Here are the answers to all 40 questions:

Q1. What isn't right? Answer: b - Both homologous incisors erupt at virtually the same time (not one followed closely by the other as a rule). Eruption starts at 5-6 months is correct; homologous teeth erupt nearly simultaneously.

Q2. Normal Newborn Infant average range of height for boys is: Answer: b - 50 cm The average length of a full-term newborn boy is approximately 50 cm.

Q3. The sensations without an obvious stimulus described as tingling, prickling, warmth or coldness, is named: Answer: Paresthesia These spontaneous abnormal sensations are called paresthesias.

Q4. What is the normal blood bilirubin level in adults? Answer: a - Direct bilirubin 0-0.2 mg/dL and total bilirubin 0.3-1.0 mg/dL (the option stating total 0.3-3.0 is slightly high; normal total bilirubin is 0.3-1.0 mg/dL, but among the choices given, a is the closest correct answer with direct bilirubin 0-0.2 mg/dL).

Q5. Ischemic Stroke risk factors include all, EXCEPT: Answer: d - Carotid stenosis is actually a risk factor, NOT an exception. Wait - re-reading the options: a. Hypertension/Diabetes, b. Smoking, c. Obesity/dyslipidemia/physical inactivity, d. Carotid [stenosis]. All of these ARE risk factors for ischemic stroke. The answer likely refers to a protective factor listed as option d (the text is cut off). Based on typical exam content, d (carotid artery disease) is still a risk factor, so the question may point to a non-modifiable factor listed. The answer is d - if the full option reads "carotid endarterectomy" or similar protective intervention.

Q6. Which laboratory equipment maintains very low temperatures close to -50°C for storing samples? Answer: Ultra-low temperature freezer (deep freezer / cryogenic freezer) The equipment described is an ultra-low temperature (ULT) freezer.

Q7. The medical equipment that uses electrodes to determine partial pressure of CO₂ and O₂ in blood is named: Answer: Blood Gas Analyzer (arterial blood gas analyzer)

Q8. All Cranial nerves control motor or sensory function of the tongue, EXCEPT: Answer: c - Trigeminal (CN V)

Q9. What is right about peculiarities of kidney function in early infancy? Answer: a - Glomerular filtration rate is low and does NOT reach adult values until later (approximately 2 years of age). Infants have immature renal function with low GFR.

Q10. Kussmaul breathing is: Answer: a - Deep, labored breathing (large tidal volumes); it is NOT the pattern where the chest fails on inspiration. Kussmaul breathing is characterized by deep, rapid, regular respirations seen in metabolic acidosis (e.g., diabetic ketoacidosis). The description in option a is actually describing paradoxical breathing. The correct definition of Kussmaul: deep and rapid breaths - so if option a says chest falls on inspiration, that is incorrect for Kussmaul. The answer is whichever option correctly describes deep, regular, sighing respirations associated with metabolic acidosis.

Q11. Sensory deficit with "stocking-glove" pattern is often seen in: Answer: a - Diabetic or alcoholic polyneuropathy The stocking-glove distribution is the classic pattern of length-dependent peripheral neuropathy.

Q12. Regarding seizures, all statements are correct, EXCEPT: Answer: b - Seizures are NOT exclusively paroxysmal disorders with cortical discharge only in epilepsy; the incorrect statement among the options would be one that mischaracterizes seizure physiology (e.g., stating seizures originate only subcortically, or that they cannot be induced).

Q13. In SAHLI'S acid method, N/10 HCl converts hemoglobin into: Answer: a - Acid hematin HCl converts hemoglobin into brown-colored acid hematin, which is then measured colorimetrically.

Q14. At 4 months, the infant CANNOT: Answer: a - Sit with adequate support At 4 months, infants can hold their head erect/steady and roll front to back, but sitting (even with support) is a ~6-month milestone.

Q15. A medical lab equipment used for tracking illness due to infections in the urinary tract: Answer: Urine Analyzer (Urinalysis Analyzer) The equipment used to track urinary tract infections and urinary diseases is a urine/urinalysis analyzer.

Q16. Anterior fontanel normal size is: Answer: b - 2-4 cm in length and 2-3 cm width The anterior fontanel is typically described as approximately 2-3 cm × 3-4 cm (diamond-shaped). Among the options, b (2-4 cm × 2-3 cm) best reflects this range.

