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Differential Diagnosis Quiz: Practice Real-World Clinical Cases

12 case-based questions for diagnostic reasoning practice. Instant results.

Editorial: Review CompletedCreated By: Eryck TaitUpdated Aug 25, 2025
Difficulty: Moderate
Questions: 20
Learning OutcomesStudy Material
Colorful paper art promoting a Clinical Differential Diagnosis Quiz.

This differential diagnosis quiz helps you practice case reasoning, recognize key findings, and compare likely causes. Work through 12 short scenarios with clear explanations and instant scoring. When you want more variety, try our medical diagnosis quiz, explore urgent scenarios in the emergency medicine quiz, or focus on women's health with an obgyn quiz.

A 25-year-old with acute pleuritic chest pain, dyspnea, normal chest X-ray, and tachycardia after a long flight. Most likely diagnosis?
Spontaneous pneumothorax
Pulmonary embolism (sudden pleuritic pain, tachycardia, normal CXR after prolonged immobility)
Acute pericarditis
Pneumonia
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A 60-year-old with crushing substernal chest pain, diaphoresis, and ST elevations in leads II, III, aVF. Which diagnosis fits?
Inferior STEMI (ST elevation in II, III, aVF localizes inferior wall)
Unstable angina
Anterior STEMI
Pericarditis
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Teen with fever, sore throat, splenomegaly, and atypical lymphocytes. Most likely cause?
Adenovirus
Cytomegalovirus reactivation
Epstein-Barr virus (mononucleosis causes atypical lymphocytes and splenomegaly)
Group A Streptococcus
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Elderly smoker with chronic cough, sputum, and barrel chest. Which pulmonary function pattern?
Restrictive with decreased TLC only
Restrictive with normal DLCO
Obstructive with decreased DLCO (emphysema phenotype)
Normal spirometry
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Young woman with unilateral throbbing headache, photophobia, nausea, and aura. Most likely diagnosis?
Cluster headache
Tension-type headache
Migraine with aura (unilateral throbbing with visual aura and photophobia)
Subarachnoid hemorrhage
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Patient with RUQ pain after fatty meal, positive Murphy sign, and gallstones on ultrasound. Diagnosis?
Acute cholecystitis (RUQ pain with Murphy sign and stones)
Acalculous cholecystitis
Cholangitis
Acute pancreatitis
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Child with barking cough, inspiratory stridor, and steeple sign on neck X-ray. Most likely diagnosis?
Epiglottitis
Asthma exacerbation
Foreign body aspiration
Croup (parainfluenza causing subglottic narrowing; steeple sign)
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Smoker with painless hematuria and normal renal function. Most likely diagnosis?
UTI
Acute glomerulonephritis
Bladder cancer (painless gross hematuria in smoker)
Nephrolithiasis
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Young woman with malar rash sparing nasolabial folds, arthritis, and proteinuria. Likely diagnosis?
Rosacea
Psoriatic arthritis
Systemic lupus erythematosus (malar rash and renal involvement)
Dermatomyositis
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IV drug user with fever, new murmur, and septic pulmonary emboli on imaging. Likely valve involved?
Tricuspid valve (right-sided endocarditis with septic lung emboli)
Pulmonic valve
Mitral valve
Aortic valve
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Obese middle-aged with episodic RUQ pain, normal labs, and stones on ultrasound. Best diagnosis?
Acute cholangitis
Acute cholecystitis
Pancreatic cancer
Biliary colic (transient cystic duct obstruction causing episodic pain)
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Young adult with hemoptysis, pleuritic pain, and wedge-shaped peripheral infarct on CT. Most likely cause?
Bronchiectasis exacerbation
Alveolar hemorrhage from vasculitis
Pulmonary edema
Pulmonary embolism (peripheral wedge infarct from occluded vessel)
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Elderly with proximal muscle weakness, elevated CK, and anti-Jo-1 antibodies. Diagnosis?
Hypothyroid myopathy without antibodies
Myasthenia gravis
Polymyositis (inflammatory myopathy with elevated CK and anti-Jo-1)
Guillain-Barre syndrome
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Teen with acute scrotal pain, relief with elevation, intact cremasteric reflex, UA shows pyuria. Diagnosis?
Varicocele
Inguinal hernia incarceration
Testicular torsion
Epididymitis (pain relief with elevation and pyuria suggest infection)
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Child with recurrent infections, oculocutaneous albinism, and giant granules in neutrophils. Diagnosis?
Chronic granulomatous disease
Leukocyte adhesion deficiency
Chediak-Higashi syndrome (LYST mutation causing giant granules and infections)
Wiskott-Aldrich syndrome
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Young woman with episodic palpitations, sweating, headache, hypertension, and elevated urine metanephrines. Tumor origin?
Adrenal medulla chromaffin cells (pheochromocytoma secretes catecholamines)
Pancreatic islet cells
Carotid body glomus cells only
Adrenal cortex zona fasciculata
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HIV patient with subacute meningitis, elevated opening pressure, and encapsulated yeasts on India ink. Diagnosis?
Cryptococcal meningitis (Cryptococcus neoformans with India ink positivity)
TB meningitis
Listeria meningitis
Toxoplasma encephalitis
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Traveler with high fever, relative bradycardia, rose spots, and leukopenia. Most likely pathogen?
Salmonella typhi (typhoid fever with rose spots and relative bradycardia)
Shigella sonnei
Vibrio cholerae
Campylobacter jejuni
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Young adult with hematuria and hearing loss; biopsy shows basket-weave basement membrane. Diagnosis?
Thin basement membrane disease
Alport syndrome (type IV collagen defect causing hematuria and hearing loss)
Post-streptococcal GN
IgA nephropathy
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Man with chronic diarrhea, weight loss, arthralgias, PAS-positive macrophages in lamina propria. Diagnosis?
Celiac disease
Ulcerative colitis
Whipple disease (Tropheryma whipplei leads to PAS-positive macrophages)
Crohn disease
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Learning Outcomes

