Clinical Decision-Making (CDM) Cases Part I Practice Test

These questions are part of the practice quiz. Start practicing

• Which statistical concepts are most relevant to clinical decision-making in case discussions?
• What condition is defined by obstruction of the common bile duct by gallstones?
• Which statement describes a NOT-appropriate item in initial nonpharmacologic therapy for mild osteoarthritis?
• If GCS<8, what is the recommended airway management step?
• When should care escalation occur based on a patient’s response to initial management?
• Which medication is used as abortive therapy for an acute migraine?
• Which practice improves prognosis uncertainty communication to a patient?
• What is the time window for intravenous tPA in acute ischemic stroke?
• Which of the following best summarizes the fever threshold?
• When deciding to order a diagnostic test, how should pretest probability be used?
• In evaluating lytic bone lesions, which statement is true?
• What signs comprise Reynolds' Pentad in acute cholangitis?
• Which statement about hepatitis B vaccination is correct in the context of healthcare workers?
• Which Fahrenheit value exactly corresponds to the fever threshold in Celsius?
• Which temperature reading corresponds to the fever threshold in Celsius?
• If a patient has a temperature reading of 100.4 F, what Celsius temperature does this correspond to?
• In which situations is shared decision making particularly critical?
• Pelvic binder purpose?
• What should be documented to reflect uncertainty and probability in a patient record?
• In suspected PE with low probability, which test should be performed first?
• For a patient with BMI ≥ 30 and cardiovascular risk factors, what is the recommended approach to weight management?
• Which electrocardiographic finding is typical of NSTEMI as opposed to STEMI?
• Which pattern is typical for osteoarthritis rather than rheumatoid arthritis?
• Which medication is contraindicated in NSTEMI patients with a history of stroke?
• Dermatitis herpetiformis is best characterized by which immunofluorescence finding?
• Which diagnostic maneuver is used to diagnose benign paroxysmal positional vertigo?
• What outcomes does the evidence quality framework GRADE focus on when formulating clinical recommendations?
• If MRI shows a prolapsed disc at L4 with cauda equina syndrome, what is the definitive management?
• Which cancer type is commonly associated with SIADH leading to hyponatremia?
• Which elements should a clinician document to support shared decision making and accountability?
• Which test helps rule out a pericardial effusion in suspected pericarditis?
• For acute back pain lasting about three weeks with no red flags, what is the recommended initial approach?
• In an acute asthma exacerbation not responding to short-acting beta-agonists, what is the recommended next step?
• How do you recognize and manage rare but serious diseases early in the clinical decision making process?
• To evaluate for diabetic ketoacidosis, which tests are appropriate?
• For suspected central cause of vertigo, which imaging is most helpful early?
• In evaluating exertional chest pain for ischemia, which test is commonly used to provoke symptoms?
• Which is the most appropriate next management step for a patient with left knee osteoarthritis whose pain persists despite weight loss and regular exercise?
• How do environment and resource constraints influence CDM?
• Which social determinants of health should be considered when selecting tests and planning treatment in clinical decision making?
• What should be documented when using a decision aid in a shared decision making scenario?
• For a patient with new-onset atrial fibrillation and diastolic heart failure, the recommended initial management includes which of the following?
• On chest X-ray, which finding is commonly observed in left-sided heart failure?
• For immunocompetent children aged 11-12, the HPV vaccine is recommended as which dosing schedule?
• In patient workups where pregnancy is possible, which is the best practice?
• For women with personal risk factors for CAD, lipid screening can begin at what age?
• What combination of medications should be started within the first 48 hours after ischemic stroke to prevent recurrence?
• What is the role of second opinions in CDM?
• If a patient has recurrent UTIs within 3 months, which test is indicated to guide therapy?
• What is the role of interprofessional collaboration in clinical decision making?
• Why are likelihood ratios often preferred over raw sensitivity and specificity in test interpretation?
• What is the impact of patient literacy and communication on CDM outcomes?
• If pain persists after nonpharmacologic therapy for osteoarthritis, which is the typical initial pharmacologic option?
• At what age should annual depression screening begin in pediatric patients?
• In a patient with suspected malignancy, how do you balance speed of diagnosis with minimizing harm from testing?
• Cephalization of the pulmonary vessels on chest X-ray is most consistent with which condition?
• Which Celsius reading would clearly indicate fever according to the threshold?
• Which examination site is listed as a potential screen for occult malignancy by palpating for lumps?
• For non-female patients, which preoperative labs are not strictly required by guidelines?
• For suspected heart failure, which initial tests are recommended before echocardiography?