Q17. Inability to recognize numbers drawn with a pen on the patient's palm is named: Answer: c - Graphesthesia (specifically the inability = agraphesthesia) Graphesthesia is the ability to recognize letters/numbers written on the skin; inability to do so is agraphesthesia.

Q18. Medicine laboratory equipment used for growth and storage of bacterial/cell cultures: Answer: Incubator The laboratory incubator maintains controlled temperature and conditions for culturing bacteria and cells.

Q19. Peculiarities of the stomach in infant: Answer: a - The stomach lies horizontally and is round until approximately 3 years of age. The infant stomach is horizontal (not vertical as in adults), which contributes to regurgitation.

Q20. Normal reference range for ESR: Answer: a - 1-9 mm/hr for males and 1-13 mm/hr for females (Westergren method normal values: males 0-15 mm/hr, females 0-20 mm/hr; however, among the given options, a with 1-9 mm/hr for males is the most appropriate answer for younger adults).

Q21. Swan neck deformity in fingers is generally found in: Answer: b - Chronic Rheumatoid Arthritis Swan neck deformity (hyperextension at PIP, flexion at DIP) is a classic feature of chronic RA.

Q22. Which laboratory finding in adult males corresponds to diagnostic criteria of anemia: Answer: Hemoglobin < 130 g/L in males (WHO criteria). The option showing Hb below normal male range (typically 135-175 g/L) corresponds to anemia.

Q23. Normal range of hemoglobin level for adult males: Answer: c - 135-175 g/L The normal Hb for adult males is 135-175 g/L (13.5-17.5 g/dL).

Q24. At 9 months, the infant CAN: Answer: b - Sit with adequate support (in fact, by 9 months most infants can sit independently). At 9 months: can sit independently, pull to stand, crawl. a - Crawl is also correct for 9 months. The most definitive milestone at exactly 9 months is b - sit with adequate support (achieved even earlier ~6 months), and crawling (~9 months). Answer: a - Crawl is the key new milestone at 9 months.

Q25. Which is NOT controlled by the Posterior column of the Sensory pathways? Answer: b - Temperature The posterior column (dorsal column) carries: proprioception/position, vibration, fine touch, and 2-point discrimination. Temperature (and pain) travels via the spinothalamic tract (anterolateral system), NOT the posterior column.

Q26. All following Cranial nerves are responsible for extraocular movements, EXCEPT: Answer: c - CN V (Trigeminal) Extraocular movements are controlled by CN III (oculomotor), CN IV (trochlear), and CN VI (abducens). CN V is sensory to the face and motor to muscles of mastication - it does NOT control eye movements.

Q27. What is right about morphological peculiarities of glomerulus in children? Answer: a - Differentiation of glomeruli is completed (ended) postnatally. Glomerular development is incomplete at birth and matures over the first 2 years of life. The glomerular epithelium in children is more cuboidal than in adults.

Q28. Which device uses liquid cryogens (nitrogen, helium) for maintaining viability of materials? Answer: a - Cryostat (or more precisely a cryogenic storage unit/liquid nitrogen storage tank) A cryostat uses liquid cryogens for ultra-low temperature preservation of biological materials.

Q29. What is right about the foramen ovale? Answer: a - The foramen ovale is functionally closed by the 3rd month of life, although anatomically a probe can still be passed through the overlapping flap valve (probe-patent). Functional closure occurs within days to weeks after birth due to pressure changes; anatomical/permanent closure occurs by ~3 months.

Q30. What is the truth about height of a normal infant? Answer: a - Length increases about 2 cm/month during the first 3 months of life (then approximately 1-1.5 cm/month thereafter). Total increase in 1st year is ~25 cm.

Q31. Medical equipment that determines concentrations of ions (Na, K, Cl) and acid-base balance: Answer: Electrolyte Analyzer / Blood Gas and Electrolyte Analyzer (Ion-selective electrode analyzer)

Q32. Peculiarities of blood in newborn - What isn't right? Answer: b - Short life of erythrocytes (12-40 days) Neonatal RBC lifespan is actually 60-90 days (shorter than adult 120 days, but NOT as short as 12-40 days). The erythrocyte level of 6-7 × 10¹²/L is correct for newborns (polycythemia). Option b is the incorrect statement.

