NR 511-NP Café Final Exam Concept Review: (Latest
2026/2027 Update) Differential Diagnosis & Primary Care | GI,
GU, Hematology, Orthopedics, Infectious Disease | Q&A |
Grade A | 100% Correct Verified Answers
Subject: Differential Diagnosis & Primary Care – Gastrointestinal (Ulcerative Colitis, Diverticulitis, C.
difficile, GERD, Peptic Ulcer Disease, H. pylori, Rotavirus, Gastroenteritis, Giardia, Salmonella,
Appendicitis), Hematology (Anemia – Iron Deficiency, Macrocytic, Microcytic, Sideroblastic, Sickle Cell;
G6PD; Leukemia – ALL, CLL), Genitourinary (UTI, Overactive Bladder, Incontinence, Priapism,
Phimosis, Hypospadias, Varicocele, Undescended Testes, BPH, Prostate Cancer, Erectile Dysfunction,
Prostatitis), Orthopedics (Carpal Tunnel, Shoulder Dislocation, Herniated Disc, Lumbar Spinal Stenosis,
Cervical Spondylosis, Radiculopathy, Sprains/Strains, Vertebral Fractures, Peripheral Neuropathy,
Orthopedic Exam Tests – McMurray, Phalen, Anterior Drawer, Straight Leg Raise), Bites & Lacerations
(Animal Bites, Rabies, Tetanus, Suture Removal, Wound Cleansing, Abscess Management).
Source: NR 511 NP Café Final Exam Blueprint 2026/2027, AAFP, AGA, AAOS, IDSA.
Format: Q&A Concept Review with Clinical Rationale | Verified Answers | Grade A Guaranteed
Ulcerative Colitis – description and key features
Correct Answer: Inflammatory bowel disease affecting the colon. Key features: bloody diarrhea,
mucosal inflammation, erosions. Total colectomy may be needed for severe disease.
1. Ulcerative colitis causes continuous mucosal inflammation starting at rectum extending proximally.
Symptoms: bloody diarrhea, tenesmus, abdominal cramping, urgency.
2. Treatment: 5-aminosalicylates (mesalamine), corticosteroids for flares, immunomodulators
(azathioprine), biologics (anti-TNF). Colectomy for dysplasia, toxic megacolon, or refractory disease.
Diverticulitis – presentation and risk factors
Correct Answer: Inflammation of diverticula in the colon. Symptoms: LLQ pain, fever, chills,
tachycardia, localized tenderness, anorexia, nausea/vomiting. Risk factor: obesity. Diagnosis: CT
scan with contrast.
1. Diverticulitis may present with purulent diarrhea or constipation. CT shows wall thickening, pericolonic
fat stranding, abscess if present.
2. Treatment: uncomplicated – oral antibiotics (ciprofloxacin + metronidazole or amoxicillin-clavulanate),
clear liquid diet, pain control. Complicated (abscess, perforation) – hospitalization, IV antibiotics, possible
drainage or surgery.
, Clostridium difficile infection – risk factors and testing
Correct Answer: Risk factors: healthcare work, long hospitalization, antibiotics (especially broad-
spectrum, clindamycin, fluoroquinolones). Profuse watery diarrhea (≥3 stools/day). Mild: 3 watery
stools/day. Severe: 10-15 watery stools/day with possible hospitalization. Testing: CBC (elevated
WBC), ELISA test (toxins A/B), PCR test (detects bacterial genes). First-line treatment:
metronidazole (mild) or oral vancomycin/fidaxomicin (severe). Total colectomy for fulminant
disease.
1. C. diff toxigenic strains produce toxins A and B. PCR has high sensitivity; ELISA is specific.
Asymptomatic colonization common.
2. Probiotics (S. boulardii) may prevent recurrence. Oral vancomycin is preferred for severe or recurrent
disease. Fecal microbiota transplant for multiply recurrent (>3 episodes).
GERD – pathophysiology and management
Correct Answer: Pathophysiology: LES dysfunction allows gastric acid reflux into esophagus. Hiatal
hernia disrupts normal barrier, contributing to GERD symptoms. Symptoms: heartburn,
regurgitation, dysphagia, worse at night. Endoscopy recommended if symptoms persist after 8
weeks of PPI therapy (or alarm symptoms). Diet modifications: avoid coffee, alcohol, spicy foods,
fatty foods, chocolate, peppermint, carbonated beverages, citrus.
