NR 511 Midterm Exam (Latest Update
) Differential Diagnosis and
Primary Care Practicum Questions with
100% Correct Answers [Grade A] –
Chamberlain
Define diagnostic reasoning-correct answer Reflective thinking because the process
involves questioning one's thinking to determine if all possible avenues have been
explored and if the conclusions that are being drawn are based on evidence.
Seen as a kind of critical thinking.
What symptoms are associated with peritonsilar abscess?-correct answer Almost
always unilateral, located between tonsil and superior pharyngeal constrictor muscle
Gradual onset of severe unilateral sore throat
Odynophagia
Fever
Otalgia
Asymmetric cervical adenopathy
Pronounced trismus (hot potato voice)
Toxic appearance (poor/absent eye contact, failure to recognize parents, irritability,
inability to be consoled/distracted, drooling, severe halitosis, tonsillar erythema,
exudates)
Swelling above affected tonsil with a discrete bulge, deviation of soft palate/uvula
What is the most common cause of viral pharyngitis?-correct answer Adenovirus
Mononucleosis (Epstein-Barr)
HSV-1
RSV
Flu A&B
Coxsackie
Enteroviruses
, NR 511 Midterm Exam (Latest Update
) Differential Diagnosis and
Primary Care Practicum Questions with
100% Correct Answers [Grade A] –
Chamberlain
What is the most common cause of acute n/v?-correct answer Acute gastroenteritis
What is the importance of obtaining an abdominal XR to rule out perforation or
obstruction even though the diagnosis of diverticulitis can be made clinically?-correct
answer To look for free air (indicating perforation), ileus, or obstruction and treat
empirically. Early treatment leads to better outcomes, so don't delay treatment.
What are colon cancer screening recommendations relative to certain populations?-
correct answer Age 50 or older: initial scope at 50yo, then every 10yrs.
If at increased/high risk of colorectal cancer, start screening earlier (i.e. age 40) and be
screened more often based on findings.
African Americans: Starts screening at age 40-45.
Identify at least two disorders that are considered to be disorders related to conductive
hearing loss.-correct answer Cerumen accumulation/impaction
FB in ear canal
Otitis externa
Chronic otitis media
Middle ear effusion
Tosclerosis
Vascular anomaly
Cholesteatoma
What is the most common cause of bacterial pharyngitis?-correct answer Group A Beta
Hemolytic Streptococcus (GABHS)
What are the clinical findings associated with mononucleosis?-correct answer Gradual
onset of fever
, NR 511 Midterm Exam (Latest Update
) Differential Diagnosis and
Primary Care Practicum Questions with
100% Correct Answers [Grade A] –
Chamberlain
Marked malaise
Severe sore throat
Maybe exudative tonsillitis (50% of cases)
Palatal petechiae/rash
Anterior/posterior cervical lymphadenopathy
Splenic enlargement
How is the diagnosis of streptococcal pharyngitis made clinically based on the Centor
criteria?-correct answer Fever >38C (100.5F)
Tender anterior cervical lymphadenopathy
No cough
Pharyngotonsillar exudate
Presence of all 4 strongly suggest GABHS infection.
3 or more present: empirically dx and treat w/out further testing
What is one intervention for a pt with gastroenteritis?-correct answer Fluid repletion
(PO if possible, pedialyte; IVF for more severe dehydration)
Nutrition
When are stool studies warranted?-correct answer In pts with severe or prolonged
diarrhea, fever >38.5C, bloody stools, stools +leukocytes/occult blood
What is an appropriate treatment for prophylaxis or treatment of traveler's diarrhea?-
correct answer Trimethoprim-sulfamethoxazole (Bactrim DS) 1 tab BID x3days
Cipro 500mg
Norfloxacin (Noroxin) 400mg
Ofloxacin (Floxin) 300mg
, NR 511 Midterm Exam (Latest Update
) Differential Diagnosis and
Primary Care Practicum Questions with
100% Correct Answers [Grade A] –
Chamberlain
Describe the component of the H&P that should be done for a pt with abd pain.-correct
answer OLDCARTS
Upper abd pain: ask about chronic/recurring and related symptoms (bloating, fullness,
heartburn, n/v)
Lower abd pain: if acute, is pain sharp, intermittent continuous? If chronic, is there a
change in bowel habits (alternating diarrhea/constipation)?
Radiation?
What is at least one effective treatment for IBS?-correct answer Diet (avoid lactose,
caffeine, legumes, artificial sweeteners; eat low-fat diet with increased protein, high
fiber, bulk-producing agents, 64oz water daily)
Lifestyle modification
Exercise
Stress reduction
Pharm (for moderate-severe symptoms only): antidiarrheals (imodium, lomotil),
laxatives (lactulose, mag hydroxide), antispasmodics (dicyclomine, hyoscyamine),
tricyclic antidepressants; avoid anticholinergics with glaucoma and BPH pts.
