APEA Differential Diagnosis Questions and Answers Flashcards

A 68-year-old presents with sudden painless monocular vision loss described as a 'curtain coming down.' The priority diagnosis is:

Answer: Retinal detachment

A curtain or shadow descending over vision is the pathognomonic description of retinal detachment requiring emergency ophthalmology referral.

A patient presents with burning epigastric pain relieved by eating, nocturnal awakening with pain, and melena. The most likely diagnosis is:

Answer: Duodenal ulcer

Duodenal ulcers classically cause pain relieved by eating (food buffers acid), with nocturnal pain and possible GI bleeding manifesting as melena.

A 25-year-old woman presents with dysmenorrhea, dyspareunia, and infertility. Which diagnosis should be investigated?

Answer: Endometriosis

The triad of dysmenorrhea, dyspareunia, and infertility in a reproductive-age woman is highly characteristic of endometriosis.

A patient with known atrial fibrillation suddenly develops right arm weakness and expressive aphasia. The NP recognizes this as:

Answer: Cardioembolic stroke

Atrial fibrillation is the most common cardiac source of emboli; sudden focal neurologic deficits in an AF patient indicate cardioembolic stroke until proven otherwise.

An 18-year-old presents with pharyngitis, cervical lymphadenopathy, and splenomegaly. The most likely diagnosis is:

Answer: Infectious mononucleosis

The triad of pharyngitis, posterior cervical lymphadenopathy, and splenomegaly in a young adult is classic for EBV-mediated infectious mononucleosis.

A 72-year-old man with known BPH presents with inability to void, severe lower abdominal pain, and a palpable suprapubic mass. The diagnosis is:

Answer: Acute urinary retention

Acute urinary retention presents with sudden inability to void, suprapubic pain, and a distended palpable bladder, commonly precipitated by BPH in older men.