Practice Questions (2025/2026)
Questions 1–200with Answers & Rationale
1. A 45-year-old male presents with sudden unilateral
facial paralysis. He cannot close his left eye and has loss
of taste on the anterior tongue. What is the most likely
diagnosis?
A. Stroke
B. Bell’s palsy
C. Myasthenia gravis
D. Trigeminal neuralgia
Correct Answer: B. Bell’s palsy
Rationale: Bell’s palsy causes unilateral facial nerve (CN VII) paralysis including inability to
close eye, loss of taste, and facial droop. Stroke usually spares the forehead.
2. Which laboratory test is the MOST sensitive marker of
early kidney damage in diabetes?
,A. Serum creatinine
B. BUN
C. Microalbuminuria
D. eGFR
Correct Answer: C. Microalbuminuria
Rationale: Microalbuminuria is the earliest sign of diabetic nephropathy, detectable before
creatinine or eGFR changes.
3. A 62-year-old smoker presents with chronic productive
cough for over 3 months for the past 2 years. What is the
most likely diagnosis?
A. Emphysema
B. Asthma
C. Chronic bronchitis
D. Pneumonia
Correct Answer: C. Chronic bronchitis
Rationale: Defined as productive cough for ≥3 months for ≥2 consecutive years.
4. Which heart murmur increases with Valsalva and
decreases with squatting?
A. Aortic stenosis
B. Mitral regurgitation
C. Hypertrophic cardiomyopathy
D. Aortic regurgitation
Correct Answer: C. Hypertrophic cardiomyopathy
Rationale: Valsalva decreases preload, worsening HCM obstruction. Squatting increases
preload, improving it.
5. A patient with hypothyroidism has a low TSH. What is
the most likely cause?
,A. Graves disease
B. Hashimoto disease
C. Pituitary failure
D. Thyroid cancer
Correct Answer: C. Pituitary failure
Rationale: Low TSH + low T4 = secondary hypothyroidism due to pituitary dysfunction.
6. A 30-year-old woman presents with dysuria, frequency,
and suprapubic pain. What is the most likely diagnosis?
A. Pyelonephritis
B. Urethritis
C. Cystitis
D. Vaginitis
Correct Answer: C. Cystitis
Rationale: Lower UTI — dysuria, frequency, suprapubic discomfort without flank pain or fever.
7. Which condition is characterized by a positive
McMurray test?
A. ACL tear
B. Meniscal tear
C. Patellar dislocation
D. MCL injury
Correct Answer: B. Meniscal tear
Rationale: McMurray test detects clicking or pain due to meniscal injury.
8. A harsh systolic ejection murmur heard best at the
right upper sternal border radiating to the neck indicates:
A. Mitral stenosis
B. Aortic stenosis
, C. Pulmonic regurgitation
D. Tricuspid stenosis
Correct Answer: B. Aortic stenosis
Rationale: Classic finding — systolic crescendo-decrescendo murmur radiating to carotids.
9. A diabetic patient has burning and tingling in both feet.
Which complication is most likely?
A. Peripheral arterial disease
B. Diabetic neuropathy
C. Charcot joint
D. Neuropathic ulcer
Correct Answer: B. Diabetic neuropathy
Rationale: Symmetrical stocking-glove paresthesias are hallmark of diabetic neuropathy.
10. Which exanthem begins on the face and spreads
downward?
A. Measles (Rubeola)
B. Roseola
C. Fifth disease
D. Scarlet fever
Correct Answer: A. Measles
Rationale: Measles rash starts at hairline → trunk → extremities.
11. A patient with COPD has a normal pH but elevated
PaCO₂ and elevated HCO₃. What does this indicate?
A. Respiratory acidosis—uncompensated
B. Respiratory acidosis—compensated
C. Metabolic acidosis—compensated
D. Mixed acidosis