What is at least one prescription med used to treat chronic constipation?-correct answer
Linzess (linaclotide)
Trulance (plecanatide)
Amitiza (lubiprostone)
Lactulose
Mag hydroxide
What is at least one treatment for Meniere's disease?-correct answer Bedrest with eyes
closed, protection from falling
) Differential Diagnosis and
Primary Care Practicum Questions with
100% Correct Answers [Grade A] –
Chamberlain
Define diagnostic reasoning-correct answer Reflective thinking because the process
involves questioning one's thinking to determine if all possible avenues have been
explored and if the conclusions that are being drawn are based on evidence.
Seen as a kind of critical thinking.
What symptoms are associated with peritonsilar abscess?-correct answer Almost
always unilateral, located between tonsil and superior pharyngeal constrictor muscle
Gradual onset of severe unilateral sore throat
Odynophagia
Fever
Otalgia
Asymmetric cervical adenopathy
Pronounced trismus (hot potato voice)
Toxic appearance (poor/absent eye contact, failure to recognize parents, irritability,
inability to be consoled/distracted, drooling, severe halitosis, tonsillar erythema,
exudates)
Swelling above affected tonsil with a discrete bulge, deviation of soft palate/uvula
What is the most common cause of viral pharyngitis?-correct answer Adenovirus
Mononucleosis (Epstein-Barr)
HSV-1
RSV
Flu A&B
Coxsackie
Enteroviruses
, NR 511 Midterm Exam (Latest Update
) Differential Diagnosis and
Primary Care Practicum Questions with
100% Correct Answers [Grade A] –
Chamberlain
What is the most common cause of acute n/v?-correct answer Acute gastroenteritis
What is the importance of obtaining an abdominal XR to rule out perforation or
obstruction even though the diagnosis of diverticulitis can be made clinically?-correct
answer To look for free air (indicating perforation), ileus, or obstruction and treat
empirically. Early treatment leads to better outcomes, so don't delay treatment.
What are colon cancer screening recommendations relative to certain populations?-
correct answer Age 50 or older: initial scope at 50yo, then every 10yrs.
If at increased/high risk of colorectal cancer, start screening earlier (i.e. age 40) and be
screened more often based on findings.
African Americans: Starts screening at age 40-45.
Identify at least two disorders that are considered to be disorders related to conductive
hearing loss.-correct answer Cerumen accumulation/impaction
FB in ear canal
Otitis externa
Chronic otitis media
Middle ear effusion
Tosclerosis
Vascular anomaly
Cholesteatoma
What is the most common cause of bacterial pharyngitis?-correct answer Group A Beta
Hemolytic Streptococcus (GABHS)
What are the clinical findings associated with mononucleosis?-correct answer Gradual
onset of fever
, NR 511 Midterm Exam (Latest Update
) Differential Diagnosis and
Primary Care Practicum Questions with
100% Correct Answers [Grade A] –
Chamberlain
Marked malaise
Severe sore throat
Maybe exudative tonsillitis (50% of cases)
Palatal petechiae/rash
Anterior/posterior cervical lymphadenopathy
Splenic enlargement
How is the diagnosis of streptococcal pharyngitis made clinically based on the Centor
criteria?-correct answer Fever >38C (100.5F)
Tender anterior cervical lymphadenopathy
No cough
Pharyngotonsillar exudate
Presence of all 4 strongly suggest GABHS infection.
3 or more present: empirically dx and treat w/out further testing
What is one intervention for a pt with gastroenteritis?-correct answer Fluid repletion
(PO if possible, pedialyte; IVF for more severe dehydration)
Nutrition
When are stool studies warranted?-correct answer In pts with severe or prolonged
diarrhea, fever >38.5C, bloody stools, stools +leukocytes/occult blood
What is an appropriate treatment for prophylaxis or treatment of traveler's diarrhea?-
correct answer Trimethoprim-sulfamethoxazole (Bactrim DS) 1 tab BID x3days
Cipro 500mg
Norfloxacin (Noroxin) 400mg
Ofloxacin (Floxin) 300mg
, NR 511 Midterm Exam (Latest Update
) Differential Diagnosis and
Primary Care Practicum Questions with
100% Correct Answers [Grade A] –
Chamberlain
Describe the component of the H&P that should be done for a pt with abd pain.-correct
answer OLDCARTS
Upper abd pain: ask about chronic/recurring and related symptoms (bloating, fullness,
heartburn, n/v)
Lower abd pain: if acute, is pain sharp, intermittent continuous? If chronic, is there a
change in bowel habits (alternating diarrhea/constipation)?
Radiation?
What is at least one effective treatment for IBS?-correct answer Diet (avoid lactose,
caffeine, legumes, artificial sweeteners; eat low-fat diet with increased protein, high
fiber, bulk-producing agents, 64oz water daily)
Lifestyle modification
Exercise
Stress reduction
Pharm (for moderate-severe symptoms only): antidiarrheals (imodium, lomotil),
laxatives (lactulose, mag hydroxide), antispasmodics (dicyclomine, hyoscyamine),
tricyclic antidepressants; avoid anticholinergics with glaucoma and BPH pts.
What is at least one prescription med used to treat chronic constipation?-correct answer
Linzess (linaclotide)
Trulance (plecanatide)
Amitiza (lubiprostone)
Lactulose
Mag hydroxide
What is at least one treatment for Meniere's disease?-correct answer Bedrest with eyes
closed, protection from falling
