DIFFERENTIAL DIAGNOSIS AND PRIMARY
CARE 2026 COMPREHENSIVE TEST PAPER
QUESTIONS WITH VERIFIED ANSWERS
◉ A 10-year-old male in 5th grade presents to the pediatric office
with his mother complaining of itchy and red eyes for 1 day. The
patient complains of watery drainage in both eyes, associated with
repetitive itching. On physical exam, he has no fever or
constitutional symptoms. His vision is normal, with no decrease in
extraocular movements. The patient has a sibling that just started
day care recently. He also has bilateral preauricular lymph nodes
that are inflamed. What is the patient's diagnosis?
1.Viral conjunctivitis.
2.Bacterial conjunctivitis.
3.Allergic conjunctivitis.
4.Blepharitis. Answer: 1.
Viral conjunctivitis.
◉ A 25-year-old male presents with "bleeding in my eye" for 1 day.
He awoke this morning with a dark area of redness in his eye. He has
,no visual loss or changes. He denies constitutional symptoms,
pruritus, drainage, or recent trauma. The redness presents on
physical exam as a dark red area in the patient's sclera of the right
eye only and takes up less than 50% of the eye. The patient's
remaining sclera is clear and white. He also notes he was drinking
alcohol last night and vomited afterward. What is the best
treatment?
1.
Topical steroids and close follow-up with an ophthalmologist.
2.
Sending the patient to the emergency department for immediate
ophthalmology consult.
3.
Reassurance that this lesion will resolve without any treatment in 2
to 4 weeks.
4.
Cold compresses and frequent handwashing. Answer: 3.
Reassurance that this lesion will resolve without any treatment in 2
to 4 weeks.
◉ A 75-year-old African American male presents to your family
practice office complaining of visual impairment. He has worn
corrective lenses for many years but has noticed that his vision has
gotten progressively worse the past 6 months. He denies pain. He
states his vision is worse in both eyes in the peripheral aspects of his
,visual field. He also notes trouble driving at night and halos around
street lights at night. You test his intraocular pressure, and it is 23
mm Hg. What is his most likely diagnosis?
1.
Open-angle glaucoma.
2.
Angle-closure glaucoma.
3.
Cataracts.
4.
Macular degeneration. Answer: 1.
Open-angle glaucoma.
◉ A 75-year-old female presents to your office complaining of
dizziness and hearing loss. The patient states she awoke yesterday
with dizziness, which she described as feeling the room spinning.
She also notes intermittent ringing in her ears. On physical exam, the
patient has lateralization of her hearing loss to the unaffected ear.
Rinne test shows air conduction lasts longer than bone conduction.
What is the next step in helping this patient's symptoms?
1.
Order a computed tomography (CT) scan to rule out acoustic
neuroma.
2.
, Start her on high-dose Augmentin.
3.
Start the patient on a low-salt, low-caffeine diet and give her
meclizine for vertigo attacks.
4.
Immediate referral to an ear, nose, and throat (ENT) specialist.
Answer: 3.
Start the patient on a low-salt, low-caffeine diet and give her
meclizine for vertigo attacks.
◉ Which of the following is not a cause of conductive hearing loss?
1.
Presbycusis.
2.
Cerumen impaction.
3.
Otitis media.
4.
Otosclerosis. Answer: 1.
Presbycusis.
◉ What is the most common bacterial pathogen associated with
acute otitis media?
CARE 2026 COMPREHENSIVE TEST PAPER
QUESTIONS WITH VERIFIED ANSWERS
◉ A 10-year-old male in 5th grade presents to the pediatric office
with his mother complaining of itchy and red eyes for 1 day. The
patient complains of watery drainage in both eyes, associated with
repetitive itching. On physical exam, he has no fever or
constitutional symptoms. His vision is normal, with no decrease in
extraocular movements. The patient has a sibling that just started
day care recently. He also has bilateral preauricular lymph nodes
that are inflamed. What is the patient's diagnosis?
1.Viral conjunctivitis.
2.Bacterial conjunctivitis.
3.Allergic conjunctivitis.
4.Blepharitis. Answer: 1.
Viral conjunctivitis.
◉ A 25-year-old male presents with "bleeding in my eye" for 1 day.
He awoke this morning with a dark area of redness in his eye. He has
,no visual loss or changes. He denies constitutional symptoms,
pruritus, drainage, or recent trauma. The redness presents on
physical exam as a dark red area in the patient's sclera of the right
eye only and takes up less than 50% of the eye. The patient's
remaining sclera is clear and white. He also notes he was drinking
alcohol last night and vomited afterward. What is the best
treatment?
1.
Topical steroids and close follow-up with an ophthalmologist.
2.
Sending the patient to the emergency department for immediate
ophthalmology consult.
3.
Reassurance that this lesion will resolve without any treatment in 2
to 4 weeks.
4.
Cold compresses and frequent handwashing. Answer: 3.
Reassurance that this lesion will resolve without any treatment in 2
to 4 weeks.
◉ A 75-year-old African American male presents to your family
practice office complaining of visual impairment. He has worn
corrective lenses for many years but has noticed that his vision has
gotten progressively worse the past 6 months. He denies pain. He
states his vision is worse in both eyes in the peripheral aspects of his
,visual field. He also notes trouble driving at night and halos around
street lights at night. You test his intraocular pressure, and it is 23
mm Hg. What is his most likely diagnosis?
1.
Open-angle glaucoma.
2.
Angle-closure glaucoma.
3.
Cataracts.
4.
Macular degeneration. Answer: 1.
Open-angle glaucoma.
◉ A 75-year-old female presents to your office complaining of
dizziness and hearing loss. The patient states she awoke yesterday
with dizziness, which she described as feeling the room spinning.
She also notes intermittent ringing in her ears. On physical exam, the
patient has lateralization of her hearing loss to the unaffected ear.
Rinne test shows air conduction lasts longer than bone conduction.
What is the next step in helping this patient's symptoms?
1.
Order a computed tomography (CT) scan to rule out acoustic
neuroma.
2.
, Start her on high-dose Augmentin.
3.
Start the patient on a low-salt, low-caffeine diet and give her
meclizine for vertigo attacks.
4.
Immediate referral to an ear, nose, and throat (ENT) specialist.
Answer: 3.
Start the patient on a low-salt, low-caffeine diet and give her
meclizine for vertigo attacks.
◉ Which of the following is not a cause of conductive hearing loss?
1.
Presbycusis.
2.
Cerumen impaction.
3.
Otitis media.
4.
Otosclerosis. Answer: 1.
Presbycusis.
◉ What is the most common bacterial pathogen associated with
acute otitis media?
