NR511: Differential Diagnosis
& Primary Care Practicum
Final Examination
625 total marks
Section
Multiple Choice
100 total marks
Instructions
Select the single best answer for each question based on clinical
guidelines and the provided material.
Question 1
A 45-year-old male presents with a 2-month history of burning
epigastric pain that occurs 2–3 hours after meals and is
occasionally relieved by food or antacids. He reports a history of
frequent NSAID use for chronic back pain. A urea breath test is
positive.
Which of the following is the most appropriate first-line
pharmacological regimen for this patient's confirmed infection?
11 marks
A
,Metronidazole 500 mg and Amoxicillin 1 g for 7 days.
B
Monotherapy with Omeprazole 40 mg daily for 8 weeks.
C
Ciprofloxacin 500 mg and Tinidazole 500 mg once daily.
Clarithromycin 500 mg, Amoxicillin 1 g, and a Proton Pump
Inhibitor (PPI) twice daily for 14 days.
Expected answer
The patient has a positive urea breath test indicating H. pylori
infection. Standard triple therapy (PPI, Clarithromycin, and
Amoxicillin) for 14 days is the recommended first-line treatment
as per GI management guidelines in the course material.
Question 2
A patient is being evaluated for hemolytic anemia after starting a
new sulfonamide antibiotic. Laboratory results show Heinz bodies
on the peripheral smear.
,Which population group is at the highest statistical risk for the
genetic condition associated with these laboratory findings?
11 marks
A
Hispanic females
B
Northern European females
C
Native American males
African American males
Expected answer
, G6PD deficiency is an X-linked recessive disorder that primarily
affects males, with the highest prevalence seen in individuals of
African, Mediterranean, or Asian descent.
Question 3
Brooke Pruitt, a 30-year-old female (185 cm, 54.5 kg), presents
to the outpatient clinic complaining of persistent neck pain. She
describes the pain as aching and worse after long hours at her
computer. She denies any radiating numbness, tingling in her arms,
or recent trauma. Physical exam shows localized tenderness over
the levator scapulae and upper trapezius muscles without
neurological deficits.
A
Based on the clinical presentation of Brooke Pruitt, which diagnosis
is most consistent with the lack of neurological symptoms and
localized muscle tenderness?
11 marks
A
Herniated Nucleus Pulposus
Myofascial Pain Syndrome
& Primary Care Practicum
Final Examination
625 total marks
Section
Multiple Choice
100 total marks
Instructions
Select the single best answer for each question based on clinical
guidelines and the provided material.
Question 1
A 45-year-old male presents with a 2-month history of burning
epigastric pain that occurs 2–3 hours after meals and is
occasionally relieved by food or antacids. He reports a history of
frequent NSAID use for chronic back pain. A urea breath test is
positive.
Which of the following is the most appropriate first-line
pharmacological regimen for this patient's confirmed infection?
11 marks
A
,Metronidazole 500 mg and Amoxicillin 1 g for 7 days.
B
Monotherapy with Omeprazole 40 mg daily for 8 weeks.
C
Ciprofloxacin 500 mg and Tinidazole 500 mg once daily.
Clarithromycin 500 mg, Amoxicillin 1 g, and a Proton Pump
Inhibitor (PPI) twice daily for 14 days.
Expected answer
The patient has a positive urea breath test indicating H. pylori
infection. Standard triple therapy (PPI, Clarithromycin, and
Amoxicillin) for 14 days is the recommended first-line treatment
as per GI management guidelines in the course material.
Question 2
A patient is being evaluated for hemolytic anemia after starting a
new sulfonamide antibiotic. Laboratory results show Heinz bodies
on the peripheral smear.
,Which population group is at the highest statistical risk for the
genetic condition associated with these laboratory findings?
11 marks
A
Hispanic females
B
Northern European females
C
Native American males
African American males
Expected answer
, G6PD deficiency is an X-linked recessive disorder that primarily
affects males, with the highest prevalence seen in individuals of
African, Mediterranean, or Asian descent.
Question 3
Brooke Pruitt, a 30-year-old female (185 cm, 54.5 kg), presents
to the outpatient clinic complaining of persistent neck pain. She
describes the pain as aching and worse after long hours at her
computer. She denies any radiating numbness, tingling in her arms,
or recent trauma. Physical exam shows localized tenderness over
the levator scapulae and upper trapezius muscles without
neurological deficits.
A
Based on the clinical presentation of Brooke Pruitt, which diagnosis
is most consistent with the lack of neurological symptoms and
localized muscle tenderness?
11 marks
A
Herniated Nucleus Pulposus
Myofascial Pain Syndrome
