NR 511 FINAL EXAM STUDY GUIDE:
DIFFERENTIAL DIAGNOSIS AND PRIMARY
CARE PRACTICUM REVIEW
1. A 45-year-old male presents with a sudden onset of severe pain, redness, and swelling in
his left great toe. He mentions a recent history of high purine intake. What is the most likely
diagnosis?
A. Rheumatoid Arthritis
B. Gouty Arthritis
C. Osteoarthritis
D. Septic Arthritis
Answer: B
Conceptual Explanation: Gouty arthritis typically presents with sudden, severe pain and
inflammation in the first metatarsophalangeal joint, often triggered by diet or alcohol.
2. When assessing a patient for a suspected rotator cuff tear, which physical examination
maneuver is most specific for identifying a supraspinatus injury?
A. Empty Can test
,B. Lachman test
C. McMurray test
D. Phalen’s sign
Answer: A
Conceptual Explanation: The Empty Can test (Jobe’s test) isolates the supraspinatus
muscle and tendon, indicating a tear or inflammation when pain or weakness is present.
3. A 24-year-old female presents with a ‘herald patch’ followed by a ‘Christmas tree’
distribution of smaller maculopapular lesions on her trunk. What is the diagnosis?
A. Secondary syphilis
B. Tinea corporis
C. Psoriasis
D. Pityriasis rosea
Answer: D
Conceptual Explanation: Pityriasis rosea is characterized by an initial herald patch
followed by a generalized eruption in a Christmas tree distribution along skin tension lines.
4. In the management of community-acquired pneumonia (CAP) in a healthy adult with no
recent antibiotic use, what is the first-line empirical treatment according to current
guidelines?
A. Ciprofloxacin
, B. Amoxicillin 1g TID or Doxycycline
C. Levofloxacin
D. Vancomycin
Answer: B
Conceptual Explanation: For healthy outpatients without comorbidities, Amoxicillin or
Doxycycline are recommended first-line options for CAP.
5. A patient presents with a ‘curtain coming down’ over their vision and flashes of light. This
presentation is highly suggestive of:
A. Retinal detachment
B. Cataracts
C. Acute angle-closure glaucoma
D. Macular degeneration
Answer: A
Conceptual Explanation: Flashing lights (photopsia), floaters, and the sensation of a
curtain over the field of vision are classic symptoms of retinal detachment.
6. Which of the following physical exam findings is most indicative of appendicitis?
A. Murphy’s sign
B. McBurney’s point tenderness
DIFFERENTIAL DIAGNOSIS AND PRIMARY
CARE PRACTICUM REVIEW
1. A 45-year-old male presents with a sudden onset of severe pain, redness, and swelling in
his left great toe. He mentions a recent history of high purine intake. What is the most likely
diagnosis?
A. Rheumatoid Arthritis
B. Gouty Arthritis
C. Osteoarthritis
D. Septic Arthritis
Answer: B
Conceptual Explanation: Gouty arthritis typically presents with sudden, severe pain and
inflammation in the first metatarsophalangeal joint, often triggered by diet or alcohol.
2. When assessing a patient for a suspected rotator cuff tear, which physical examination
maneuver is most specific for identifying a supraspinatus injury?
A. Empty Can test
,B. Lachman test
C. McMurray test
D. Phalen’s sign
Answer: A
Conceptual Explanation: The Empty Can test (Jobe’s test) isolates the supraspinatus
muscle and tendon, indicating a tear or inflammation when pain or weakness is present.
3. A 24-year-old female presents with a ‘herald patch’ followed by a ‘Christmas tree’
distribution of smaller maculopapular lesions on her trunk. What is the diagnosis?
A. Secondary syphilis
B. Tinea corporis
C. Psoriasis
D. Pityriasis rosea
Answer: D
Conceptual Explanation: Pityriasis rosea is characterized by an initial herald patch
followed by a generalized eruption in a Christmas tree distribution along skin tension lines.
4. In the management of community-acquired pneumonia (CAP) in a healthy adult with no
recent antibiotic use, what is the first-line empirical treatment according to current
guidelines?
A. Ciprofloxacin
, B. Amoxicillin 1g TID or Doxycycline
C. Levofloxacin
D. Vancomycin
Answer: B
Conceptual Explanation: For healthy outpatients without comorbidities, Amoxicillin or
Doxycycline are recommended first-line options for CAP.
5. A patient presents with a ‘curtain coming down’ over their vision and flashes of light. This
presentation is highly suggestive of:
A. Retinal detachment
B. Cataracts
C. Acute angle-closure glaucoma
D. Macular degeneration
Answer: A
Conceptual Explanation: Flashing lights (photopsia), floaters, and the sensation of a
curtain over the field of vision are classic symptoms of retinal detachment.
6. Which of the following physical exam findings is most indicative of appendicitis?
A. Murphy’s sign
B. McBurney’s point tenderness
