CLINICAL REASONING, ADVANCED HEALTH
ASSESSMENT, DIFFERENTIAL DIAGNOSIS,
EVIDENCE-BASED PRACTICE, AND PRIMARY
CARE MANAGEMENT
John is a 16-year-old boy who presents to the emergency room after hurting his knee in a
football game. He described twisting his knee and then being unable to extend it completely.
John tells the clinician that he heard a pop when the injury occurred and has been experiencing
localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to
assess for the presence of a meniscal tear?
a. valgus stress test
b. McMurray circumduction test
c. Lachman's test
d. Varus stress test - ANSWER ✓b. McMurray circumduction test
Your patient has decided to give Chantix a try to quit smoking. YOu are discussing his quit date,
and he will begin taking the medication starting tomorrow. When should he plan to quit
smoking?
a. he should stop smoking today
b. he should stop smoking tomorrow
c. his quit date should be in one week
d. he will be ready to quit after the first 30 days - ANSWER ✓c. his quit date should be in one
week
The patient is prescribed radioactive iodine (RAI) and asks the clinician how this drug works. The
clinicans response should include which of the following data?
a. RAI prevents the peripheral conversion of T4 to T3
b. RAI binds to free T4
c. RAI destroys thyroid tissue
,d. RAI reduces freely circulating iodine - ANSWER ✓c. RAI destroys thyroid tissue
Not sure of the question...something about the oral mucosa membranes
a. vincents stomatitis
b. allergic stomatitis
c. apthous stomatitis
d. herpetic stomatitis - ANSWER ✓a. vincents stomatitis
Janet is a 30 year old woman who has been recently diagnosed with a herniated disc at the level
of L5-S1. She is currently in the emergency room with suspician of cauda equna compression.
Which of the following is a sign or symptom of cauda equina compression?
a. gastrocnemius weakness
b. reduced or absent ankle refles
c. numbness of the lateral foot
d. paresthesia of the perineum and buttocks - ANSWER ✓d. paresthesia of the perineum and
buttocks
The patient has acute pancreatitis with 7 of the diagnostic criteria from Ranson's Criteria. In
order to plan care, the clinician understands that this criteria score has which of the following
meanings?
a. a high mortality rate
b. an increased chance of recurrence
c. 7% chance of the disease becoming chronic
d. all of the above - ANSWER ✓a. a high mortality rate
Reuben, age 24, has HIV and just had a routine viral load test done. The results show a falling
viral load What does this indicate
, a. a favorable diagnostic trend
b. disease progression
c. the need to be more aggressive with Reuben's medications
d. the eradication of the HIV - ANSWER ✓a. a favorable diagnostic trend
Which is the differentiating symptom mbetween labyrinthitis and vestibular neuritis?
a. symptoms with vestibular neuritis are usually acute in onset, whereas with labyrinthitis the
onet is more gradual
b. hearing loss may be associated with vestibular neuritis, but not with labyrinthitis
c. symptoms with labyrinthitis are usually acute in onset, ,whereas with vesticular neuritis the
onset is more gradual
d. hearing loss may be associated with labyrinthitis ,but not with vestibular neuritis. - ANSWER
✓d. hearing loss may be associated with labyrinthitis ,but not with vestibular neuritis.
A 27 year old female presents with a chief complaint of burning and pain on urination. She has
no previous history of urinary tract infection. what are some additional symptoms consistant
with a diagnosis of lower UTI?
a. back and abdominal pain
b. fever, chills, costovertebral angle (CVA) tenderness
c. blood in urine and frequency
d. foul-smelling discharge, perineal itch - ANSWER ✓c. blood in urine and frequency
The differential diagnosis for vertigo can be classified into which of the following categories:
a. peripheral vestibular disease
b. CNS disorders
c. Systemic disorders
d. all of the above - ANSWER ✓d. all of the above
Sam is a 25-year-old man who has been diagnosed with low back strain based on his history of
localized low back pain and muscle spasm along with a normal neurological examination. As
ASSESSMENT, DIFFERENTIAL DIAGNOSIS,
EVIDENCE-BASED PRACTICE, AND PRIMARY
CARE MANAGEMENT
John is a 16-year-old boy who presents to the emergency room after hurting his knee in a
football game. He described twisting his knee and then being unable to extend it completely.