  1. Analyse clinical scenarios to differentiate possible diagnoses
  2. Identify critical diagnostic clues and red flags
  3. Apply systematic frameworks for accurate diagnosis
  4. Evaluate reasoning processes in patient case assessments
  5. Demonstrate effective prioritization of potential diagnoses

Cheat Sheet

  1. Master the VINDICATE Mnemonic - Jumpstart your diagnostic detective work by recalling Vascular, Infectious, Neoplastic, Degenerative, Iatrogenic, Congenital, Autoimmune, Traumatic, and Endocrine causes. This framework keeps you on track so you won't overlook quirky or common culprits.
  2. Use the VITAMINS ABCDEK Mnemonic - Supercharge your differentials with an expanded checklist covering Trauma, Idiopathic, Neoplasia, Social, Alcohol, Behavioral, Degenerative, Exocrine, Karyotype, and more. It's like a power-up for your brain to scoop up every possible diagnosis.
  3. Apply the AEIOU-TIPS Trick - When a patient's mental status changes, race through Alcohol, Epilepsy, Infection, Overdose, Uremia, Trauma, Insulin issues, Psychogenic causes, and Stroke. This quick-hit mnemonic means you'll never miss a life-threatening cause in an emergency.
  4. Explore the IMPASSIVE DICTATING Strategy - Delve into every angle of a complex case by ticking off Immunologic, Metabolic, Psychiatric, Allergic, Structural, Social, Infectious, Vascular, Endocrine, Degenerative, Iatrogenic, Congenital, Traumatic, Autoimmune, Toxic, Idiopathic, Neoplastic, and Genetic factors. This exhaustive list turns you into a diagnostic wizard who leaves no stone unturned.
  5. Combine Anatomy and Pathophysiology - Fuse structural knowledge with functional insights to map out potential diagnoses from organ systems down to cellular processes. Harmonizing these perspectives sharpens your clinical reasoning like a laser beam.
  6. Craft Differential Diagnoses with VITAMIN CDE - Organize your thoughts using Vascular, Infectious, Trauma, Autoimmune, Metabolic, Idiopathic, Neoplastic, Congenital, Degenerative, and Endocrine tags. This focused mnemonic helps you juggle multiple hypotheses without confusion.
  7. Enhance Diagnostics with CHOPPED MINTS - Chop through clinical confusion by listing Congenital, Hematologic, Organ, Psychiatric, Pregnancy, Environmental, Drugs, Metabolic, Infectious, Neoplastic, Trauma, and Surgical factors. It's like a candy assortment of causes ensuring your list is sweetly comprehensive.
  8. Embrace Social Determinants - Remember that a patient's home environment, stress levels, and support systems can influence disease presentation and outcomes. Incorporating social context turns a good diagnosis into a great, personalized care plan.
  9. Spot Psychiatric and Behavioral Factors - Don't let mood swings, psychosis, or substance habits hide behind medical masks; psychiatric issues can mimic or magnify physical illnesses. Spotting these clues paves the way for holistic treatments that cover mind and body.
  10. Prioritize History & Physical Exam - Your stethoscope and pen are your best friends: gathering detailed history and conducting a thorough exam often uncovers the biggest leads. Solid fundamentals guide smarter testing and save precious time in the diagnostic journey.
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