NR 511 Differential Diagnosis and Primary Care- Mid Term Review
Study online at https://quizlet.com/_dlnf7b
1. what is the sensitivity of the Prostate Specific Antigen (PSA) for detecting
prostate cancer?: # men with prostate cancer
# men with positive PSA
160
# men with negative PSA
40
total
200
The correct answer is 160/200. Sensitivity is the proportion of patients with the
disease that have a positive result; it is the number of true positives divided by the
total number of patients who have the disease.
2. A diagnostic test is used in a sample of 1000 patients. 500 of these patients
have the disease, while 500 do not. Of those 500 patients without the disease,
30 test positive, and 470 test negative. What is the specificity of the test?: The
correct answer is 470/500.
Specificity is the proportion of patients who test negative out of the total number
of patients who do not have the disease; it is the number of true negatives overall
negatives. In this example, 500/1000 patients have the disease. Of those 500
patients without the disease, 30 test positive, and 470 test negative.
3. The Positive Predictive Value (PPV) of a test refers to which of the follow-
ing?: the proportion of patients with a positive test who have the disease.
4. Which of the following depends on the prevalence of the disease?: positive
predictive value.
Predictive values depend on the prevalence of disease in the population whereas
sensitivity and specificity are intrinsic properties of the test. Reliability refers to the
consistency or stability of a measure.
5. A low pretest probability of disease may lead to which of the following?: low
positive predictive value and more false-positive results.
Positive predictive value increases with prevalence; therefore, a low prevalence
value yields a low positive predictive value and implies a high false-positive rate.
Negative predictive value decreases with prevalence, and sensitivity and specificity
do not vary with prevalence.
, NR 511 Differential Diagnosis and Primary Care- Mid Term Review
Study online at https://quizlet.com/_dlnf7b
6. If you strongly suspect that a patient is positive for a specific condition but
tests negative, the negative result may be:: false-negative test results due to a
low negative predictive value.
At the individual level, your clinical suspicion is equivalent to pre-test probability
and high prevalence at the population level. Negative predictive value is inversely
correlated with prevalence; therefore, your clinical suspicion translates to a low
negative predictive value, suggesting a false-negative test result.
7. Which test(s) provide data relevant to the chief complaint: Fever: CBC
Check CBC with differential for neutrophil shift in suspected infection
8. Which test(s) provide data relevant to the chief complaint: Unexplained
bruising: CBC
Check platelet count
9. Which test(s) provide data relevant to the chief complaint: Fatigue: Both CBC
and CMP
Check RBC, Hgb and Hct for anemia, CMP for potential liver or kidney abnormalities
10. Which test(s) provide data relevant to the chief complaint: Cardiac dys-
rhythmias: CMP
Monitor electrolytes for abnormalities
11. Which test(s) provide data relevant to the chief complaint: Unexplained
weight loss: Both CBC and CMP
Check WBC for inflammation or possible cancer, CMP for glucose, liver or kidney
abnormalities
12. Which test(s) provide data relevant to the chief complaint: Edema: CMP
Check for kidney function
13. What is SNAPPS?: Summarize the history and findings
Narrow the differential diagnosis to two or three possibilities
Analyze the differential by comparing and contrasting the possibilities
Probe the preceptor by asking questions about alternative approaches or uncertain-
ties
Plan the management of the client's health issues
Select an issue from the case for self-directed learning
, NR 511 Differential Diagnosis and Primary Care- Mid Term Review
Study online at https://quizlet.com/_dlnf7b
14. a 13 year old presents to the clinic complaining of severe left side sore
throat and pain with swallowing for 1
day. upon exam, the patient appears uncomfortable and febrile. Cervical
adenopathy is present on left side,
difficulty opening and closing mouth. What should you do?: Refer to the ER
15. a 37 year old female presents for her annual visit. She mentions that her
13 year old daughter has had to
recent infestions of lice. She asks what she can do to prevent this?: After 2
days of no head lice, her bedding is lice free
16. Which of the following is the appropriate treatment for giardia: quin.hydr.
17. Your client, a 72-year-old smoker of 50 years, is at the office today for a
routine physical. During your inspection of the oral mucosa, you discover
a white lesion on the lateral surface of the tongue that you suspect to be
cancerous. You document your finding as:: A white, painless, firm, ulcerated
lesion with indurated borders
18. Maryann, age 28, presents to the clinic because of a rapid onset of patchy
hair loss. The skin within these oval patches of hair loss is very smooth. Ta-
pered hairs that resemble exclamation points are seen at the margin of a patch
of hair loss. Based on these findings, you suspect Maryann has:: Alopecia
areata The findings are consistent with alopecia areata, ie, nonscarring hair loss
of rapid onset,
the pattern of which is most commonly sharply defined round or oval patches.
19. Which of the following is not a complication of group a strep
hemolytic anemia
glomerular nephritis:
20. Which of the following is an example of conductive hearing loss?: Serous
OM
21. Medical coding is the process of submitting and following up on claims
made to the payer in order: Coding is done in order to process demographic,
insurance, ... number as shown on insured's ID card for the payer to whom the claim
is being submitted.
22. Tom, age 50, is complaining of an itchy rash that occurred about a half hour
after putting on his leather jacket. He recalls having a slightly similar rash
last year when he wore his jacket. The annular lesions are on his neck and
both arms. They are erythematous, sharply circumscribed, and both flat and
elevated. His voice seems a little raspy, although he states that his breathing
is normal. What is your first action?: Determine the need for 0.5 mL 1:1000
epinephrine subcutaneously.
