NR511 | NR511 Differential Diagnosis & Primary
Care Midterm v2 | Questions with Correct Answers
and Expert Explanation for Each Question |
Chamberlain
1. Which component of the SOAP note includes the patient’s age, sex, and chief complaint?
A. Objective
B. Subjective
C. Assessment
D. Plan
Correct Answer: B
Expert Explanation: The Subjective section contains the information provided by the
patient or their representative. This includes the identifying data, the chief complaint, and
the history of present illness. It captures the patient’s personal perspective of their
symptoms and medical history.
2. When evaluating a diagnostic test, ‘sensitivity’ is defined as:
A. The ability of a test to correctly identify those without the disease
B. The ability of a test to correctly identify those with the disease
C. The proportion of patients with positive tests who actually have the disease
D. The proportion of patients with negative tests who are disease-free
Correct Answer: B
Expert Explanation: Sensitivity refers to the true positive rate of a diagnostic tool. It
measures how well a test detects the presence of a condition among people who actually
have it. High sensitivity is crucial for screening tests to ensure fewer cases are missed.
3. A 65-year-old patient presents with a pearly, waxy skin lesion with telangiectasia on his
nose. What is the most likely diagnosis?
A. Squamous Cell Carcinoma
B. Basal Cell Carcinoma
C. Malignant Melanoma
D. Actinic Keratosis
Correct Answer: B
,Expert Explanation: Basal Cell Carcinoma is the most common type of skin cancer and
often presents as a pearly or waxy papule. Telangiectasias, or visible small blood vessels,
are a hallmark feature of this lesion. It typically grows slowly and rarely metastasizes but
can be locally invasive.
4. According to the USPSTF guidelines, at what age should average-risk screening for
colorectal cancer begin?
A. 40
B. 50
C. 45
D. 55
Correct Answer: C
Expert Explanation: The USPSTF updated its guidelines to recommend that colorectal
cancer screening begin at age 45 for all average-risk adults. This change was implemented
to address the increasing incidence of colorectal cancer in younger populations. Screening
can include stool-based tests or visual examinations like colonoscopy.
5. Which of the following physical exam findings is most characteristic of Otitis Media with
Effusion (OME)?
A. Fluid bubbles or air-fluid levels behind the tympanic membrane
B. Bulging, erythematous tympanic membrane
C. Tenderness when pulling on the pinna
D. Purulent drainage in the external canal
Correct Answer: A
Expert Explanation: Otitis Media with Effusion is characterized by the presence of fluid in
the middle ear without signs of acute infection. Visible air-fluid levels or bubbles are classic
indicators of this condition. Unlike acute otitis media, OME typically does not involve fever
or severe ear pain.
6. A patient presents with ‘honey-colored crusts’ on an erythematous base near the mouth.
What is the preferred topical treatment?
A. Ketoconazole cream
B. Hydrocortisone ointment
C. Mupirocin (Bactroban)
D. Permethrin cream
Correct Answer: C
, Expert Explanation: Honey-colored crusting is the pathognomonic sign for non-bullous
impetigo. This bacterial infection is typically caused by Staphylococcus aureus or
Streptococcus pyogenes. Mupirocin is the first-line topical antibiotic treatment for localized
impetigo.
7. What is the first-line antibiotic treatment for an adult with bacterial rhinosinusitis and no
drug allergies?
A. Azithromycin
B. Ciprofloxacin
C. Amoxicillin-Clavulanate (Augmentin)
D. Doxycycline
Correct Answer: C
Expert Explanation: Amoxicillin-clavulanate is the recommended first-line agent for acute
bacterial rhinosinusitis according to current guidelines. It provides coverage against the
most common pathogens, including Streptococcus pneumoniae and Haemophilus
influenzae. Doxycycline is often reserved as an alternative for patients with penicillin
allergies.
8. The Centor criteria are used to evaluate the likelihood of infection by which pathogen?
A. Group A Beta-Hemolytic Streptococcus
B. Influenza A
C. Epstein-Barr Virus
D. Mycoplasma pneumoniae
Correct Answer: A
Expert Explanation: The Centor criteria assess four factors: fever, absence of cough,
tonsillar exudates, and anterior cervical lymphadenopathy. A higher score increases the
probability of Group A Strep pharyngitis. This clinical decision rule helps clinicians decide
whether to perform a rapid strep test or initiate antibiotics.
