Correct Answer: D

Rationale: The correct answer is D: Trigeminal neuralgia. This condition is characterized by recurrent, severe, stabbing pain in the trigeminal nerve distribution triggered by touch, chewing, or cold exposure. The key feature is the characteristic lancinating pain, which is not typical of migraine (choice A), cluster headache (choice B), or tension-type headache (choice C). Migraine typically presents with pulsating, moderate to severe headache associated with nausea and sensitivity to light and sound. Cluster headache is characterized by severe, unilateral pain around the eye associated with autonomic symptoms. Tension-type headache presents with bilateral, pressing or tightening pain without specific triggers. Therefore, based on the description of the symptoms in the question, trigeminal neuralgia is the most likely diagnosis.

Correct Answer: C

Rationale: The correct answer is C: Acquired von Willebrand syndrome. This condition is characterized by a defect in von Willebrand factor function, leading to prolonged bleeding time and mucocutaneous bleeding. Normal platelet count rules out Glanzmann thrombasthenia and Bernard-Soulier syndrome which are platelet disorders. Normal PT and aPTT rule out Hemophilia A, a coagulation factor deficiency. Acquired von Willebrand syndrome is the most likely cause based on the clinical presentation and laboratory findings.

Correct Answer: C

Rationale: The correct answer is C: Fifth month. Nurse Vera should explain that the fetal heart can typically be heard using a Doppler ultrasound device around the fifth month of pregnancy. This is because the baby's heart is developed enough to produce audible sounds by this time. Choices A, B, and D are incorrect because in the ninth month, the baby is ready for delivery, in the third month the heart is still developing, and in the first month the heart is just beginning to form and is not yet audible.

Correct Answer: C

Rationale: The correct answer is C: Renal colic due to ureteral calculus. The sudden-onset severe colicky flank pain radiating to the groin along with tenderness over the costovertebral angle and hematuria are classic symptoms of kidney stones (ureteral calculus). The pain results from the obstruction of urine flow by the stone, leading to increased pressure and spasm in the ureter. Acute pyelonephritis (choice A) presents with fever, chills, and systemic symptoms. Renal artery embolism (choice B) typically presents with acute onset severe flank pain but is associated with risk factors like atrial fibrillation. Renal infarction (choice D) presents with sudden-onset severe flank pain but is less likely than ureteral calculus in a patient with a history of nephrolithiasis.

Correct Answer: A

Rationale: The correct answer is A: Rotator cuff tear. The presentation of acute shoulder pain and limited range of motion after a fall onto an outstretched hand, along with tenderness over the greater tuberosity and pain with passive abduction and external rotation, is classic for a rotator cuff tear. The mechanism of injury and physical exam findings are consistent with this condition. B: Glenohumeral dislocation typically presents with a visibly deformed shoulder and loss of normal shoulder contour. C: Acromioclavicular joint separation would present with tenderness over the AC joint rather than the greater tuberosity, and typically involves a history of direct trauma to the shoulder. D: Proximal humerus fracture would present with more diffuse shoulder pain and swelling, and not specific tenderness over the greater tuberosity.