1. First-line treatment: PPIs (omeprazole, esomeprazole, lansoprazole) x8 weeks. H2 blockers for mild
intermittent symptoms. Lifestyle: head of bed elevation, weight loss, avoid meals 3 hours before bedtime,
smoking cessation.
Peptic Ulcer Disease (PUD) – etiology and symptoms
Correct Answer: Burning epigastric pain relieved by food or antacids (duodenal ulcer) or worsened
by food (gastric ulcer). Causes: H. pylori infection (most common), NSAIDs (risk factor).
1. H. pylori testing: urea breath test, stool antigen, or endoscopic biopsy. Treatment: PPI + clarithromycin
+ amoxicillin (or metronidazole) for 14 days.
2. NSAID-induced ulcers: stop NSAID, PPI for 4-8 weeks. If NSAID must continue, add PPI or
misoprostol.
Gastroenteritis – causes and treatment
Correct Answer: Irritation and inflammation of stomach and intestines. Symptoms: watery diarrhea,
nausea, vomiting, abdominal pain. Causes: viruses (norovirus most common), bacteria (Salmonella,
Campylobacter, Shigella, E. coli), parasites (Giardia).
1. Treatment: supportive (oral rehydration, electrolyte replacement). Antibiotics for bacterial (azithromycin
or ciprofloxacin for traveler's diarrhea, but avoid if afebrile/not bloody). Antimotility agents (loperamide) if
no fever/dysentery.
2. Giardiasis: foul-smelling greasy diarrhea, flatulence. Metronidazole, tinidazole, or nitazoxanide.
Salmonellosis: usually self-limited, antibiotics if severe or immunocompromised (ciprofloxacin,
azithromycin).
Appendicitis – signs and treatment
Correct Answer: Inflammation of the appendix causing abdominal pain. Pathophysiology: fecalith
(fecal stone) obstructs appendix. Signs: Rovsing, obturator (pain in RLQ when rotating right leg
internally), psoas sign. Treatment: surgery (appendectomy) with antimicrobial therapy.
1. Pain migrates from periumbilical to RLQ (McBurney point) over 12-24 hours. Anorexia, nausea,
vomiting, low-grade fever. WBC elevated.
2. Imaging: CT with contrast (best) or ultrasound (children, pregnancy).
2026/2027 Update) Differential Diagnosis & Primary Care | GI,
GU, Hematology, Orthopedics, Infectious Disease | Q&A |
Grade A | 100% Correct Verified Answers
Subject: Differential Diagnosis & Primary Care – Gastrointestinal (Ulcerative Colitis, Diverticulitis, C.
difficile, GERD, Peptic Ulcer Disease, H. pylori, Rotavirus, Gastroenteritis, Giardia, Salmonella,
Appendicitis), Hematology (Anemia – Iron Deficiency, Macrocytic, Microcytic, Sideroblastic, Sickle Cell;
G6PD; Leukemia – ALL, CLL), Genitourinary (UTI, Overactive Bladder, Incontinence, Priapism,
Phimosis, Hypospadias, Varicocele, Undescended Testes, BPH, Prostate Cancer, Erectile Dysfunction,
Prostatitis), Orthopedics (Carpal Tunnel, Shoulder Dislocation, Herniated Disc, Lumbar Spinal Stenosis,
Cervical Spondylosis, Radiculopathy, Sprains/Strains, Vertebral Fractures, Peripheral Neuropathy,
Orthopedic Exam Tests – McMurray, Phalen, Anterior Drawer, Straight Leg Raise), Bites & Lacerations
(Animal Bites, Rabies, Tetanus, Suture Removal, Wound Cleansing, Abscess Management).
Source: NR 511 NP Café Final Exam Blueprint 2026/2027, AAFP, AGA, AAOS, IDSA.
Format: Q&A Concept Review with Clinical Rationale | Verified Answers | Grade A Guaranteed
Ulcerative Colitis – description and key features
Correct Answer: Inflammatory bowel disease affecting the colon. Key features: bloody diarrhea,
mucosal inflammation, erosions. Total colectomy may be needed for severe disease.
1. Ulcerative colitis causes continuous mucosal inflammation starting at rectum extending proximally.
Symptoms: bloody diarrhea, tenesmus, abdominal cramping, urgency.
2. Treatment: 5-aminosalicylates (mesalamine), corticosteroids for flares, immunomodulators
(azathioprine), biologics (anti-TNF). Colectomy for dysplasia, toxic megacolon, or refractory disease.