• What should a test rationale include when documenting a decision to order a diagnostic test?
• Which molecular abnormality, when overexpressed, guides targeted therapy in many breast cancers?
• Which examination finding would most likely indicate occult malignancy on abdominal palpation?
• When should you involve specialists or pursue referral in clinical decision making?
• FAST exam tests for free fluid in which regions?
• How should a clinician generate a differential diagnosis that balances breadth and clinical relevance?
• Which of the following is an appropriate initial pharmacologic option for acute nonspecific low back pain?
• A patient with dermatitis herpetiformis associated with celiac disease requires therapy; which two treatments are standard initial management?
• Heart failure due to impaired contractile function is known as:
• What is the purpose of a problem representation in clinical reasoning, and how does it differ from a verbose patient history?
• 38 C is equivalent to how many Fahrenheit?
• Which substance is a ketone body used in ruling out diabetic ketoacidosis?
• In decision-analytic framing, how are patient preferences incorporated to determine the best option?
• After Total Knee Arthroplasty, which postoperative orders are appropriate to reduce risk of DVT and aid recovery?
• According to updated guidelines, oxygen therapy is used under what condition in acute chest pain?
• Which statement best differentiates osteoarthritis from rheumatoid arthritis?
• Which of the following is a preventive treatment for migraines?
• At what age can the HPV vaccine be started?
• Which statement best describes using risk-stratified testing protocols in suspected cancer to balance speed and harm?
• Which lifestyle modification reduces cardiovascular risk and mortality in patients with angina?
• Which statement correctly describes the adolescent meningococcal vaccination schedule?
• Which laboratory finding on CMP is commonly elevated in bone metastases and multiple myeloma?
• In a complex case with multiple possible etiologies, how do you guard against premature closure?
• Acute interstitial nephritis is commonly associated with which medication class?
• Histology of invasive ductal carcinoma classically shows?
• Which medication helps prevent progression of atherosclerosis?
• How should a decision aid be used in a shared decision making scenario?
• Biliary colic typically presents with pain that:
• Which is the most accurate statement about fever thresholds mentioned in the material?
• Which procedure is used to obtain the diagnostic duodenal biopsy in suspected celiac disease?
• After STI testing and pregnancy testing are negative, a patient with recurrent urinary symptoms is suspected to have a complicated UTI. Which imaging is recommended to evaluate the urinary tract?
• What is the gold standard diagnostic procedure to evaluate intestinal involvement in suspected celiac disease?
• Which of the following strategies best mitigates anchoring and premature closure?
• Which practices are recommended to assess prognosis and prognosis uncertainty in chronic disease management?
• In CDM case questions, what is the recommended approach to selecting answers?
• What is the appropriate approach to discordant data from different information sources during CDM?
• Which organ system is specifically mentioned as a site to check for enlargement to suggest metastatic involvement?
• For home management of migraines, which option correctly represents a plausible approach?
• Define sensitivity, specificity, positive predictive value, and negative predictive value, and explain how prevalence affects them.
• Recurrent acute otitis media is defined as more than how many episodes within 6 months or within 12 months?
• In suspected acute cholangitis due to CBD stone, which interventions are part of management?
• Immediate management for open-book pelvic fracture with shock?
• What features should a case-based practice exercise include to improve CDM skills?
• In clinical decision making, what does the term problem representation refer to?
• After staging evaluation for invasive ductal carcinoma, which procedure is required to detect microscopic nodal spread?
• GP IIb/IIIa inhibitors in NSTEMI: which statement is true?
• Which metric indicates the probability of a positive test result among those with the disease?
• In suspected myocardial infarction, which test should be obtained first?
• Which of the following constitutes a red flag that would prompt imaging in acute back pain?
• Which Fahrenheit reading is at or above the fever threshold?
• Heart failure with preserved ejection fraction is also called:
• Which therapy is added specifically for unstable angina but not for stable angina?
• Which of the following is a correct pair of temperature scales for fever determination as described?
• How should test results be integrated into clinical context rather than interpreted in isolation?
• Which statement best describes how to quantify the clinical impact of a decision in terms of expected value?
• If a suspected drug-induced interstitial nephritis does not improve after removing the offending agent, which test is the gold standard for dx?
• A 23-year-old woman presents with shortness of breath, wheezing, chest wall pain and dry cough. Which initial tests should be ordered to evaluate suspected asthma?
• In a patient with suspected deep vein thrombosis, which approach optimizes decision making?
• In biliary colic evaluation for possible choledocholithiasis, which tests are indicated?
