Formulating a Diagnosis Flashcards
7 cards from real Physician Assistant practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Formulating a Diagnosis flashcards as text
A PA is evaluating a 30-year-old woman with episodic hypertension, headaches, palpitations, and diaphoresis. Which secondary cause of hypertension should be included on the differential?
Answer: Pheochromocytoma
The triad of episodic hypertension, headache, and diaphoresis with palpitations is classic for pheochromocytoma, a catecholamine-secreting adrenal tumor.
Which finding most strongly supports a diagnosis of acute appendicitis in a 25-year-old man with right lower quadrant pain?
Answer: Migration of pain from periumbilical region to the RLQ with rebound tenderness and fever
Pain migration from periumbilical to RLQ (McBurney's point), rebound tenderness, and fever represent the classic progression of acute appendicitis.
In a patient with polyarthritis, which additional finding shifts the differential strongly toward systemic lupus erythematosus (SLE)?
Answer: Malar rash, photosensitivity, and oral ulcers
Malar rash, photosensitivity, and oral ulcers alongside polyarthritis fulfill multiple ACR/EULAR SLE classification criteria, making SLE the leading diagnosis.
A PA evaluates two patients with identical presentations but very different pre-test probabilities for pulmonary embolism. How does pre-test probability affect diagnostic reasoning?
Answer: A positive test result is more meaningful in a high-probability patient, raising post-test probability substantially
Pre-test probability directly influences post-test probability through Bayes' theorem; the same positive test result carries more weight when disease is more likely before testing.
A 58-year-old man with diabetes presents with a painless foot ulcer. His history of peripheral neuropathy is known. Which complication should be highest on the differential?
Answer: Diabetic neuropathic ulcer with possible underlying osteomyelitis
Painless foot ulcers in diabetics with neuropathy are hallmarks of diabetic neuropathic ulcers, and osteomyelitis must be excluded given its high prevalence in this context.
When formulating a diagnosis, which approach best reduces diagnostic error from the framing effect?
Answer: Deliberately reframe the case from multiple perspectives to challenge the initial impression
Reframing the case from different angles counteracts the framing effect by preventing the initial presentation of information from anchoring the diagnostic conclusion.
A 22-year-old male athlete presents with sharp chest pain that worsens on inspiration and a friction rub on auscultation one week after a viral upper respiratory infection. Which diagnosis is most consistent?
Answer: Acute pericarditis
Post-viral pleuritic chest pain with a pericardial friction rub is the classic presentation of acute pericarditis, often caused by viral inflammation of the pericardium.