APEA Differential Diagnosis Questions and Answers Flashcards

A patient presents with a 'herald patch' followed by a Christmas tree distribution of oval scaly lesions on the trunk. The diagnosis is:

Answer: Pityriasis rosea

Pityriasis rosea characteristically begins with a herald patch followed by a Christmas tree pattern of oval lesions along Langer's lines on the trunk.

A 45-year-old obese woman presents with right upper quadrant pain, fever, and jaundice. The NP's priority diagnosis is:

Answer: Acute cholangitis

Charcot's triad of RUQ pain, fever, and jaundice indicates acute cholangitis, a biliary emergency requiring urgent decompression.

A toddler presents with high fever for 3-5 days that suddenly resolves, followed by a maculopapular rash spreading from trunk to extremities. The most likely diagnosis is:

Answer: Roseola infantum

Roseola (HHV-6) classically presents with 3-5 days of high fever that abruptly defervesces, followed by a rose-colored truncal rash spreading outward.

A 60-year-old presents with progressive dysphagia starting with solids then progressing to liquids, weight loss, and odynophagia. The most concerning diagnosis is:

Answer: Esophageal cancer

Progressive dysphagia from solids to liquids with constitutional symptoms like weight loss is a classic alarm feature for esophageal malignancy requiring urgent investigation.

A patient presents with acute onset severe headache described as 'the worst headache of my life.' The NP's priority differential is:

Answer: Subarachnoid hemorrhage

A 'thunderclap headache' reaching maximum intensity instantly is the hallmark of subarachnoid hemorrhage until proven otherwise, requiring emergency CT imaging.

A 28-year-old woman has a positive urine pregnancy test, vaginal bleeding, and unilateral pelvic pain. The NP's first concern is:

Answer: Ectopic pregnancy

Positive pregnancy test with unilateral pain and vaginal bleeding constitutes an ectopic pregnancy until proven otherwise, as rupture can cause life-threatening hemorrhage.