Q33. Quality control standards depend upon the following factors: Answer: a - The time between collection and performance of the test is a key pre-analytical quality control factor, along with proper specimen handling, storage conditions, and reagent quality.

Q34. A 23 y/o male with sharp grating pain during shoulder motion and weakness lifting arm overhead: Answer: This clinical picture describes rotator cuff pathology (likely supraspinatus tear or impingement syndrome). The corresponding diagnosis/finding would be a rotator cuff tear or subacromial impingement.

Q35. Localization of kidneys in older children: Answer: a - On the level from 1st to 5th lumbar vertebrae. In older children, the kidneys descend to approximately the adult position (T12-L3), which corresponds roughly to the lumbar region.

Q36. A gait with lack of coordination and instability, mostly due to cerebellar disease, is named: Answer: Ataxic gait (cerebellar ataxia) The gait described is ataxic gait, associated with cerebellar disease - wide-based, unsteady, uncoordinated.

Q37. Damage to upper motor neurons can cause all, EXCEPT: Answer: The exception with UMN lesions would be decreased/absent deep tendon reflexes and flaccidity - these are LMN signs. UMN lesions cause: spasticity (increased tone), hyperreflexia (exaggerated reflexes), weakness/paralysis, and Babinski sign. The option that does NOT match UMN damage would be decreased muscle tone or flaccid paralysis.

Q38. Which statement is correct regarding blood glucose level and diabetes mellitus? Answer: b - Fasting blood glucose 100-125 mg/dL indicates pre-diabetes (impaired fasting glucose), NOT diabetes. Diabetes is diagnosed at fasting glucose ≥ 126 mg/dL. So statement a (fasting 100-125 = diabetes) is incorrect; b is correct.

Q39. Corresponding spinal segmental level for the Plantar Response reflex: Answer: b - Lumbar 5, Sacral 1 (L5-S1) The plantar reflex (Babinski) is mediated by the L5-S1 spinal segments.

Q40. Correct matching of muscle stretch reflexes with spinal segmental levels: Answer: b - Knee reflex = L3-L4 (patellar reflex: L3-L4; ankle reflex: S1-S2; biceps: C5-C6; triceps: C7-C8) The ankle reflex - L2, L3, L4 listed in option a is incorrect (ankle reflex is S1-S2). Therefore b (knee reflex at the correct level) is the right matching.

Here are the answers to all 40 questions:

Q1. Cramping pain in the legs during exertion that is relieved by rest within 10 minutes is named as: Answer: Intermittent Claudication This is the hallmark symptom of Peripheral Arterial Disease (PAD). DVT pain is not relieved by rest; neurogenic claudication is from spinal stenosis. The correct answer is intermittent claudication (option not fully visible, but it is the defining answer - distinct from both DVT and neurogenic claudication).

Q2. In Chronic Rheumatoid Arthritis all signs are present, EXCEPT: Answer: b - Heberden and Bouchard nodes Heberden nodes (DIP) and Bouchard nodes (PIP) are features of Osteoarthritis, NOT rheumatoid arthritis. RA involves MCP and PIP joints with swelling/thickening, but NOT these bony nodules.

Q3. Gangrene always develops in chronic venous insufficiency. This statement is? Answer: b - False Gangrene is a feature of severe Peripheral Arterial Disease (PAD), not chronic venous insufficiency. CVI causes ulcers, edema, and skin changes, but gangrene is not a typical outcome.

Q4. Which statement is correct? Answer: b - Ulnar deviation Knobby swellings with white chalk-like discharge are characteristic of Gout (tophi), NOT chronic rheumatoid arthritis. The correct statement is b - ulnar deviation of the fingers is a classic feature of RA.

Q5. The Rotator cuff consists of the following muscles, EXCEPT: Answer: c - Trapezius The rotator cuff = SITS: Supraspinatus, Infraspinatus, Teres minor, Subscapularis. The Trapezius is a superficial back/neck muscle and is NOT part of the rotator cuff.

Q6. Which statement is true? Answer: a - Hyperpigmentation, edema, cyanosis, and ulcers are the major signs of PAD (Peripheral Arterial Disease) / chronic venous insufficiency. Raynaud's disease is due to vasospasm, not acute occlusion.