9. Which physical exam maneuver is used to assess for a torn meniscus in the knee?
A. McMurray test
B. Lachman test
C. Ankle-Brachial Index
D. Phalen’s maneuver
Correct Answer: A
Care Midterm v2 | Questions with Correct Answers
and Expert Explanation for Each Question |
Chamberlain
1. Which component of the SOAP note includes the patient’s age, sex, and chief complaint?
A. Objective
B. Subjective
C. Assessment
D. Plan
Correct Answer: B
Expert Explanation: The Subjective section contains the information provided by the
patient or their representative. This includes the identifying data, the chief complaint, and
the history of present illness. It captures the patient’s personal perspective of their
symptoms and medical history.
2. When evaluating a diagnostic test, ‘sensitivity’ is defined as:
A. The ability of a test to correctly identify those without the disease
B. The ability of a test to correctly identify those with the disease
C. The proportion of patients with positive tests who actually have the disease
D. The proportion of patients with negative tests who are disease-free
Correct Answer: B
Expert Explanation: Sensitivity refers to the true positive rate of a diagnostic tool. It
measures how well a test detects the presence of a condition among people who actually
have it. High sensitivity is crucial for screening tests to ensure fewer cases are missed.
3. A 65-year-old patient presents with a pearly, waxy skin lesion with telangiectasia on his
nose. What is the most likely diagnosis?
A. Squamous Cell Carcinoma
B. Basal Cell Carcinoma
C. Malignant Melanoma
D. Actinic Keratosis
Correct Answer: B
,Expert Explanation: Basal Cell Carcinoma is the most common type of skin cancer and
often presents as a pearly or waxy papule. Telangiectasias, or visible small blood vessels,
are a hallmark feature of this lesion. It typically grows slowly and rarely metastasizes but
can be locally invasive.
4. According to the USPSTF guidelines, at what age should average-risk screening for
colorectal cancer begin?
A. 40
B. 50
C. 45
D. 55
Correct Answer: C
Expert Explanation: The USPSTF updated its guidelines to recommend that colorectal
cancer screening begin at age 45 for all average-risk adults. This change was implemented
to address the increasing incidence of colorectal cancer in younger populations. Screening
can include stool-based tests or visual examinations like colonoscopy.
5. Which of the following physical exam findings is most characteristic of Otitis Media with
Effusion (OME)?
A. Fluid bubbles or air-fluid levels behind the tympanic membrane
B. Bulging, erythematous tympanic membrane
C. Tenderness when pulling on the pinna
D. Purulent drainage in the external canal
Correct Answer: A
Expert Explanation: Otitis Media with Effusion is characterized by the presence of fluid in
the middle ear without signs of acute infection. Visible air-fluid levels or bubbles are classic
indicators of this condition. Unlike acute otitis media, OME typically does not involve fever
or severe ear pain.
6. A patient presents with ‘honey-colored crusts’ on an erythematous base near the mouth.
What is the preferred topical treatment?
A. Ketoconazole cream
B. Hydrocortisone ointment
C. Mupirocin (Bactroban)
D. Permethrin cream
Correct Answer: C
, Expert Explanation: Honey-colored crusting is the pathognomonic sign for non-bullous
impetigo. This bacterial infection is typically caused by Staphylococcus aureus or
Streptococcus pyogenes. Mupirocin is the first-line topical antibiotic treatment for localized
impetigo.
7. What is the first-line antibiotic treatment for an adult with bacterial rhinosinusitis and no
drug allergies?
A. Azithromycin
B. Ciprofloxacin
C. Amoxicillin-Clavulanate (Augmentin)
D. Doxycycline
Correct Answer: C
Expert Explanation: Amoxicillin-clavulanate is the recommended first-line agent for acute
bacterial rhinosinusitis according to current guidelines. It provides coverage against the
most common pathogens, including Streptococcus pneumoniae and Haemophilus
influenzae. Doxycycline is often reserved as an alternative for patients with penicillin
allergies.
8. The Centor criteria are used to evaluate the likelihood of infection by which pathogen?
A. Group A Beta-Hemolytic Streptococcus
B. Influenza A
C. Epstein-Barr Virus
D. Mycoplasma pneumoniae
Correct Answer: A
Expert Explanation: The Centor criteria assess four factors: fever, absence of cough,
tonsillar exudates, and anterior cervical lymphadenopathy. A higher score increases the
probability of Group A Strep pharyngitis. This clinical decision rule helps clinicians decide
whether to perform a rapid strep test or initiate antibiotics.
9. Which physical exam maneuver is used to assess for a torn meniscus in the knee?
A. McMurray test
B. Lachman test
C. Ankle-Brachial Index
D. Phalen’s maneuver
Correct Answer: A
