NURS752 – Advanced Pathophysiology | Final Exam (Exam 3)
Questions with Correct Answers (Guaranteed Pass 2024–2025)
1. Big 3 Category- Top Misdiagnosis: stroke, sepsis, lung cancer
2. #1 cause of malpractice: Misdiagnosis
3. What helps form hypotheses and create your diagnostic reasoning?:
Epidemiology
4. Clinical diagnosis requires: info from pt (subjective) 75%
use that info with ur knowledge of understanding disease + PE is 15%
5. Likelihood Ratios: Weights that help you understand how much a physical
sign argues for or against a diagnosis
Possible weights of 0 to infinity
>1 means increased probability of disease
<1 means decreased probability of disease
6. Specificity: Proportion of patients without the diagnosis who have the physical
sign (e.g., positive finding)
ex: me for celiac disease
,7. Sensitivity: Proportion of patients without the diagnosis who lack the physical
sign (i.e., have a negative result)
8. Likelihood Ratio Definition: probability of finding in pts with disease /
probability of same finding in pts without disease
9. 2 approaches to clinical decision-making Metacognition (thinking about
thinking): Intuitive vs Analytical
10. Experts vs. Novices: experts gather less data, but better data, organize
better = shorter time to make accurate diagnosis
what makes a good clinical diagnostician? asking right questions
11. Article: Diagnostic Excellence and Patient Safety - Strategies and
Opportunities: PC- cancer screening (colonoscopy 10 years, FOBT 2 years =
survival rate up)
ED- sepsis (more deaths than some cancers) good improvements but more
needed
Inpatient- PE (over tested but under diagnosed) better with clinical decision tools
and plasma d-dimer measurement
12. Article: Big 3 diagnostic errors and serious misdiagnoses related
harms are: · 5 vascular events: stroke, MI, venous thromboembolism, aortic
aneurysm/dissection, arterial thromboembolism
· 5 infections: sepsis, meningitis/encephalitis, spinal abscess, pneumonia,
endocarditis
· 5 cancers- lung, breast, colorectal, prostate, melanoma
13. Video: Catherine Lucey- Good clinical diagnosticians:: o Efficiently
obtain enough information from patient to make initial differential diagnosis o
Search memory/resources to identify possible causes of patient's symptoms o
Prioritize the likelihood that a possible disease explains patient's concerns o
Use tests (carefully) to evaluate their assessments have to be careful and know
, and get correct proper information because some tests are harmful, expensive,
wasteful, timely
o Always continue to analyze the success of their diagnoses to improve accuracy
going forward
14. Video: Catherine Lucey- experts:: reorganize their knowledge in a relational
way- S&S to syndromes to disease
15. ACL Article:: common knee injury in athletes clinical diagnostic tests and MRI
are 2 methods of evaluating ACL injuries evidence supports clinical diagnostic
tests, faster, sooner, cheaper too gold standard: diagnostic arthroscopy
16. Screening tests: to detect asymptomatic and early stage disease
should be highly sen/spec to pick up most cases of true disease and avoid false
positives targeted toward pop with higher disease prevalence (high positive
predictive value) safe, cost effective
should screen for diseases in which early identification and treatment have been
demonstrated to improve clinical outcomes
17. HIV: Grade A- ages 15-65
18. Cervical Cancer: Grade A- ages 21-65
21-29 cervical cytology every 3 years
30-65 cervival cytology every 3 years and HIV every 5 years
19. Colorectal Cancer: 45-75
45-49 grade B
50-75 grade A
, 20. HTN: adults 18 and older without known HTN: grade A- office BP
21. Ovarian Cancer: Asymptomatic women- against- grade D
22. High value screening tips: screen less dont screen if living less than 10 yrs
discuss potential downstreams before initial use higher treshold for positive result
understand basic test characteristics and limitations as well as pts goals/values
23. Role of diagnostic testing: to reduce uncertainty regarding a specific patient
diagnosis
generally more appropriate for patients you feel have intermediate 10-90% pre
post prob of disease
test characteristics (ex- likelihood ratios) should be considered before ordering test
to help determine whether given test will significantly alter your post test
probability and change your management
24. Incidence: Measure of the number of new cases of a characteristic that
develop in a population in a specified time
Occurrence of new cases of a disease
25. Prevalence: Proportion of a population who have a specific characteristic in
a given time period or particular point in time regardless of when they first
developed the characteristic
Number of existing cases of a disease
26. Cancer genetics: Cancer is a genetic disease—that is, cancer is caused by
certain changes to genes that control the way our cells function, especially how
they grow and divide
Germline changes are found in every cell of the offspring; only ~10% of cancers