Q7. A 41-year-old female with tender, red, swollen right knee, first occurrence: Answer: The most likely diagnosis for a single acutely tender, red, swollen joint in a middle-aged female with no prior history is Septic arthritis or Crystal arthropathy (gout/pseudogout). Pseudogout commonly affects the knee. This scenario likely tests acute monoarthritis - answer would depend on the full options, but likely Gout/Pseudogout or Septic arthritis.

Q8. What isn't right about physiological growth of infants? Answer: b - Resp. rate: 45 ± 10 c/min Normal infant respiratory rate is 30-60 breaths/min (some sources: 40-60). Pulse 110-150 b/min is normal for infants. Breathing through the nose is correct (obligate nose breathers). The respiratory rate of 45 ± 10 is within range and actually correct; however, looking at the options, the answer likely relates to the blood pressure value (option d, cut off) being incorrectly stated. Among visible options, b could be incorrect if the exam considers a narrower normal range.

Q9. To which muscle group do Pectoralis major and Pectoralis minor belong? Answer: a - The Axiohumeral group The pectoral muscles connect the axial skeleton to the humerus, placing them in the Axiohumeral (thoracohumeral) group.

Q10. A 31 y/o male admitted with complaints - metatarsophalangeal joint of the great toe is very painful: Answer: Classic presentation of Gout - podagra (acute inflammation of the 1st MTP joint) is pathognomonic of gout. The answer is Gout.

Q11. What isn't right about head circumference of normal infant? Answer: b - Then ½ cm/month Normal head circumference: increases ~2 cm/month for first 3 months, then ~1 cm/month for the next 3 months, then ~0.5 cm/month. If option b says ½ cm/month applies after the first 3 months, that is actually correct for months 6-12. The incorrect statement would relate to the rate being misapplied to the wrong time period.

Q12. They lose 5-10% of weight by 3-4 days after birth isn't a result of: Answer: a - Withdrawal of hormones from mother Physiological weight loss in newborns (5-10% by day 3-4) is due to: loss of extracellular fluid (meconium, urine), inadequate intake initially. It is NOT primarily due to withdrawal of maternal hormones. Answer: a.

Q13. The medical laboratory device used to separate blood components (RBCs, WBCs, platelets): Answer: Centrifuge A centrifuge separates blood components by density using centrifugal force.

Q14. When the limb distal to the occlusion becomes cold, pale, and pulseless - emergency treatment should be started immediately: Answer: This describes acute limb ischemia (the "6 P's": Pain, Pallor, Pulselessness, Paresthesia, Paralysis, Poikilothermia). Emergency treatment = immediate surgical embolectomy or thrombolysis. This is a true statement.

Q15. The medical equipment that uses electrodes to determine partial pressure of CO₂ and O₂ in blood: Answer: Blood Gas Analyzer (ABG analyzer) Uses Clark electrode (O₂) and Severinghaus electrode (CO₂) to measure arterial blood gases.

Q16. The primary research includes all, EXCEPT: Answer: d - Analytical research Primary research types include: laboratory-based, clinical research, and epidemiological research. Analytical research is a type of secondary/review research methodology, not primary research. Answer: d.

Q17. A 68-year-old patient's ABI = 0.85. What does this mean? Answer: a - ABI 0.85 is within the borderline/mild range. Normal ABI = 1.0-1.4. ABI 0.9-1.0 = acceptable/borderline. ABI 0.85 indicates mild PAD or borderline - mild peripheral arterial disease with possible mild symptoms. The statement that it is "normal with no symptoms of PAD" is approximately correct at this borderline level, but technically it suggests mild PAD.

Q18. What is NOT a Red Flag in infant development? Answer: b - Unable to transfer objects from hand to hand by age 1 year Unable to sit alone by age 9 months IS a red flag. Unable to transfer objects hand-to-hand by 6 months is a red flag, but by 1 year this skill should be well established - however, the milestone for hand-to-hand transfer is ~6 months. At 1 year, not transferring objects is indeed a red flag. The answer is a is a red flag; question asks what is NOT a red flag - b (if the age listed makes it a normal variant) or whichever option describes a normal developmental pattern.

Q19. Strength tests for the shoulder joint for assessment of rotator cuff disorders include all tests, EXCEPT: Answer: a - Painful arc The painful arc is a special test (impingement test), not specifically a strength test. Strength tests include: empty can test (supraspinatus), external rotation resistance (infraspinatus/teres minor), lift-off test (subscapularis). Painful arc is a range-of-motion/impingement assessment, not a pure strength test.

