Physician Assistant Formulating a Diagnosis 4

Question 1

A PA is evaluating a 72-year-old with confusion, fever, and costovertebral angle tenderness. Which diagnosis best explains this triad?

Accepted Answer

Urosepsis

Answer

Confusion with fever and CVA tenderness in an elderly patient points to urosepsis—a urinary source of infection causing systemic inflammatory response.

Question 2

Which pattern of joint involvement is most consistent with a diagnosis of rheumatoid arthritis?

Accepted Answer

Symmetric small joint polyarthritis affecting MCPs and PIPs with morning stiffness

Answer

Rheumatoid arthritis classically presents with symmetric polyarthritis of the MCPs and PIPs accompanied by prolonged morning stiffness.

Question 3

A PA applies the principle of parsimony (Occam's Razor) in formulating a diagnosis. What does this principle suggest?

Accepted Answer

One unifying diagnosis should explain all of the patient's findings when possible

Answer

Occam's Razor in clinical reasoning favors a single unifying diagnosis over multiple separate diagnoses when the clinical evidence supports it.

Question 4

A 45-year-old woman with a history of migraines presents with a new-onset headache that is different from her usual migraines. What is the most important next step in diagnostic reasoning?

Accepted Answer

Treat this headache as a new diagnostic problem and evaluate for secondary causes

Answer

A change in headache pattern in a known migraineur requires treating the presentation as a new diagnostic problem to exclude secondary causes such as intracranial pathology.

Question 5

Which feature distinguishes cardiac syncope from vasovagal syncope during diagnostic formulation?

Accepted Answer

Syncope occurring without prodrome during exertion or at rest

Answer

Syncope without prodrome during exertion or at rest suggests an arrhythmic or structural cardiac cause and requires urgent cardiac evaluation.

Physician Assistant Practice Test

Physician Assistant Practice Test

Physician Assistant Formulating a Diagnosis 4