documentclass[a4paper,12pt, twoside, bibliography=totocnumbered]{scrreprt}

usepackage{ngerman}
usepackage[utf8]{inputenc}
usepackage{xspace}
usepackage{mdframed}
usepackage{xifthen}
usepackage{enumitem}
usepackage{xcolor}
usepackage{lipsum}

usepackage[math]{iwona}

textwidth165mm
setlength{marginparsep}{0cm}
setlength{marginparwidth}{1.5cm}
setlength{oddsidemargin}{-0.5cm}
setlength{evensidemargin}{-1.5cm}
setlength{topmargin}{-2cm}
setlength{textheight}{25cm}

mdfdefinestyle{plainstyle}{%
    backgroundcolor=lightgray,
    hidealllines=true,
}

setcounter{secnumdepth}{1}
setcounter{tocdepth}{1}

newcommand{negation}[1]{underline{textbf{#1}}}
newcommand{highlightened}[1]{textit{#1}}
newcommand{examIntroduction}[0]{}
newcommand{sectionDescription}[0]{}
newcommand{itemVignette}[0]{}
newcommand{questionVignette}[1]{ifthenelse{isempty{#1}}{#1}{#1vspace{3mm}}}
newcommand{questionText}[0]{}

newcounter{itemobject}
renewcommandtheitemobject{arabic{itemobject}}

newcounter{questionobjectcase}[itemobject]
renewcommandthequestionobjectcase{
stepcounter{questionobject}
hfilltextbf{arabic{questionobject}}  newline
{normalfontfootnotesize{  (Fall arabic{itemobject})}}
}

newcounter{questionobject}
renewcommandthequestionobject{arabic{questionobject}}

newcommandtestquestion{
  begin{minipage}[t]{15mm}
    begin{flushright}
       textbf{stepcounter{questionobject}
       thequestionobject}  hspace{3mm}
    end{flushright}
   end{minipage}
   hfill
   begin{minipage}[t]{15cm}
        questionVignette{The quick brown fox jumps over the lazy dog. Jeder wackere Bayer vertilgt bequem zwo Pfund Kalbshaxen. Heavy boxes perform waltzes and jigs. The five boxing wizards jump quickly. Five quacking Zephyrs jolt my wax bed. A quick movement of the enemy will jeopardize six gunboats. Portez ce vieux whisky au juge blond qui fume. Zornig und gequält rügen jeweils Pontifex und Volk die maßlose bischöfliche Hybris. Die heiße Zypernsonne quälte Max und Victoria ja böse auf dem Weg bis zur Küste.}par
         questionText{What is the correct answer?}par

        begin{enumerate}[label=(Alph*)]
    item  Nothing
    item  Everything
    item  Nearly nothing
    item  All of them
    item  I don't know
        end{enumerate}
        vspace{10mm}
   end{minipage}
 }

begin{document}

testquestion
testquestion
testquestion

pagebreak
begin{addmargin}{1.5cm}
    setcounter{questionobjectcase} {0}
    Fallstudie Nr. stepcounter{itemobject}
    theitemobject
    begin{mdframed}[style=plainstyle,userdefinedwidth=15cm]
        itemVignette{lipsum}
    end{mdframed}
end{addmargin}

testquestion
testquestion
testquestion

end{document}