Q20. Factors related to mothers during pregnancy - what ISN'T a maternal factor? Answer: d (cut off, likely "use of drugs" or "uterine abnormality" - but among visible options) Nutritional deficiencies, faulty placental implantation, and exposure to radiation are all maternal factors. The option d (cut off) is likely the answer - possibly describing a fetal/neonatal factor rather than a maternal one.

Q21. Cyanotic skin on dependency, petechiae, brown pigmentation, and ulceration at the ankle area are characteristic for: Answer: Chronic Venous Insufficiency (CVI) These are classic signs of CVI: venous stasis changes including hemosiderin deposition (brown pigmentation), dependent cyanosis, and venous ulcers near the medial malleolus.

Q22. At 4 months, the infant CAN: Answer: a - Bring hands together in midline and play with fingers At 4 months: brings hands to midline, watches hands, holds head steady, laughs. Sitting with support (~6 months) and balancing head well when sitting is a later milestone.

Q23. The type of medical lab equipment mainly used for sterilizing surgical, pharmaceutical and other medical procedure items: Answer: Autoclave (Steam Sterilizer) Autoclaves use steam under pressure to sterilize surgical instruments and lab equipment.

Q24. Which statement is correct regarding the Buerger test? Answer: a - If the pink color of the foot returns in 5 seconds = no sign of arterial insufficiency. Normal capillary refill on the Buerger test: color returns in <5 seconds = normal. If it takes longer = arterial insufficiency is present. Statement a is correct.

Q25. Restricted range of motion in the Shoulder joint can occur in: Answer: d - In all Bursitis, tendinitis, capsulitis, sprains, and rotator cuff tears can all cause restricted range of motion in the shoulder.

Q26. Type of lab equipment that separates non-soluble material from a sample, used for separating cells: Answer: Centrifuge Centrifugation separates cells and non-soluble material from liquid samples by density.

Q27. Trendelenburg test helps to assess: Answer: a - Competency of venous valves The Trendelenburg test assesses the competence of venous valves (particularly the saphenofemoral junction) and is used in the evaluation of varicose veins.

Q28. A medical lab equipment used for tracking illness due to infections in the urinary tract and other urinary diseases: Answer: Urine Analyzer (Urinalysis Analyzer) Detects WBCs, nitrites, bacteria, and other markers of urinary tract infection.

Q29. The medical laboratory device that can monitor diseases such as leukemia, lymphoma, multiple myeloma, and types of bleeding disorders: Answer: Hematology Analyzer (Complete Blood Count analyzer) A hematology analyzer performs CBC with differential, identifying abnormal cell counts associated with hematological malignancies and bleeding disorders.

Q30. Inflammatory cause of joint pain can be found in all joint disorders, EXCEPT: Answer: Osteoarthritis (if listed as an option) Among the visible options - crystalline-induced (gout/pseudogout) and infectious origin are inflammatory. Osteoarthritis is primarily a degenerative, non-inflammatory condition (though mild secondary inflammation can occur). The exception is osteoarthritis.

Q31. Osteoarthritis is characterized by: Answer: c (cut off, but based on options a and b being incorrect)

Q32. At 6 months, the infant CANNOT: Answer: b - Turn completely over (abdomen to abdomen) At 6 months: can roll front to back AND back to front. Sitting briefly is possible at 6 months. The infant at 6 months cannot yet turn completely abdomen-to-abdomen (full rotation) as a coordinated movement. However, a (sit alone briefly) is actually achievable around 6 months with some support. The answer is b - complete axial rotation is not yet a 6-month milestone.

Q34. Emotional development of school-age child isn't: Answer: b - Jealous of siblings (especially 6-8 years old children) Jealousy of siblings is a feature of toddler/preschool age (2-5 years), NOT school-age children (6-12 years). Fear of injury and dark (option a) are also more characteristic of preschool, but jealousy of siblings is particularly a pre-school trait. The highlighted correct answer in the image is b.

Q35. Unilateral calf and ankle swelling/edema can mostly suggest all conditions, EXCEPT: Answer: Options a (venous thromboembolic disease) and b (DVT) are essentially the same condition, both causing unilateral leg swelling. The exception would be a condition causing bilateral swelling (like heart failure, hypoalbuminemia). The answer is the cut-off option c - likely bilateral edema condition or a systemic cause.

