FREE Physician Assistant Formulating a Diagnosis Questions and Answers

Question 1

A 4-year-old child is brought to the clinic with a 5-day history of pronounced facial puffiness, especially around the eyes in the morning, and swelling in the legs.
The parents also report recent weight gain.
Urinalysis reveals 4+ proteinuria, but is negative for blood and white blood cells.
Which of the following is the most likely diagnosis?

Accepted Answer

Minimal change disease

Answer

Post-streptococcal glomerulonephritis

Answer

IgA nephropathy

Answer

Urinary tract infection

Question 2

A 68-year-old female with type 2 diabetes presents to the emergency department with altered mental status. Her family reports a week of increasing polyuria, polydipsia, and lethargy. Laboratory results show a blood glucose of 850 mg/dL, serum bicarbonate of 20 mEq/L, arterial pH of 7.35, and minimal urine ketones. Serum osmolality is calculated to be 345 mOsm/kg. Which of the following is the most likely diagnosis?

Accepted Answer

Hyperosmolar hyperglycemic state (HHS)

Answer

Diabetic ketoacidosis (DKA)

Answer

Severe hypoglycemia

Answer

Lactic acidosis

Question 3

A 72-year-old female presents with a six-week history of severe, symmetrical aching and morning stiffness in her shoulders, neck, and hips. The stiffness lasts for over an hour and makes it difficult for her to get out of bed or comb her hair. She reports fatigue but denies new headaches or vision changes. Laboratory studies show an erythrocyte sedimentation rate (ESR) of 85 mm/hr. Which of the following is the most likely diagnosis?

Accepted Answer

Polymyalgia rheumatica

Answer

Rheumatoid arthritis

Answer

Osteoarthritis

Answer

Fibromyalgia

Question 4

A 38-year-old male presents to his primary care provider after being bitten by a tick while hiking in New England two weeks ago. He now complains of fever, fatigue, and myalgias. On examination, a large, annular, erythematous rash approximately 15 cm in diameter with central clearing is noted on his thigh. Which of the following is the most appropriate term for this rash?

Accepted Answer

Erythema migrans

Answer

Urticaria

Answer

Nummular eczema

Answer

Tinea corporis

Question 5

A 45-year-old industrial painter presents with complaints of fatigue, irritability, and diffuse abdominal pain. A complete blood count reveals a microcytic, hypochromic anemia. Which of the following findings on a peripheral blood smear would be most suggestive of lead poisoning as the underlying cause?

Accepted Answer

Basophilic stippling

Answer

Howell-Jolly bodies

Answer

Schistocytes

Answer

Hypersegmented neutrophils

Question 6

A 34-year-old male complains of recurrent episodes of excruciating, unilateral pain behind his right eye, which he describes as a 'hot poker' sensation. The attacks last for 60-90 minutes and occur several times a day for weeks at a time. During these episodes, he also experiences right-sided nasal congestion and tearing from his right eye. Which of the following is the most likely diagnosis?

Accepted Answer

Cluster headache

Answer

Migraine with aura

Answer

Tension-type headache

Answer

Trigeminal neuralgia