ADVANCED ASSESSMENT INTERPRETING
FINDINGS AND FORMULATING DIFFERENTIAL
DIAGNOSES REVISION HANDBOOK 2026
DIAGNOSTIC FRAMEWORKS AND CLINICAL
DECISION MAKING
◉ A 22-year-old advertising copywriter presents for evaluation of
joint pain. The pain is new, located in the wrists and fingers
bilaterally, with some subjective fever. The patient denies a rash; she
also denies recent travel or camping activities. She has a family
history significant for rheumatoid arthritis. Based on this
information, which of the following pathologic processes would be
the most correct?
A) Infectious
B) Inflammatory
C) Hematologic
D) Traumatic.
Answer: B) inflammatory
◉ A 47-year-old contractor presents for evaluation of neck pain,
which has been intermittent for several years. He normally takes
over-the-counter medications to ease the pain, but this time they
haven't worked as well and he still has discomfort. He recently
,wallpapered the entire second floor in his house, which caused him
great discomfort. The pain resolved with rest. He denies fever, chills,
rash, upper respiratory symptoms, trauma, or injury to the neck.
Based on this description, what is the most likely pathologic
process?
A) Infectious
B) Neoplastic
C) Degenerative
D) Traumatic.
Answer: C) degenerative
◉ A 15-year-old high school sophomore comes to the clinic for
evaluation of a 3-week history of sneezing; itchy, watery eyes; clear
nasal discharge; ear pain; and nonproductive cough. Which is the
most likely pathologic process?
A) Infection
B) Inflammation
C) Allergic
D) Vascular.
Answer: C) allergic
*consistent with allergic rhinitis*
,◉ A 19-year old-college student presents to the emergency room
with fever, headache, and neck pain/stiffness. She is concerned
about the possibility of meningococcal meningitis. Several of her
dorm mates have been vaccinated, but she hasn't been. Which of the
following physical examination descriptions is most consistent with
meningitis?
A) Head is normocephalic and atraumatic, fundi with sharp discs,
neck supple with full range of motion
B) Head is normocephalic and atraumatic, fundi with sharp discs,
neck with paraspinous muscle spasm and limited range of motion to
the right
C) Head is normocephalic and atraumatic, fundi with blurred disc
margins, neck tender to palpation, unable to perform range of
motion
D) Head is normocephalic and atraumatic, fundi with blurred disc
margins, neck supple with full range of motion.
Answer: C)
◉ A 37-year-old nurse comes for evaluation of colicky right upper
quadrant abdominal pain. The pain is associated with nausea and
vomiting and occurs 1 to 2 hours after eating greasy foods. Which
one of the following physical examination descriptions would be
most consistent with the diagnosis of cholecystitis?
A) Abdomen is soft, nontender, and nondistended, without
hepatosplenomegaly or masses.
, B) Abdomen is soft and tender to palpation in the right lower
quadrant, without rebound or guarding.
C) Abdomen is soft and tender to palpation in the right upper
quadrant with inspiration, to the point of stopping inspiration, and
there is no rebound or guarding.
D) Abdomen is soft and tender to palpation in the mid-epigastric
area, without rebound or guarding..
Answer: C) tender to palpation in RUQ
◉ A 55-year-old data entry operator comes to the clinic to establish
care. She has the following symptoms: headache, neck pain, sinus
congestion, sore throat, ringing in ears, sharp brief chest pains at
rest, burning abdominal pain with spicy foods, constipation, urinary
frequency that is worse with coughing and sneezing, and swelling in
legs. This cluster of symptoms is explained by:
A) One disease process
B) More than one disease process.
Answer: B) more than one disease process
◉ A 62-year-old teacher presents to the clinic for evaluation of the
following symptoms: fever, headache, sinus congestion, sore throat,
green nasal discharge, and cough. This cluster of symptoms is best
explained by:
A) One disease process
B) More than one disease process.
FINDINGS AND FORMULATING DIFFERENTIAL
DIAGNOSES REVISION HANDBOOK 2026
DIAGNOSTIC FRAMEWORKS AND CLINICAL
DECISION MAKING
◉ A 22-year-old advertising copywriter presents for evaluation of
joint pain. The pain is new, located in the wrists and fingers
bilaterally, with some subjective fever. The patient denies a rash; she
also denies recent travel or camping activities. She has a family
history significant for rheumatoid arthritis. Based on this
information, which of the following pathologic processes would be
the most correct?
A) Infectious
B) Inflammatory
C) Hematologic
D) Traumatic.
Answer: B) inflammatory
◉ A 47-year-old contractor presents for evaluation of neck pain,
which has been intermittent for several years. He normally takes
over-the-counter medications to ease the pain, but this time they
haven't worked as well and he still has discomfort. He recently
,wallpapered the entire second floor in his house, which caused him
great discomfort. The pain resolved with rest. He denies fever, chills,
rash, upper respiratory symptoms, trauma, or injury to the neck.
Based on this description, what is the most likely pathologic
process?
A) Infectious
B) Neoplastic
C) Degenerative
D) Traumatic.
Answer: C) degenerative
◉ A 15-year-old high school sophomore comes to the clinic for
evaluation of a 3-week history of sneezing; itchy, watery eyes; clear
nasal discharge; ear pain; and nonproductive cough. Which is the
most likely pathologic process?
A) Infection
B) Inflammation
C) Allergic
D) Vascular.
Answer: C) allergic
*consistent with allergic rhinitis*
,◉ A 19-year old-college student presents to the emergency room
with fever, headache, and neck pain/stiffness. She is concerned
about the possibility of meningococcal meningitis. Several of her
dorm mates have been vaccinated, but she hasn't been. Which of the
following physical examination descriptions is most consistent with
meningitis?
A) Head is normocephalic and atraumatic, fundi with sharp discs,
neck supple with full range of motion
B) Head is normocephalic and atraumatic, fundi with sharp discs,
neck with paraspinous muscle spasm and limited range of motion to
the right
C) Head is normocephalic and atraumatic, fundi with blurred disc
margins, neck tender to palpation, unable to perform range of
motion
D) Head is normocephalic and atraumatic, fundi with blurred disc
margins, neck supple with full range of motion.
Answer: C)
◉ A 37-year-old nurse comes for evaluation of colicky right upper
quadrant abdominal pain. The pain is associated with nausea and
vomiting and occurs 1 to 2 hours after eating greasy foods. Which
one of the following physical examination descriptions would be
most consistent with the diagnosis of cholecystitis?
A) Abdomen is soft, nontender, and nondistended, without
hepatosplenomegaly or masses.
, B) Abdomen is soft and tender to palpation in the right lower
quadrant, without rebound or guarding.
C) Abdomen is soft and tender to palpation in the right upper
quadrant with inspiration, to the point of stopping inspiration, and
there is no rebound or guarding.
D) Abdomen is soft and tender to palpation in the mid-epigastric
area, without rebound or guarding..
Answer: C) tender to palpation in RUQ
◉ A 55-year-old data entry operator comes to the clinic to establish
care. She has the following symptoms: headache, neck pain, sinus
congestion, sore throat, ringing in ears, sharp brief chest pains at
rest, burning abdominal pain with spicy foods, constipation, urinary
frequency that is worse with coughing and sneezing, and swelling in
legs. This cluster of symptoms is explained by:
A) One disease process
B) More than one disease process.
Answer: B) more than one disease process
◉ A 62-year-old teacher presents to the clinic for evaluation of the
following symptoms: fever, headache, sinus congestion, sore throat,
green nasal discharge, and cough. This cluster of symptoms is best
explained by:
A) One disease process
B) More than one disease process.