Q36. Which medical laboratory device is used to disinfect and sterilize medical/laboratory equipment such as pipette tips and plastic tubes? Answer: Autoclave or UV sterilizer/germicidal cabinet For plastic equipment that cannot withstand high heat: UV sterilizer or chemical disinfection unit. For heat-resistant items: autoclave.

Q37. Types of development - which is NOT a type? Answer: d - Physiological growth Types of development include: Motor, Cognitive, Emotional, Social, and Language development. Physiological growth is a component of physical development/growth, not classified as a "type of development" in developmental psychology. Answer: d.

Q38. The most essential lab equipment (beakers, flasks) used for transferring, storing, measuring, and heating liquids: Answer: Glassware (Laboratory glassware) Beakers and flasks are standard laboratory glassware used for these purposes.

Q39. A 67-year-old patient's ABI = 0.34. What does this mean? Answer: ABI of 0.34 indicates severe peripheral arterial disease (PAD)

Q40. Secondary sex characteristics in boys: Answer: Secondary sex characteristics in boys include: voice deepening, pubic/axillary/facial hair growth, penile/testicular enlargement, increased muscle mass. The options listed:

Here are the answers to all 40 questions:

Q1. A child able to copy a triangle, ask the meaning of words, climb by alternate feet, help in household tasks, and dress/undress: Answer: 5 years old This developmental profile is classic for a 5-year-old child. Copying a triangle, dressing independently, and climbing stairs with alternating feet are all 5-year milestones.

Q2. The Normal reference range for Prothrombin time (PT) is: Answer: a - 11 to 13.5 seconds Normal PT is 11-13.5 seconds (INR ~1.0). Values of 14-16 seconds or 7-10.5 seconds are outside the normal range.

Q3. All the following types are primary headaches, EXCEPT: Answer: d - Headaches caused [by another condition] Tension, migraine, and cluster headaches are all primary headaches. "Headaches caused by [another condition]" = secondary headaches (e.g., caused by hypertension, infection, tumor). Answer: d.

Q4. All the following types are primary headaches, EXCEPT: Answer: d - Headaches caused [by another condition] Same as Q3 - migraine, tension, and cluster are all primary headaches. Any headache attributed to an underlying cause is a secondary headache. Answer: d.

Q5. The frequency of heart beat during the fifth year of life (beats per minute): Answer: e - 70-80 bpm Normal heart rate by age:

Q6. Extra-articular structure diseases mainly can cause the following symptoms, EXCEPT: Answer: b - Limitation of active range of motion Extra-articular diseases (bursitis, tendinitis, fibromyalgia) cause focal tenderness at specific points. Limitation of active range of motion is more characteristic of intra-articular (joint space) pathology. Answer: b.

Q7. In SAHLI'S acid method N/10 HCl converts hemoglobin into: Answer: a - Acid hematin HCl converts hemoglobin into brown-colored acid hematin, which is compared to a standard for colorimetric measurement.

Q8. Meningeal signs include all, EXCEPT: Answer: c - Positive Romberg's sign Meningeal signs: nuchal rigidity, Brudzinski's sign, Kernig's sign, and Jolt accentuation. Romberg's sign tests proprioception/posterior column function and is a cerebellar/vestibular test - NOT a meningeal sign. Answer: c.

Q9. Disease-specific risk factors of stroke include all conditions, EXCEPT: Answer: c - Trigeminal neuralgia Atrial fibrillation and carotid artery stenosis are both direct risk factors for ischemic stroke. Trigeminal neuralgia is a pain condition of CN V and is NOT a stroke risk factor. Answer: c.

Q10. Pain with walking or prolonged standing, radiating from the spinal area into the buttocks, thighs, lower legs, or feet, is named as: Answer: Neurogenic claudication This is the classic description of neurogenic claudication from lumbar spinal stenosis. It is differentiated from vascular claudication (DVT/PAD) by its spinal radiation pattern and relief with flexion/sitting.

Q11. Bilateral distal weakness often with sensory loss is mainly caused by: Answer: d - Peripheral neuropathy (the cut-off option) Bilateral distal weakness with sensory loss = peripheral neuropathy (stocking-glove pattern). Glucocorticoid treatment causes proximal myopathy; polymyositis and dermatomyositis cause proximal weakness without sensory loss. Answer: d (peripheral neuropathy).

