days
Nitrofurantoin is a first-line agent for uncomplicated UTIs in women,
with minimal resistance and good efficacy.
8. A patient presents with a painless, hard testicular mass. What is the next best
diagnostic step?
Scrotal ultrasound
A scrotal ultrasound is the imaging modality of choice to evaluate
testicular masses and differentiate between solid and cystic lesions.
9. A 70-year-old patient presents with fatigue, pallor, and black tarry stools.
What lab test would best confirm your suspicion of GI bleeding?
Hemoglobin and hematocrit
A low H&H supports blood loss. Black tarry stools (melena) are
consistent with upper GI bleeding.
