The confusion comes first
We start from a documented mistake — two conditions that are genuinely mistaken for one another, and the finding that separates them. The question is written to test that discrimination. The distractors are the real confusions, not filler.
The explanation teaches the split
Not “D is correct.” Instead: why the finding that pulled you toward C cannot survive the sentence that rules it out. You leave knowing what to look for next time — which is the only thing that transfers to exam day.
Then it has to survive the gates
Every item is attacked before it's published. The ones that don't survive are discarded, not patched — we would rather you never see a question than see a shaky one.