• All patients with a new hip fracture should have baseline bone health tests including DEXA, calcium, and vitamin D. Which option lists these correctly?
• How should you respond when evolving symptoms change the differential diagnosis?
• For dermatitis herpetiformis with suspected celiac disease, which combination of tests best supports the diagnosis?
• How should patient preferences and values be integrated into a decision about initiating antibiotic therapy for suspected infection?
• Which test is not appropriate during an acute asthma exacerbation?
• After an ischemic stroke, what tests help identify the embolic source?
• How should you approach end-of-life decisions within CDM?
• Which finding warrants stroke evaluation in a patient with dizziness?
• Which statement about fever threshold is correct?
• Which preoperative test is least likely required for nonpregnant adults?
• At what age should men begin fasting lipid screening according to routine risk-based guidelines?
• Which test is required for all patients with new-onset heart failure or new-onset atrial fibrillation to evaluate an endocrine cause?
• What practice helps avoid cognitive biases that dismiss uncommon causes in clinical decision making?
• Which condition predisposes to fungal intertrigo in intertriginous skin folds?
• Percutaneous coronary intervention is NOT indicated for which scenario?
• Regarding evaluation of suspected stable angina, which statement is true?
• Which test is not used to confirm typical stable ischemic heart disease?
• Regarding imaging for distant metastases in newly diagnosed invasive ductal carcinoma, which statement best reflects routine practice?
• In acute ischemic stroke without hemorrhage, what is the recommended BP management?
• In NSTEMI management, when is unfractionated heparin continued?
• In the management of invasive ductal carcinoma of the breast, what are the recommended initial staging investigations to detect possible metastasis?
• Which vaccine is indicated for adults aged 65 and older or those with certain comorbidities such as asthma, COPD, heart disease, diabetes, or asplenia?
• What is the role of evidence quality frameworks like GRADE in choosing diagnostic tests or therapies?
• What preoperative test is indicated for all female patients?
• In pregnancy, which imaging modality is preferred to evaluate potential urinary tract complications?
• Which P2Y12 inhibitors are appropriate choices in NSTEMI?
• Which medication reduces cardiac workload by lowering heart rate and contractility?
• Which of the following is a component of CHADS-VASc scoring for stroke risk?
• Which endpoint best captures safety in CDM outcomes?
• True or False: 38 C equals 100.4 F.
• Which option lists the four categories of syncope?
• Which of the following findings supports acute interstitial nephritis in a patient with rising creatinine and eosinophiluria?
• What should be documented when a patient-centered plan is agreed upon?
• In acute cholangitis, which procedure helps decompress the biliary tree?
• In acute chest pain, which characteristic of a diagnostic test makes it most valuable for ruling out a serious condition?
• What is a safety-netting plan and why is it essential in uncertain diagnoses?
• Which statement is true regarding biopsy methods in suspected cancer?
• A 36-year-old woman with shortness of breath and chest pain on oral contraceptives presents; which test is most appropriate to evaluate suspected pulmonary embolism given the context?
• Which medication is an antiplatelet used to prevent myocardial infarction or thrombus?
• After obtaining new data, what should you do with probabilities in diagnostic reasoning?
• What Celsius temperature defines fever?
• How should you monitor for potential diagnostic drift over the course of a case?
• How many days is amoxicillin typically prescribed for uncomplicated acute otitis media in children?
• Which murmur may be heard in left-sided heart failure due to mitral regurgitation?
• A child with tympanostomy tubes develops drainage for two weeks. What is the recommended management?
• In pregnancy, pyelonephritis is best managed with which approach?
• What is the purpose of a prognosis-based plan in clinical decision making?
• Renal replacement therapy decisions emphasize which principle before starting dialysis?
• In a reproductive-age woman with dysuria and a new sexual partner, which single initial test is most important to order?
• Which metric is an example of a predictive value used in clinical decision-making?
• In suspected acute stroke, what is the initial imaging to rule out hemorrhage?
• In trauma with suspected injury, which imaging is part of the primary survey?
• Which test is used for initial screening for type 2 diabetes according to common practice?
• Why is monitoring for red flags an essential part of safety-netting?
• Which action should be included in the management plan for a patient newly diagnosed with asthma?
• Which tests are part of the initial evaluation for acute cholangitis?
• Which practice improves patient understanding and engagement in CDM?
• What is the role of follow-up testing in a diagnostic pathway?
• What is the role of red flags in evaluating a patient with possible cancer, and how should they be managed?
• In cauda equina syndrome due to lumbar disc herniation, which of the following is the recommended management?
• Which vaccine combination is appropriate for routine immunization in adults at risk (travel, exposure, sexual activity)?