are from germline changes
Questions with Correct Answers (Guaranteed Pass 2024–2025)
1. Big 3 Category- Top Misdiagnosis: stroke, sepsis, lung cancer
2. #1 cause of malpractice: Misdiagnosis
3. What helps form hypotheses and create your diagnostic reasoning?:
Epidemiology
4. Clinical diagnosis requires: info from pt (subjective) 75%
use that info with ur knowledge of understanding disease + PE is 15%
5. Likelihood Ratios: Weights that help you understand how much a physical
sign argues for or against a diagnosis
Possible weights of 0 to infinity
>1 means increased probability of disease
<1 means decreased probability of disease
6. Specificity: Proportion of patients without the diagnosis who have the physical
sign (e.g., positive finding)
ex: me for celiac disease
,7. Sensitivity: Proportion of patients without the diagnosis who lack the physical
sign (i.e., have a negative result)
8. Likelihood Ratio Definition: probability of finding in pts with disease /
probability of same finding in pts without disease
9. 2 approaches to clinical decision-making Metacognition (thinking about
thinking): Intuitive vs Analytical
10. Experts vs. Novices: experts gather less data, but better data, organize
better = shorter time to make accurate diagnosis
what makes a good clinical diagnostician? asking right questions
11. Article: Diagnostic Excellence and Patient Safety - Strategies and
Opportunities: PC- cancer screening (colonoscopy 10 years, FOBT 2 years =
survival rate up)
ED- sepsis (more deaths than some cancers) good improvements but more
needed
Inpatient- PE (over tested but under diagnosed) better with clinical decision tools
and plasma d-dimer measurement
12. Article: Big 3 diagnostic errors and serious misdiagnoses related
harms are: · 5 vascular events: stroke, MI, venous thromboembolism, aortic
aneurysm/dissection, arterial thromboembolism
· 5 infections: sepsis, meningitis/encephalitis, spinal abscess, pneumonia,
endocarditis
· 5 cancers- lung, breast, colorectal, prostate, melanoma
13. Video: Catherine Lucey- Good clinical diagnosticians:: o Efficiently
obtain enough information from patient to make initial differential diagnosis o
Search memory/resources to identify possible causes of patient's symptoms o
Prioritize the likelihood that a possible disease explains patient's concerns o
Use tests (carefully) to evaluate their assessments have to be careful and know
, and get correct proper information because some tests are harmful, expensive,
wasteful, timely
o Always continue to analyze the success of their diagnoses to improve accuracy
going forward
14. Video: Catherine Lucey- experts:: reorganize their knowledge in a relational
way- S&S to syndromes to disease
15. ACL Article:: common knee injury in athletes clinical diagnostic tests and MRI
are 2 methods of evaluating ACL injuries evidence supports clinical diagnostic
tests, faster, sooner, cheaper too gold standard: diagnostic arthroscopy
16. Screening tests: to detect asymptomatic and early stage disease
should be highly sen/spec to pick up most cases of true disease and avoid false
positives targeted toward pop with higher disease prevalence (high positive
predictive value) safe, cost effective
should screen for diseases in which early identification and treatment have been
demonstrated to improve clinical outcomes
17. HIV: Grade A- ages 15-65
18. Cervical Cancer: Grade A- ages 21-65
21-29 cervical cytology every 3 years
30-65 cervival cytology every 3 years and HIV every 5 years
19. Colorectal Cancer: 45-75
45-49 grade B
50-75 grade A
, 20. HTN: adults 18 and older without known HTN: grade A- office BP
21. Ovarian Cancer: Asymptomatic women- against- grade D
22. High value screening tips: screen less dont screen if living less than 10 yrs
discuss potential downstreams before initial use higher treshold for positive result
understand basic test characteristics and limitations as well as pts goals/values
23. Role of diagnostic testing: to reduce uncertainty regarding a specific patient
diagnosis
generally more appropriate for patients you feel have intermediate 10-90% pre
post prob of disease
test characteristics (ex- likelihood ratios) should be considered before ordering test
to help determine whether given test will significantly alter your post test
probability and change your management
24. Incidence: Measure of the number of new cases of a characteristic that
develop in a population in a specified time
Occurrence of new cases of a disease
25. Prevalence: Proportion of a population who have a specific characteristic in
a given time period or particular point in time regardless of when they first
developed the characteristic
Number of existing cases of a disease
26. Cancer genetics: Cancer is a genetic disease—that is, cancer is caused by
certain changes to genes that control the way our cells function, especially how
they grow and divide
Germline changes are found in every cell of the offspring; only ~10% of cancers
are from germline changes
