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Chamberlain NR- 511 Differential Diagnosis & Primary
Care Practicum| Advanced/Hard/Mixed Difficulty ||
100% Pass Guaranteed | Graded A+
Question 1
A 45-year-old male presents with acute onset of severe, tearing chest pain radiating to his back.
His blood pressure is 180/100 mmHg in the right arm and 130/80 mmHg in the left arm. Which
of the following is the most likely diagnosis?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
☑ Correct Answer: C
☑ Explanation: Aortic dissection is characterized by acute, severe, tearing chest pain that
radiates to the back, along with a difference in blood pressure between arms. This is a medical
emergency requiring immediate imaging and surgical consultation. Acute myocardial infarction
typically presents with pressure-like chest pain; pulmonary embolism with sudden dyspnea and
pleuritic chest pain; pericarditis with positional chest pain relieved by sitting forward.
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Question 2
A 28-year-old female presents with fatigue, weight gain, cold intolerance, and constipation. On
examination, she has a bradycardic heart rate, dry skin, and a palpable goiter. Which of the
following laboratory findings would be most consistent with her presentation?
A. Elevated T3 and T4, low TSH
B. Low T3 and T4, elevated TSH
C. Elevated TSH, elevated T3 and T4
D. Low TSH, low T3 and T4
☑ Correct Answer: B
☑ Explanation: Primary hypothyroidism is characterized by low T3 and T4 with an elevated
TSH due to lack of negative feedback on the pituitary. Option A is consistent with
hyperthyroidism. Option C is consistent with a TSH-secreting pituitary adenoma. Option D is
consistent with secondary hypothyroidism (pituitary dysfunction).
Question 3
A 55-year-old male with a 30-pack-year smoking history presents with a chronic cough,
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hemoptysis, and weight loss. A chest X-ray shows a suspicious lung mass. Which of the
following is the most appropriate next step?
A. Empiric antibiotics and follow-up chest X-ray in 6 weeks
B. CT-guided biopsy of the lung mass
C. Bronchoscopy with biopsy
D. PET scan to assess for metastasis
☑ Correct Answer: C
☑ Explanation: Bronchoscopy with biopsy is the most appropriate next step for a suspicious
lung mass with hemoptysis, as it allows direct visualization and tissue sampling. CT-guided
biopsy is also an option but is typically used for peripheral lesions. Empiric antibiotics are
inappropriate without evidence of infection. PET scan is useful for staging but should follow
histologic confirmation.
Question 4
A 32-year-old woman presents with dysuria, urinary frequency, and suprapubic pain. She
reports no vaginal discharge or fever. Urinalysis reveals positive leukocyte esterase and nitrites.
Which of the following is the most appropriate initial management?
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A. Urine culture and sensitivity, then antibiotics
B. Empiric antibiotics without culture
C. Pelvic ultrasound
D. Cystoscopy
☑ Correct Answer: B
☑ Explanation: In an uncomplicated urinary tract infection (UTI) in a young, healthy
woman, empiric antibiotics without culture is appropriate. Culture is recommended for
complicated UTIs, recurrent infections, or if symptoms do not improve. Pelvic ultrasound and
cystoscopy are not indicated for an uncomplicated UTI.
Question 5
A 65-year-old male presents with progressive difficulty urinating, weak urinary stream, and
nocturia. Digital rectal examination reveals a symmetrically enlarged, firm, non-tender prostate.
Which of the following is the most likely diagnosis?
A. Prostate cancer
B. Benign prostatic hyperplasia (BPH)
Chamberlain NR- 511 Differential Diagnosis & Primary
Care Practicum| Advanced/Hard/Mixed Difficulty ||
100% Pass Guaranteed | Graded A+
Question 1
A 45-year-old male presents with acute onset of severe, tearing chest pain radiating to his back.
His blood pressure is 180/100 mmHg in the right arm and 130/80 mmHg in the left arm. Which
of the following is the most likely diagnosis?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
☑ Correct Answer: C
☑ Explanation: Aortic dissection is characterized by acute, severe, tearing chest pain that
radiates to the back, along with a difference in blood pressure between arms. This is a medical
emergency requiring immediate imaging and surgical consultation. Acute myocardial infarction
typically presents with pressure-like chest pain; pulmonary embolism with sudden dyspnea and
pleuritic chest pain; pericarditis with positional chest pain relieved by sitting forward.
,2
Question 2
A 28-year-old female presents with fatigue, weight gain, cold intolerance, and constipation. On
examination, she has a bradycardic heart rate, dry skin, and a palpable goiter. Which of the
following laboratory findings would be most consistent with her presentation?
A. Elevated T3 and T4, low TSH
B. Low T3 and T4, elevated TSH
C. Elevated TSH, elevated T3 and T4
D. Low TSH, low T3 and T4
☑ Correct Answer: B
☑ Explanation: Primary hypothyroidism is characterized by low T3 and T4 with an elevated
TSH due to lack of negative feedback on the pituitary. Option A is consistent with
hyperthyroidism. Option C is consistent with a TSH-secreting pituitary adenoma. Option D is
consistent with secondary hypothyroidism (pituitary dysfunction).
Question 3
A 55-year-old male with a 30-pack-year smoking history presents with a chronic cough,
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hemoptysis, and weight loss. A chest X-ray shows a suspicious lung mass. Which of the
following is the most appropriate next step?
A. Empiric antibiotics and follow-up chest X-ray in 6 weeks
B. CT-guided biopsy of the lung mass
C. Bronchoscopy with biopsy
D. PET scan to assess for metastasis
☑ Correct Answer: C
☑ Explanation: Bronchoscopy with biopsy is the most appropriate next step for a suspicious
lung mass with hemoptysis, as it allows direct visualization and tissue sampling. CT-guided
biopsy is also an option but is typically used for peripheral lesions. Empiric antibiotics are
inappropriate without evidence of infection. PET scan is useful for staging but should follow
histologic confirmation.
Question 4
A 32-year-old woman presents with dysuria, urinary frequency, and suprapubic pain. She
reports no vaginal discharge or fever. Urinalysis reveals positive leukocyte esterase and nitrites.
Which of the following is the most appropriate initial management?
, 4
A. Urine culture and sensitivity, then antibiotics
B. Empiric antibiotics without culture
C. Pelvic ultrasound
D. Cystoscopy
☑ Correct Answer: B
☑ Explanation: In an uncomplicated urinary tract infection (UTI) in a young, healthy
woman, empiric antibiotics without culture is appropriate. Culture is recommended for
complicated UTIs, recurrent infections, or if symptoms do not improve. Pelvic ultrasound and
cystoscopy are not indicated for an uncomplicated UTI.
Question 5
A 65-year-old male presents with progressive difficulty urinating, weak urinary stream, and
nocturia. Digital rectal examination reveals a symmetrically enlarged, firm, non-tender prostate.
Which of the following is the most likely diagnosis?
A. Prostate cancer
B. Benign prostatic hyperplasia (BPH)