Diverticulitis – presentation and risk factors
Correct Answer: Inflammation of diverticula in the colon. Symptoms: LLQ pain, fever, chills,
tachycardia, localized tenderness, anorexia, nausea/vomiting. Risk factor: obesity. Diagnosis: CT
scan with contrast.
1. Diverticulitis may present with purulent diarrhea or constipation. CT shows wall thickening, pericolonic
fat stranding, abscess if present.
2. Treatment: uncomplicated – oral antibiotics (ciprofloxacin + metronidazole or amoxicillin-clavulanate),
clear liquid diet, pain control. Complicated (abscess, perforation) – hospitalization, IV antibiotics, possible
drainage or surgery.
, Clostridium difficile infection – risk factors and testing
Correct Answer: Risk factors: healthcare work, long hospitalization, antibiotics (especially broad-
spectrum, clindamycin, fluoroquinolones). Profuse watery diarrhea (≥3 stools/day). Mild: 3 watery
stools/day. Severe: 10-15 watery stools/day with possible hospitalization. Testing: CBC (elevated
WBC), ELISA test (toxins A/B), PCR test (detects bacterial genes). First-line treatment:
metronidazole (mild) or oral vancomycin/fidaxomicin (severe). Total colectomy for fulminant
disease.
1. C. diff toxigenic strains produce toxins A and B. PCR has high sensitivity; ELISA is specific.
Asymptomatic colonization common.
2. Probiotics (S. boulardii) may prevent recurrence. Oral vancomycin is preferred for severe or recurrent
disease. Fecal microbiota transplant for multiply recurrent (>3 episodes).
GERD – pathophysiology and management
Correct Answer: Pathophysiology: LES dysfunction allows gastric acid reflux into esophagus. Hiatal
hernia disrupts normal barrier, contributing to GERD symptoms. Symptoms: heartburn,
regurgitation, dysphagia, worse at night. Endoscopy recommended if symptoms persist after 8
weeks of PPI therapy (or alarm symptoms). Diet modifications: avoid coffee, alcohol, spicy foods,
fatty foods, chocolate, peppermint, carbonated beverages, citrus.
1. First-line treatment: PPIs (omeprazole, esomeprazole, lansoprazole) x8 weeks. H2 blockers for mild
intermittent symptoms. Lifestyle: head of bed elevation, weight loss, avoid meals 3 hours before bedtime,
smoking cessation.
Peptic Ulcer Disease (PUD) – etiology and symptoms
Correct Answer: Burning epigastric pain relieved by food or antacids (duodenal ulcer) or worsened
by food (gastric ulcer). Causes: H. pylori infection (most common), NSAIDs (risk factor).
1. H. pylori testing: urea breath test, stool antigen, or endoscopic biopsy. Treatment: PPI + clarithromycin
+ amoxicillin (or metronidazole) for 14 days.
2. NSAID-induced ulcers: stop NSAID, PPI for 4-8 weeks. If NSAID must continue, add PPI or
misoprostol.
Gastroenteritis – causes and treatment
Correct Answer: Irritation and inflammation of stomach and intestines. Symptoms: watery diarrhea,
nausea, vomiting, abdominal pain. Causes: viruses (norovirus most common), bacteria (Salmonella,
Campylobacter, Shigella, E. coli), parasites (Giardia).
1. Treatment: supportive (oral rehydration, electrolyte replacement). Antibiotics for bacterial (azithromycin
or ciprofloxacin for traveler's diarrhea, but avoid if afebrile/not bloody). Antimotility agents (loperamide) if
no fever/dysentery.
2. Giardiasis: foul-smelling greasy diarrhea, flatulence. Metronidazole, tinidazole, or nitazoxanide.
Salmonellosis: usually self-limited, antibiotics if severe or immunocompromised (ciprofloxacin,
azithromycin).
Appendicitis – signs and treatment
Correct Answer: Inflammation of the appendix causing abdominal pain. Pathophysiology: fecalith
(fecal stone) obstructs appendix. Signs: Rovsing, obturator (pain in RLQ when rotating right leg
internally), psoas sign. Treatment: surgery (appendectomy) with antimicrobial therapy.
1. Pain migrates from periumbilical to RLQ (McBurney point) over 12-24 hours. Anorexia, nausea,
vomiting, low-grade fever. WBC elevated.
2. Imaging: CT with contrast (best) or ultrasound (children, pregnancy).