• If a prompt says 'you may list up to 3 responses', which of the following is true?
• When patient values conflict with evidence-based guidelines, the best approach is to:
• In the context of new diagnoses, what is an essential step with the patient?
• In acute otitis media, if the patient has used a beta-lactam in the past 30 days or has conjunctivitis, which antibiotic is preferred?
• Oxygen therapy in NSTEMI should be given only under what condition?
• If a test result contradicts clinical intuition, what is recommended?
• Troponin levels can be elevated in which condition?
• Kerley B lines on chest X-ray indicate:
• Is metformin an appropriate first-line monotherapy for a patient with an A1c of 7.2%?
• What is the difference between diagnostic accuracy and clinical usefulness?
• When a question prompt says 'pick up to 4 of 10' and only one option is correct, which approach is best?
• What is a recommended approach to assess and manage risk in a patient with polypharmacy and multiple comorbidities?
• In CHADS-VASc scoring, which statement about age thresholds is correct?
• Which combination lists the four therapies typically included in NSTEMI management?
• How should pretest probability guide imaging decisions in suspected pulmonary embolism?
• Which approach helps differentiate correlation from causation when interpreting data?
• In type 2 diabetes with an A1c greater than 9%, what is the recommended initial pharmacologic therapy?
• In adolescents who are immunocompromised or older than 15, how many HPV vaccine doses are recommended?
• Years later, a patient with knee osteoarthritis remains in pain, wearing a knee brace daily and using a cane, and is dependent on morphine for pain control. What is the best option for this patient?
• Which vaccination is recommended for all adults aged over 50?
• PTH should be measured only if which condition is present?
• In evaluating suspected heart failure, which statement about troponin testing is true?
• Which endpoints are typical to evaluate success of decisions in CDM?
• In elderly patients with diabetes presenting with myocardial infarction, which symptom may predominate rather than classic chest pain?
• How long after removing the offending agent in suspected drug-induced acute interstitial nephritis does creatinine typically begin to improve?
• To reduce diagnostic errors, which practice should be used?
• Which of the following is part of the initial nonpharmacologic management for mild osteoarthritis?
• A 57-year-old man experiences chest pain with exertion radiating to the left shoulder; which initial tests are appropriate?
• Which serologic test is most specific for detecting celiac disease in the setting of dermatitis herpetiformis?
• Which test would be unlikely to add new information when performing an initial malignancy workup?
• Which statement is true about fever definitions?
• Explain how to use Bayesian reasoning to update disease probability after a diagnostic test with a given likelihood ratio.
• In angina management, which medication is used as a vasodilator to increase blood flow during an episode?
• What does pretest probability describe?
• After total knee arthroplasty, which prophylaxis is commonly used to reduce the risk of DVT?
• Which sign is most characteristic of right-sided heart failure?
• How should CDM approaches be tailored for vulnerable populations such as the elderly, pregnant individuals, or pediatrics?
• What is the purpose of considering pretest probability in test utilization?
• How does patient context influence the interpretation of test results?
• Describe at least three cognitive biases that commonly affect CDM and strategies to mitigate them.
• What is a diagnostic likelihood ratio for a test, and how is it used in clinical decision making?
• Which test is NOT indicated as an initial step until the primary cancer is identified?
• Which statement best describes the MenB vaccine schedule for adolescents?
• Which statement identifies the definitive airway?
• Which strategies help integrate new evidence into ongoing patient care?
• When new, high-quality guidelines are published for ongoing care, what should you do?
• Which strategy helps optimize test utilization to reduce false positives?
• If disease prevalence increases, which of the following is true about PPV and NPV?
• Which ethical principles are involved when considering withholding diagnostic testing due to cost?
• What factors can lead to misinterpretation of imaging in clinical decision-making?
• What makes up the standard liver function test (LFT) panel?
• In a pregnant patient with a urinary tract infection complicated by pyelonephritis, what is the recommended management?
• Which of the following is a correct conversion assertion?
• What is the Fahrenheit equivalent of 38 C at the threshold?
• Which molecular marker is routinely tested in invasive breast carcinoma to guide targeted therapy?
• Which statement about lytic bone lesions in an older patient with weight loss is true?
• If a patient with suspected PE has an elevated D-dimer and tachycardia (HR 108), what is the next appropriate step?
• In acute chest pain, what sequence of steps optimizes diagnostic yield while minimizing harm?
• How do you determine when to stop testing and proceed with treatment in a patient with ambiguous symptoms?
• Which imaging modality is described as the most initial step to identify the source of a suspected malignancy?