Question 1

Doorway information about patient The patient is a 20-year-old woman who comes to the office due to burning during urination. Vital signs Temperature: 38.3 C (100.9 F) Blood pressure: 110/80 mm Hg Pulse: 82/min Respirations: 16/min Basic differential diagnosis Cystitis Pyelonephritis Urethritis Vulvovaginitis Pelvic inflammatory disease

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The answer of Doorway information about patient The patient is a...

Question 2

Doorway information about patient The patient is a 30-year-old man who comes to the office to refill medications for HIV. Vital signs Temperature: 37.1 C (98.8 F) Blood pressure: 120/75 mm Hg Pulse: 78/min Respirations: 16/min Basic differential diagnosis HIV

Accepted Answer

The answer of Doorway information about patient The patient is a...

Question 3

Doorway information about patient The patient is a 53-year-old man who comes to the emergency department due to right knee pain and swelling. Vital signs Temperature: 38.3 C (101 F) Blood pressure: 130/60 mm Hg Pulse: 80/min Respirations: 18/min Basic differential diagnosis Osteoarthritis Septic arthritis and bursitis Pseudogout and gout Reactive arthritis Traumatic knee injury Lyme disease Monoarticular rheumatoid arthritis Psoriatic arthritis

Accepted Answer

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Question 4

Doorway information about patient The patient is a 55-year-old man who comes to the emergency department due to chest pain. Vital signs Temperature: 37.1 C (98.7 F) Blood pressure: 130/80 mm Hg Pulse: 78/min Respirations: 20/min Clinical images ECG is shown in the image. Basic differential diagnosis Myocardial infarction Unstable angina Pulmonary embolism Costochondritis Pleuritis Pericarditis Aortic dissection Gastroesophageal reflux Esophageal perforation

Accepted Answer

The answer of Doorway information about patient The patient is a...

Question 5

Doorway information about patient The patient is a 65-year-old woman who comes to the office due to loss of hearing. Vital signs Temperature: 36.7 C (98.1 F) Blood pressure: 130/86 mm Hg Pulse: 80/min Respirations: 16/min Basic differential diagnosis Conductive hearing loss Cerumen impaction Otitis media with effusion Tympanic membrane perforation Otosclerosis Foreign body in ear canal Cholesteatoma Tympanosclerosis Tumor of the ear canal or middle ear Sensorineural hearing loss Presbycusis (age-related hearing loss) Ototoxicity Noise-induced hearing loss Ménière disease Diabetes Acoustic neuroma

Accepted Answer

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Question 6

Doorway information about patient The patient is a 53-year-old man who comes to the emergency department due to epigastric pain. Vital signs Temperature: 36.1 C (97 F) Blood pressure: 120/70 mm Hg Pulse: 84/min Respirations: 16/min Abdominal x-ray is as shown in the exhibit. Basic differential diagnosis Peptic ulcer Gastritis Esophagitis (GERD) Carcinoma of esophagus, stomach, or pancreas Acute or chronic pancreatitis Cholecystitis Hepatitis Acute coronary event

Accepted Answer

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Question 7

Doorway information about patient The patient is a 50-year-old man who comes to the office due to blurred vision. Vital signs Temperature: 36.7 C (98.1 F) Blood pressure: 160/90 mm Hg Pulse: 70/min Respirations: 22/min Basic differential diagnosis Diabetes mellitus Cataract Hypertensive retinopathy Glaucoma Macular degeneration Brain lesions Hyperviscosity syndrome (eg, polycythemia) Illicit drugs Temporal arteritis (usually starts unilaterally) Trauma to or infections of the eye (if unilateral)

Accepted Answer

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Question 8

Doorway information about patient The patient is a 70-year-old man with insomnia. Vital signs Temperature: 36.7 C (98.1 F) Blood pressure: 130/90 mm Hg Pulse: 58/min Respirations: 16/min Basic differential diagnosis Depression Post-traumatic stress disorder Anxiety disorder Chronic pain syndromes Adverse effect of medication Age-related sleep changes Thyroid problems Sleep apnea Restless legs syndrome

Accepted Answer

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Question 9

Doorway information about patient The patient is a 65-year-old man who comes to the office due to difficulty with urination. Vital signs Temperature: 37.2 C (99 F) Blood pressure: 130/80 mm Hg Pulse: 92/min Respirations: 16/min Basic differential diagnosis Benign prostatic hyperplasia Prostatitis UTI/cystitis Carcinoma of the prostate Stone in the urinary tract (obstructive) Carcinoma of the bladder Neurological dysfunction Drug-induced bladder dysfunction

Accepted Answer

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Question 10

Doorway information about patient The patient is a 32-year-old woman who comes to the emergency department due to multiple bruises. Vital signs Temperature: 37.4 C (99.3 F) Blood pressure: 120/80 mm Hg Pulse: 90/min Respirations: 16/min Basic differential diagnosis Accident Physical assault Spousal abuse Bleeding disorders Collagen vascular disorders

Accepted Answer

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Question 11

Doorway information about patient The patient is a 60-year-old man who comes to the emergency department due to lower abdominal pain. Vital signs Temperature: 38.3 C (101 F) Blood pressure: 130/84 mm Hg Pulse: 98/min Respirations: 22/min Basic differential diagnosis Diverticulitis Renal colic Appendicitis Ischemic colitis Infectious colitis Abdominal aortic aneurysm Intestinal obstruction