Q12. The left boundary of the heart of a 1-year-old child is determined: Answer: a - 1-2 cm outside the left middle collarbone (midclavicular) line In infants and young children, the cardiac silhouette is proportionally larger. The left border of the heart in a 1-year-old extends 1-2 cm lateral to the left midclavicular line.

Q13. 90% of brain growth is achieved by: Answer: c - 3 years of age By age 3, the brain has reached approximately 80-90% of its adult size. Brain growth is most rapid in the first 3 years of life.

Q14. All are articular structures of the joint, EXCEPT: Answer: e - Intra-articular ligaments (if listed as extra-articular) OR the cut-off option Articular structures: articular cartilage, joint capsule, synovium, intra-articular ligaments, articular discs. Periarticular (extra-articular) ligaments are outside the joint capsule. However, the cut-off option e likely refers to bursae - bursae are extra-articular structures. Answer: e (bursae).

Q15. Examining a 25-year-old patient with high fever and severe headache - physical examination in the supine position: Answer: This describes testing for meningeal signs (Kernig's sign and Brudzinski's sign) in a suspected case of bacterial meningitis. The clinical scenario points to meningitis.

Q16. Kernig's reflex is considered physiological up to the age of: Answer: b - 2 months Kernig's sign (resistance to knee extension with hip flexed) is physiological/normal in infants up to approximately 2 months of age, after which it becomes a pathological sign of meningeal irritation.

Q17. Immune-related cause of joint pain is present in: Answer: c - Rheumatoid Arthritis Rheumatoid arthritis is an autoimmune/immune-mediated inflammatory arthritis. Crystalline arthritis (gout) is metabolic; gonococcal arthritis is infectious; rotator cuff tear is mechanical. Answer: c.

Q18. Which is an extra-articular structure? Answer: b - Periarticular ligaments Extra-articular = outside the joint capsule. Periarticular (extra-capsular) ligaments lie outside the joint. Articular cartilage, joint capsule, synovium, and intra-articular ligaments are all within/part of the joint. Answer: b.

Q19. The impaired muscle strength or weakness in the limb is named as: Answer: b - Paresis

Q20. In diabetic patients, condition with slow progression, burning electrical pain, tingling, numbness in the lower extremities: Answer: Diabetic peripheral neuropathy (distal symmetric polyneuropathy) This is the classic description of diabetic distal symmetric polyneuropathy - the most common complication of diabetes, presenting with slow-onset burning/tingling/numbness in a stocking-glove distribution.

Q21. Inflammatory causes of joint pain may include all conditions, EXCEPT: Answer: c - Fibromyalgia Inflammatory joint causes: gout, reactive arthritis, pseudogout, RA, septic arthritis, SLE. Fibromyalgia is a non-inflammatory chronic pain syndrome - there is no joint inflammation, synovitis, or elevated inflammatory markers. Answer: c.

Q22. During treatment with warfarin (blood thinners) for prevention of blood clots, INR should be kept in the range: Answer: 2.0 to 3.0 Standard therapeutic INR range for warfarin therapy (DVT/PE prevention, AF, mechanical heart valves - standard): 2.0-3.0. For mechanical mitral valve: 2.5-3.5.

Q23. Inflammatory causes of joint pain may include all conditions, EXCEPT: Answer: d - Osteoarthritis Osteoarthritis is primarily a degenerative/mechanical condition, NOT inflammatory. Reactive arthritis, gout, pseudogout, and RA are all inflammatory arthritides. Answer: d.

Q24. The systolic blood pressure of a 1-year-old child is (mm of mercury): Answer: b - 80-90 mmHg Normal BP for a 1-year-old: approximately 85-90 / 55-65 mmHg (systolic ~80-95 mmHg). Answer: b - 80-90.

Q25. All statements are true, EXCEPT: Answer: b - In structural coma pupils are equal and reactive to light In structural coma (e.g., brainstem lesion, herniation), pupils are typically unequal (anisocoria) and may be unreactive. Equal and reactive pupils suggest metabolic coma. Answer: b.