Study online at https://quizlet.com/_dlnf7b
1. what is the sensitivity of the Prostate Specific Antigen (PSA) for detecting
prostate cancer?: # men with prostate cancer
# men with positive PSA
160
# men with negative PSA
40
total
200
The correct answer is 160/200. Sensitivity is the proportion of patients with the
disease that have a positive result; it is the number of true positives divided by the
total number of patients who have the disease.
2. A diagnostic test is used in a sample of 1000 patients. 500 of these patients
have the disease, while 500 do not. Of those 500 patients without the disease,
30 test positive, and 470 test negative. What is the specificity of the test?: The
correct answer is 470/500.
Specificity is the proportion of patients who test negative out of the total number
of patients who do not have the disease; it is the number of true negatives overall
negatives. In this example, 500/1000 patients have the disease. Of those 500
patients without the disease, 30 test positive, and 470 test negative.
3. The Positive Predictive Value (PPV) of a test refers to which of the follow-
ing?: the proportion of patients with a positive test who have the disease.
4. Which of the following depends on the prevalence of the disease?: positive
predictive value.
Predictive values depend on the prevalence of disease in the population whereas
sensitivity and specificity are intrinsic properties of the test. Reliability refers to the
consistency or stability of a measure.
5. A low pretest probability of disease may lead to which of the following?: low
positive predictive value and more false-positive results.
Positive predictive value increases with prevalence; therefore, a low prevalence
value yields a low positive predictive value and implies a high false-positive rate.
Negative predictive value decreases with prevalence, and sensitivity and specificity
do not vary with prevalence.
, NR 511 Differential Diagnosis and Primary Care- Mid Term Review
Study online at https://quizlet.com/_dlnf7b
6. If you strongly suspect that a patient is positive for a specific condition but
tests negative, the negative result may be:: false-negative test results due to a
low negative predictive value.
At the individual level, your clinical suspicion is equivalent to pre-test probability
and high prevalence at the population level. Negative predictive value is inversely
correlated with prevalence; therefore, your clinical suspicion translates to a low
negative predictive value, suggesting a false-negative test result.
7. Which test(s) provide data relevant to the chief complaint: Fever: CBC
Check CBC with differential for neutrophil shift in suspected infection
8. Which test(s) provide data relevant to the chief complaint: Unexplained
bruising: CBC
Check platelet count
9. Which test(s) provide data relevant to the chief complaint: Fatigue: Both CBC
and CMP
Check RBC, Hgb and Hct for anemia, CMP for potential liver or kidney abnormalities
10. Which test(s) provide data relevant to the chief complaint: Cardiac dys-
rhythmias: CMP
Monitor electrolytes for abnormalities
11. Which test(s) provide data relevant to the chief complaint: Unexplained
weight loss: Both CBC and CMP
Check WBC for inflammation or possible cancer, CMP for glucose, liver or kidney
abnormalities
12. Which test(s) provide data relevant to the chief complaint: Edema: CMP
Check for kidney function
13. What is SNAPPS?: Summarize the history and findings
Narrow the differential diagnosis to two or three possibilities
Analyze the differential by comparing and contrasting the possibilities
Probe the preceptor by asking questions about alternative approaches or uncertain-
ties
Plan the management of the client's health issues
Select an issue from the case for self-directed learning
, NR 511 Differential Diagnosis and Primary Care- Mid Term Review
Study online at https://quizlet.com/_dlnf7b
14. a 13 year old presents to the clinic complaining of severe left side sore
throat and pain with swallowing for 1
day. upon exam, the patient appears uncomfortable and febrile. Cervical
adenopathy is present on left side,
difficulty opening and closing mouth. What should you do?: Refer to the ER
15. a 37 year old female presents for her annual visit. She mentions that her
13 year old daughter has had to
recent infestions of lice. She asks what she can do to prevent this?: After 2
days of no head lice, her bedding is lice free
16. Which of the following is the appropriate treatment for giardia: quin.hydr.
17. Your client, a 72-year-old smoker of 50 years, is at the office today for a
routine physical. During your inspection of the oral mucosa, you discover
a white lesion on the lateral surface of the tongue that you suspect to be
cancerous. You document your finding as:: A white, painless, firm, ulcerated
lesion with indurated borders
18. Maryann, age 28, presents to the clinic because of a rapid onset of patchy
hair loss. The skin within these oval patches of hair loss is very smooth. Ta-
pered hairs that resemble exclamation points are seen at the margin of a patch
of hair loss. Based on these findings, you suspect Maryann has:: Alopecia
areata The findings are consistent with alopecia areata, ie, nonscarring hair loss
of rapid onset,
the pattern of which is most commonly sharply defined round or oval patches.
19. Which of the following is not a complication of group a strep
hemolytic anemia
glomerular nephritis:
20. Which of the following is an example of conductive hearing loss?: Serous
OM
21. Medical coding is the process of submitting and following up on claims
made to the payer in order: Coding is done in order to process demographic,
insurance, ... number as shown on insured's ID card for the payer to whom the claim
is being submitted.
22. Tom, age 50, is complaining of an itchy rash that occurred about a half hour
after putting on his leather jacket. He recalls having a slightly similar rash
last year when he wore his jacket. The annular lesions are on his neck and
both arms. They are erythematous, sharply circumscribed, and both flat and
elevated. His voice seems a little raspy, although he states that his breathing
is normal. What is your first action?: Determine the need for 0.5 mL 1:1000
epinephrine subcutaneously.
