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Assessment & Diagnosis

CONO-2 assessment and diagnosis question bank with clinical stems, focused history, physical examination, differential diagnosis, red flags, investigations, lab interpretation, imaging selection, mental health screening, prevention, and exam traps.

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Question 1

BQ-AD-HX-0001

A 57-year-old man reports pressure in the centre of his chest for the past month. It occurs when he walks uphill or climbs stairs and improves after resting. He has diabetes, hypertension, and dyslipidemia. He believes it is “acid reflux” because he sometimes burps.
Which history question is most important?

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Assessment & Diagnosis Quick Review

Red-flag assessmentChest pain with exertion, syncope, neurologic deficit, severe dyspnea, sepsis features, suicidal intent, pregnancy bleeding, acute abdomen, and rapidly progressive weakness require immediate escalation.
Common lab valuesHemoglobin male 135–175 g/L; female 120–160 g/L.
WBC 4.0–11.0 ×10⁹/L.
Platelets 150–400 ×10⁹/L.
Sodium 135–145 mmol/L; potassium 3.5–5.0 mmol/L.
Creatinine ~45–110 µmol/L; eGFR ≥60 mL/min/1.73m².
Investigation trapsUse ECG/troponin for possible acute coronary syndrome, pregnancy test before imaging in reproductive-age patients, urinalysis/culture for urinary symptoms, CBC/ferritin/B12/TSH for anemia or macrocytosis, and targeted imaging for focal neurologic or abdominal red flags.
Exam trapsDo not dismiss high-risk symptoms as anxiety, reflux, musculoskeletal pain, or naturopathic aggravation until dangerous diagnoses are assessed. The best answer often identifies safety, focused assessment, or the most appropriate diagnostic discriminator.

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