Q26. The parameters of RBC and Hemoglobin include assessment of all, EXCEPT: Answer: d - [cut-off option, likely "mean arterial pressure" or "platelet count"] RBC/Hb parameters include: RBC count, reticulocyte count, hemoglobin level, hematocrit, MCV, MCH, MCHC. The exception (option d, cut off) is likely a non-hematological parameter such as platelet count (which is part of CBC but not an RBC/Hb parameter) or mean arterial pressure.

Q27. The upper border of the newborn's heart reaches: Answer: a - II intercostal space In newborns, the heart is relatively large and positioned more horizontally. The upper border reaches the 2nd intercostal space.

Q28. All are articular structures of the joint, EXCEPT: Answer: d - Bursae Articular structures: articular cartilage, joint capsule, synovium, intra-articular ligaments. Bursae are fluid-filled sacs located near joints but are extra-articular structures (not part of the joint itself). Answer: d.

Q29. In Emergency Department performing focused neurological exam for a 37-year-old in the postictal period: Answer: A patient in the postictal period (post-seizure) will have: temporary confusion, disorientation, fatigue, Todd's paralysis (focal weakness that resolves), and gradually returning consciousness. The neurological exam should focus on: level of consciousness, focal deficits, cranial nerves, and assessing for Todd's paralysis.

Q30. The normal range of hemoglobin level for adult females: Answer: e - 120-150 g/L (or more precisely 120-160 g/L) Normal female Hb: 120-160 g/L (12.0-16.0 g/dL). Among the options, e - 120-150 is the closest correct answer. Option b (115-135) is too low; option c (135-175) is the male range.

Q31. Normal reference range for C-Reactive Protein (CRP) as an inflammatory marker: Answer: c - < 0.8 mg/dL Normal CRP: < 1.0 mg/dL (or < 10 mg/L). The closest correct option is c - < 0.8 mg/dL, indicating no significant inflammation.

Q32. Normal range of hemoglobin level for male adults: Answer: c - 135-175 g/L Normal male Hb: 135-175 g/L (13.5-17.5 g/dL). Answer: c.

Q33. The parameters of RBC and Hemoglobin include assessment of all, EXCEPT: Answer: d (cut-off option - same as Q26) Same question as Q26 - RBC/Hb parameters are RBC count, reticulocytes, Hb, hematocrit, MCV, MCH, MCHC. The exception is whichever option d describes (likely platelet count or a non-RBC parameter).

Q34. Normal reference range for Hematocrit level: Answer: b - male: 42-50%, female: 37-47% Normal hematocrit: Males: 40-52% (typically 42-50%), Females: 36-48% (typically 37-47%). Answer: b.

Q35. Frequency of heart beat during the first year of life (beats per minute): Answer: b - 120-130 bpm Normal heart rate in the first year of life:

Q36. The systolic blood pressure of a 5-year-old child (mm of mercury): Answer: a - 70-76 ... actually normal systolic BP for a 5-year-old is approximately 95-110 mmHg. Using the formula: 80 + (2 × age in years) = 80 + 10 = 90 mmHg (minimum), with upper range ~100-110. Among the options visible (70-76, 80-90, 90-100, 100-110), the answer is c - 90-100 or d - 100-110 mmHg.

Q37. Inflammatory causes of joint pain may include all conditions, EXCEPT: Answer: Rotator cuff tear A rotator cuff tear is a mechanical/structural injury, not an inflammatory arthritis. Reactive arthritis, gout, pseudogout, and RA are all inflammatory. Answer: rotator cuff tear.

Q38. A child is able to tell stories - at what age? Answer: b - 24 months / 2 years Children begin telling simple stories and stringing sentences together at approximately 24-30 months (2-2.5 years).

Q39. Immune-related cause of joint pain is present in: Answer: d - RA (Rheumatoid Arthritis) Crystalline arthritis = metabolic; gonococcal arthritis = infectious; septic arthritis = infectious. Rheumatoid Arthritis is immune-mediated. Answer: d - RA.

Q40. The normal range of International Normalized Ratio (INR) is: Answer: b - 0.8 to 1.2 (or 0 to 1 per option a, 2.0 to 3.0 per option c) Normal INR for a healthy person NOT on anticoagulation: 0.8-1.2. Options: a. 0.1 to 0.6, b. 0.8 to 1.2, c. 2.0 to 3.0, d. 0 to 0.4. Answer: b - 0.8 to 1.2.