John tells the clinician that he heard a pop when the injury occurred and has been experiencing
localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to
assess for the presence of a meniscal tear?
a. valgus stress test
b. McMurray circumduction test
c. Lachman's test
d. Varus stress test - ANSWER ✓b. McMurray circumduction test
Your patient has decided to give Chantix a try to quit smoking. YOu are discussing his quit date,
and he will begin taking the medication starting tomorrow. When should he plan to quit
smoking?
a. he should stop smoking today
b. he should stop smoking tomorrow
c. his quit date should be in one week
d. he will be ready to quit after the first 30 days - ANSWER ✓c. his quit date should be in one
week
The patient is prescribed radioactive iodine (RAI) and asks the clinician how this drug works. The
clinicans response should include which of the following data?
a. RAI prevents the peripheral conversion of T4 to T3
b. RAI binds to free T4
c. RAI destroys thyroid tissue
,d. RAI reduces freely circulating iodine - ANSWER ✓c. RAI destroys thyroid tissue
Not sure of the question...something about the oral mucosa membranes
a. vincents stomatitis
b. allergic stomatitis
c. apthous stomatitis
d. herpetic stomatitis - ANSWER ✓a. vincents stomatitis
Janet is a 30 year old woman who has been recently diagnosed with a herniated disc at the level
of L5-S1. She is currently in the emergency room with suspician of cauda equna compression.
Which of the following is a sign or symptom of cauda equina compression?
a. gastrocnemius weakness
b. reduced or absent ankle refles
c. numbness of the lateral foot
d. paresthesia of the perineum and buttocks - ANSWER ✓d. paresthesia of the perineum and
buttocks
The patient has acute pancreatitis with 7 of the diagnostic criteria from Ranson's Criteria. In
order to plan care, the clinician understands that this criteria score has which of the following
meanings?
a. a high mortality rate
b. an increased chance of recurrence
c. 7% chance of the disease becoming chronic
d. all of the above - ANSWER ✓a. a high mortality rate
Reuben, age 24, has HIV and just had a routine viral load test done. The results show a falling
viral load What does this indicate
, a. a favorable diagnostic trend
b. disease progression
c. the need to be more aggressive with Reuben's medications
d. the eradication of the HIV - ANSWER ✓a. a favorable diagnostic trend
Which is the differentiating symptom mbetween labyrinthitis and vestibular neuritis?
a. symptoms with vestibular neuritis are usually acute in onset, whereas with labyrinthitis the
onet is more gradual
b. hearing loss may be associated with vestibular neuritis, but not with labyrinthitis
c. symptoms with labyrinthitis are usually acute in onset, ,whereas with vesticular neuritis the
onset is more gradual
d. hearing loss may be associated with labyrinthitis ,but not with vestibular neuritis. - ANSWER
✓d. hearing loss may be associated with labyrinthitis ,but not with vestibular neuritis.
A 27 year old female presents with a chief complaint of burning and pain on urination. She has
no previous history of urinary tract infection. what are some additional symptoms consistant
with a diagnosis of lower UTI?
a. back and abdominal pain
b. fever, chills, costovertebral angle (CVA) tenderness
c. blood in urine and frequency
d. foul-smelling discharge, perineal itch - ANSWER ✓c. blood in urine and frequency
The differential diagnosis for vertigo can be classified into which of the following categories:
a. peripheral vestibular disease
b. CNS disorders
c. Systemic disorders
d. all of the above - ANSWER ✓d. all of the above
Sam is a 25-year-old man who has been diagnosed with low back strain based on his history of
localized low back pain and muscle spasm along with a normal neurological examination. As
