DIFFERENTIAL DIAGNOSIS AND PRIMARY CARE
PRACTICUM MIDTERM COMPREHENSIVE
ASSESSMENT 2026 SOLVED QUESTIONS WITH
VERIFIED SOLUTION GUIDE
◉ In Crohn's Disease there is a characteristic segmental
presentation of the diseased bowel, separated by normal areas of
mucosa. What are these areas referred to as? Answer: Skipped
lesions
◉ What is one characteristic of Crohn's that differentiates it from UC
related to the bowel tissues themselves? Answer: Crohn's affects the
tissue to a deeper level and can affect any or all layers of the bowel.
◉ What is the theory behind the etiology of IBD? Answer: An
initiating factor such as a virus, allergic, or bacterial process occurs
and inflames the intestine. Subsequently, those with a certain
genetic predisposition may produce antibodies that chronically
attack the intestine (autoimmune). Sometimes other relatives are
found to also have IBD demonstrating a genetic component.
◉ Describe IBS as it pertains to its effect on the bowels... Answer:
Disordered sensation or abnormal function of the small or large
intestine.
,◉ What is the most consistent characteristics of IBS? Answer:
Alteration in bowel habits alternating. Abdominal pain is also
common. Painless diarrhea may occur.
◉ What are the three most common areas of abdominal tenderness
for patients with suspected IBS? Answer: LLQ, umbilicus, or
epigastrium.
◉ T or F: The physical exam for patients with suspected IBS is
usually abnormal Answer: False: It's usually normal because there is
no anatomical abnormality behind this condition.
◉ T or F: Digital rectal exams are usually normal in patients with
suspected IBS but may exacerbate symptoms. Answer: True
◉ T or F: Extensive testing such as thyroid testing, abdominal
imaging, and stool studies are indicated in patients with suspected
IBS Answer: False: Start with basic labs such as CBC and ESR,
although elevated ESR and leukocytosis is typically seen with IBD,
not IBS.
◉ T or F: Colonoscopy and barium enema are abnormal in a patient
with suspected IBS Answer: False: Those tests would be normal
because there is no anatomical abnormality behind this condition.
,◉ What are 4 main points of diagnosis for patients with suspected
IBS? Answer: 1. Reveal an increase in bowel symptoms with the
onset of pain.
2. Relief of pain with defecation
3. Heightened sensation in bowel activity
4. Sense of incomplete defecation
◉ T or F: Symptoms of IBS are accompanied by fever and/or
bleeding. Answer: False
◉ What is the first step to treating a newly diagnosed IBS patient?
Answer: Determine whether they are IBS-D, IBS-C, or IBS-M
◉ What are the 4 main points of IBS treatment? Answer: 1. Diet
2. Education
3. Pharmacological therapy
4. Supportive interventions: i.e.reduce stress
◉ T of F: There is proven treatment for IBS Answer: False
◉ At what severity are pharmacological measures taken in patients
with IBS? Mild, moderate, or severe? Answer: Moderate to severe
, ◉ What is the first-line treatment for IBS-D? Answer: 1. High fiber
diet and hydration
2. Exercise
3. Bulking agents
◉ T of F: Stimulant laxatives can be used as long as is needed to treat
IBS-D when first-line treatment fails. Answer: False. Not for long-
term use.
◉ What stimulant laxatives can be used for IBD-D on a short-term
basis? And if these fail? Answer: 1. Lactulose, magnesium hydroxide.
2. Linzess (linaclotide), Trulance (plecanatide), or Amitiza
(lubiprostone)
◉ What medication can be used to help with abdominal
pain/spasms due to IBS? Answer: Antispasmodics: Bentyl
(dicyclomine) or Levisn (hyoscyamine)
◉ T of F: Patients with IBS and comorbid BPH or glaucoma,
especially in the elderly, should avoid anticholinergics to treat
abdominal pain. Answer: True
PRACTICUM MIDTERM COMPREHENSIVE
ASSESSMENT 2026 SOLVED QUESTIONS WITH
VERIFIED SOLUTION GUIDE
◉ In Crohn's Disease there is a characteristic segmental
presentation of the diseased bowel, separated by normal areas of
mucosa. What are these areas referred to as? Answer: Skipped
lesions
◉ What is one characteristic of Crohn's that differentiates it from UC
related to the bowel tissues themselves? Answer: Crohn's affects the
tissue to a deeper level and can affect any or all layers of the bowel.
◉ What is the theory behind the etiology of IBD? Answer: An
initiating factor such as a virus, allergic, or bacterial process occurs
and inflames the intestine. Subsequently, those with a certain
genetic predisposition may produce antibodies that chronically
attack the intestine (autoimmune). Sometimes other relatives are
found to also have IBD demonstrating a genetic component.
◉ Describe IBS as it pertains to its effect on the bowels... Answer:
Disordered sensation or abnormal function of the small or large
intestine.
,◉ What is the most consistent characteristics of IBS? Answer:
Alteration in bowel habits alternating. Abdominal pain is also
common. Painless diarrhea may occur.
◉ What are the three most common areas of abdominal tenderness
for patients with suspected IBS? Answer: LLQ, umbilicus, or
epigastrium.
◉ T or F: The physical exam for patients with suspected IBS is
usually abnormal Answer: False: It's usually normal because there is
no anatomical abnormality behind this condition.
◉ T or F: Digital rectal exams are usually normal in patients with
suspected IBS but may exacerbate symptoms. Answer: True
◉ T or F: Extensive testing such as thyroid testing, abdominal
imaging, and stool studies are indicated in patients with suspected
IBS Answer: False: Start with basic labs such as CBC and ESR,
although elevated ESR and leukocytosis is typically seen with IBD,
not IBS.
◉ T or F: Colonoscopy and barium enema are abnormal in a patient
with suspected IBS Answer: False: Those tests would be normal
because there is no anatomical abnormality behind this condition.
,◉ What are 4 main points of diagnosis for patients with suspected
IBS? Answer: 1. Reveal an increase in bowel symptoms with the
onset of pain.
2. Relief of pain with defecation
3. Heightened sensation in bowel activity
4. Sense of incomplete defecation
◉ T or F: Symptoms of IBS are accompanied by fever and/or
bleeding. Answer: False
◉ What is the first step to treating a newly diagnosed IBS patient?
Answer: Determine whether they are IBS-D, IBS-C, or IBS-M
◉ What are the 4 main points of IBS treatment? Answer: 1. Diet
2. Education
3. Pharmacological therapy
4. Supportive interventions: i.e.reduce stress
◉ T of F: There is proven treatment for IBS Answer: False
◉ At what severity are pharmacological measures taken in patients
with IBS? Mild, moderate, or severe? Answer: Moderate to severe
, ◉ What is the first-line treatment for IBS-D? Answer: 1. High fiber
diet and hydration
2. Exercise
3. Bulking agents
◉ T of F: Stimulant laxatives can be used as long as is needed to treat
IBS-D when first-line treatment fails. Answer: False. Not for long-
term use.
◉ What stimulant laxatives can be used for IBD-D on a short-term
basis? And if these fail? Answer: 1. Lactulose, magnesium hydroxide.
2. Linzess (linaclotide), Trulance (plecanatide), or Amitiza
(lubiprostone)
◉ What medication can be used to help with abdominal
pain/spasms due to IBS? Answer: Antispasmodics: Bentyl
(dicyclomine) or Levisn (hyoscyamine)
◉ T of F: Patients with IBS and comorbid BPH or glaucoma,
especially in the elderly, should avoid anticholinergics to treat
abdominal pain. Answer: True