Accepted Answer

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Question 12

Doorway information about patient The patient is a 35-year-old man who comes to the office due to cough and chest pain. Vital signs Temperature: 38.7 C (101.7 F) Blood pressure: 130/80 mm Hg Pulse: 94/min Respirations: 24/min Basic differential diagnosis Pneumonia Pleuritic pain Pleural effusion Pulmonary edema Tuberculosis Pulmonary embolism Lung cancer Infective endocarditis GERD

Accepted Answer

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Question 13

Doorway information about patient The patient is a 35-year-old man who comes to the office due to fatigue. Vital signs Temperature: 37 C (98.6 F) Blood pressure: 120/80 mm Hg Pulse: 82/min Respirations: 16/min Basic differential diagnosis Depression Anemia Thyroid disorders HIV/AIDS Chronic fatigue syndrome

Accepted Answer

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Question 14

Doorway information about patient The patient is a 16-year-old girl who comes to the office due to amenorrhea. Vital signs Temperature: 36.7 C (98.1 F) Blood pressure: 120/70 mm Hg Pulse: 76/min Respirations: 16/min Basic differential diagnosis Pregnancy Primary amenorrhea Chromosomal disorders Abnormal müllerian development Androgen insensitivity Secondary amenorrhea Eating disorder Hyperprolactinemia Thyroid dysfunction Polycystic ovarian syndrome Functional hypothalamic amenorrhea Postpill amenorrhea Hypothalamic/pituitary mass

Accepted Answer

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Question 15

Doorway information about patient The patient is a 35-year-old woman who comes to the emergency department due to breathlessness and anxiety. Vital signs Temperature: 36.1 C (97 F) Blood pressure: 130/80 mm Hg Pulse: 94/min Respirations: 22/min Basic differential diagnosis Anxiety secondary to medical condition (eg, hyperthyroidism, arrhythmias) Substance abuse Panic disorder Generalized anxiety disorder Adjustment disorder with anxious mood Acute stress disorder or post-traumatic stress disorder Hypochondriasis

Accepted Answer

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Question 16

Doorway information about patient The patient is a 45-year-old man who comes to the emergency department due to vomiting blood. Vital signs Temperature: 36.7 C (98 F) Blood pressure: 100/60 mm Hg Pulse: 90/min Respirations: 18/min Basic differential diagnosis Peptic ulcer Esophageal and gastric varices Mallory-Weiss tear Gastritis Erosive esophagitis Gastric malignancy Vascular ectasia

Accepted Answer

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Question 17

Doorway information about patient The patient is a 50-year-old man who comes to the office due to difficulty swallowing. Vital signs Temperature: 36.7 C (98.1 F) Blood pressure: 130/90 mm Hg Pulse: 85/min Respirations: 16/min Basic differential diagnosis Oropharyngeal dysphagia Neuromuscular (stroke, parkinsonism, multiple sclerosis) Mechanical obstruction (Zenker diverticulum, thyromegaly) Skeletal muscle disorders (myasthenia gravis, muscular dystrophies, polymyositis) Miscellaneous (medications, radiation) Esophageal dysphagia Mechanical obstruction (esophageal carcinoma, benign strictures, webs and rings [Schatzki]) Abnormal motility (achalasia, scleroderma) Gastroesophageal reflux disease Miscellaneous (diabetes, alcoholism)

Accepted Answer

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Question 18

Doorway information about patient The patient is a 70-year-old man who comes to the office due to frequent falls. Vital signs Temperature: 37.1 C (98.7 F) Blood pressure: 130/80 mm Hg Pulse: 78/min Respirations: 20/min Basic differential diagnosis Neurologic Cerebellar disease (alcohol, tumor, stroke) Parkinson disease Brain tumor Seizure Decreased vision Metabolic Diabetic neuropathy Hypoglycemia Thyroid disease Cardiovascular Valvular heart disease Miscellaneous Medication side effect Vitamin B₁₂ deficiency Vertigo

Accepted Answer

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Question 19

Doorway information about patient The patient is a 56-year-old woman who comes to the emergency department due to vomiting blood. Vital signs Temperature: 36.7 C (98 F) Blood pressure: 90/60 mm Hg Pulse: 98/min Respirations: 20/min Clinical images The patient has vomited into a pan of water at the bedside, as shown in the image. Basic differential diagnosis Peptic ulcer disease Gastric erosions Esophageal varices Mallory-Weiss tear Esophagitis Duodenitis Malignancy (esophageal and gastric)

Accepted Answer

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Question 20

Doorway information about patient The patient is a 35-year-old woman who comes to the office due to acute right lumbar and lower abdominal pain. Vital signs Temperature: 38.3 C (100.9 F) Blood pressure: 110/70 mm Hg Pulse: 100/min Respirations: 16/min Basic differential diagnosis Renal colic Ovarian torsion Urinary tract infection/pyelonephritis Pelvic inflammatory disease Mittelschmerz Appendicitis Threatened abortion Ectopic pregnancy Dysmenorrhea Endometriosis Fibroids

Accepted Answer

The answer of Doorway information about patient The patient is a...

Exam 2: STEP 2 CS - Practice Cases

Doorway information about patient The patient is a 30-year-old man who comes to the office to refill medications for HIV. Vital signs Temperature: 37.1 C (98.8 F) Blood pressure: 120/75 mm Hg Pulse: 78/min Respirations: 16/min Basic differential diagnosis HIV