BANK| COMPLETE 250 REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
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1. A 58-year-old man reports new daily frontal headaches for
2 months. On exam, tenderness over the left temporal artery
with decreased pulsation. Which lab finding confirms the
suspected diagnosis?
A) Elevated rheumatoid factor
B) Positive ANA
C) Elevated ESR (>100 mm/hr)
D) Low C3
Answer: C
Rationale: Giant cell (temporal) arteritis presents with headache,
jaw claudication, and tender temporal artery. ESR is typically
>100. Temporal artery biopsy is diagnostic.
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,2. A 32-year-old woman with episodic severe unilateral
periorbital pain, ipsilateral lacrimation, and rhinorrhea. The
attacks last 30 minutes. Most likely diagnosis?
A) Migraine
B) Cluster headache
C) Tension headache
D) Trigeminal neuralgia
Answer: B
Rationale: Cluster headaches are strictly unilateral, associated
with autonomic symptoms (lacrimation, rhinorrhea, ptosis), short
duration (15–180 min), and occur in clusters.
3. During palpation of the skull, you note a palpable
depression in a 2-week-old infant. What is the most
appropriate next step?
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,A) Reassure parents it is normal
B) Order CT head
C) Refer to neurosurgery if enlarging
D) Measure head circumference
Answer: C
Rationale: A palpable depression in a newborn may be a
congenital skull fracture or ping-pong fracture. Most benign if
not enlarging, but neurosurgical evaluation is prudent.
4. A 45-year-old with HIV presents with new-onset severe
headache, fever, and photophobia. Neurologic exam is
nonfocal. What is the priority diagnostic test?
A) MRI brain
B) CT head without contrast
C) Lumbar puncture
D) EEG
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, Answer: C
Rationale: Immunocompromised patient with headache + fever
needs LP to rule out cryptococcal meningitis, toxoplasmosis, or
other chronic meningitis. CT first if focal deficits or papilledema.
5. A 70-year-old man reports painless swelling on the right
side of his face for 1 year. On exam, a firm, nontender mass
over the parotid. Facial nerve function is intact. Next best
step?
A) Fine-needle aspiration
B) Observation
C) Antibiotics
D) Parotidectomy
Answer: A
Rationale: Slow-growing parotid mass without facial nerve
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