Student Name ______________________________________ ID. No.

_________________

RVU FACULTY OF HEALTH SCIENCE DEPARTMENT OF PUBLIC HEALTH

MODEL LISENCESURE EXAM FOR YEAR- IV PUBLIC HEALTH STUDENTS

Time allowed 3: 30hr

Name ___________________________ Id No. __________ Signiture _____

I. Choose the correct answer & write on separate answer sheet provided (Use upper case only)

1. A 44-year-old woman infected with HIV is noted to have a CD4 count of 200 cells/mm 3. Which of the
following is recommended as useful prophylactic agent in this patient at this point?

A.Fluconazole B. Azithromycin C. Trimethoprim-sulfamethoxazole D. Ganciclovir

2. A 48-year-old woman presented for medical evaluation with a 2-week history of cough, productive of
yellow-green sputum and high grade fever. She underwent left mastectomy 2 months earlier that was
followed by chemotherapy. She also received radiation therapy to the left breast 2 weeks ago. Chest X-
Ray revealed a left lower lobe consolidation. The most appropriate therapy for this patient is
A. Antibiotic administration B. Oral corticosteroids C. Intravenous corticosteroids D. Non-steroidal anti-
inflammatory agents
3. A 17-year-old man, with diabetes type I has been complaining of stomach ache, and nausea for last two
days. Blood glucose is 217 mg/dl, bicarbonate is 12mg/, and serum potassium level are 3.3mg/l. Which of
the following must be a part of the treatment in the emergency room?
A. Subcutaneous insulin B. Intravenous insulin C. Intravenous empirical antibiotics D. Intravenous
bicarbonate
4. A 38-week pregnant woman presents with headaches, BP of 155/115, and +3 protein on
urinary exam. Which of the following is most important next step in managing this patient?
A. Magnesium sulfate treatment while inducing labor
B. Medical management of the hypertension, awaiting spontaneous delivery
C. Emergency cesarean section
D. Immediate treatment with magnesium, corticosteroids & nitroprusside, & induction of labor
E. Brain imaging as soon as possible
5. A 45-year-old man was brought to the ER after vomiting bright red blood. He has a blood pressure of
88/46mm Hg and heart rate of 120 bpm. Which of the following is the best next step?
A. Intravenous fluid resuscitation and preparation for a transfusion C. Guaiac test of the stool
B. Administration of a proton-pump inhibitor D. Treatment for H pylori
6. A 62 yrs female with septic shock secondary to Community Acquired Pneumonia requiring mechanical
ventilation and on appropriate antibiotics. Despite adequate fluid resuscitation and high dose
norepinephrine infusion, her Mean Arterial pressure remains 50mm Hg..
Which of the following is true regarding management of this patient
A. No indication for systemic steroids in view of severe sepsis
B. Perform ACTH and give steroids if adrenal insufficient
C. Administer hydrocortisone 200 mg/d iv.
D. Start vasopressin and if MAP remains <65, start hydrocortisone
7. A 24-year-old man has been treated with isoniazid, rifampin, and pyrazinamide for active pulmonary
tuberculosis. After 3 months, he states that he is having numbness and tingling of both feet but no back
pain. He denies taking other medications. Which of the following is the most appropriate next step
A. CT scan of the lumbar spine. B. Initiate pyridoxine.
C. Continue the tuberculosis agents and monitor for further neurologic problems.
D. Initiate a workup for tuberculosis adenopathy compression on the femoral nerve
8. Patient with asthma, well controlled by albuterol, came complaining of asthma symptoms not respond
to albuterol, what medication could be added?
A. Corticosteroid inhaler B. Long acting B-agonist C. Oral corticosteroid D.Theophylline

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9. Radiological feature of miliary TB:

A. Pleural effusion B. 3-4 diffuse nodules C. Small cavities
10. 58 years old male patient came with history of fever, cough with purulent foul smelling sputum and
CXR showed: fluid filled cavity, what is the most likely diagnosis is?
A. Abscess B. TB C. Bronchiectasis D. Lung collapse
11. Patient has fever, night sweating, bloody sputum, weight loss, PPD test was positive. X-ray shows
infiltrate in apex of lung, PPD test is now reactionary, diagnosis
A. Activation of primary TB B. sarcoidosis C. CHF D. COPD
12. Known case of DM patient present with calf pain during walking. On examination: weak peripheral
pulse , cold and absent hair over legs .What is your diagnosis
A. Peripheral arterial disease B. Varicose vein C.Deep vein thrombosis D.Lymphedema

13. Patient with 3 weeks history of shortness of breath with hemoptysis the appropriate investigation is:
A. CXR, AFB, ABG B. CXR, PPD, AFB C. CT, AFB, ABG
14. 3 years old presented with shortness of breath and cough at night which resolved by itself in 2 days.
He has Hx of rash on his hands and allergic rhinitis. he most likely had
A. Croup B. Bronchial asthma C. Epiglottitis D. CHF
15. 15 years male with history of 3 days yellow sclera, anorexia, abdominal pain, LFT: Total. bilirubin =
253 Indirect bilirubin = 98 ALT = 878, AST = 1005, what is the diagnosis?
A. Gilbert disease B. Infective hepatitis B C. Obstructive Jaundice D. Acute pancreatitis
16. A 31-year-old woman attends the gynecologic clinic saying she had unprotected sexual intercourse
with a new partner 3 weeks ago. She reports seeing a dull red spot on her labia which has now turned
into a single, painless, well demarcated ulcer. She is otherwise well. What is the most likely
diagnosis?
A. Chancroid B. Granuloma inguinale C. Syphilis D. Lymphogranuloma venereum
17. 50 years old male with 2 years history of dysphagia, mass in the throat, excessive salivation,
intermittent hoarseness & weight loss. The most likely diagnosis is:
A. Cricopharyngeal dysfunction B. Achalasia C. Diffuse spasm of the oesophagus.
D. Scleroderma. E. Cancer of cervical esophagus
18. A 62-year-old woman is hospitalized following an acute pulmonary embolism. All of the following
would typically indicate a massive pulmonary embolism EXCEPT:
A. Elevated serum troponin levels B. Initial presentation with hemoptysis
C. Initial presentation with syncope
D. Presence of right ventricular enlargement on CT scan of the chest
E. Presence of right ventricular hypokinesis on echocardiogr
19. Patient was diagnosed to have duodenal ulcer and was given ranitidine for 2 weeks and now he is
diagnosed to have H. pylori. What is your choice of management?
A. Omeprazole, clarithromycin &amoxicillin B. Bismuth+ tetracycline+ metronidazole
C. Metronidazole and amoxicillin. D. Omeprazole+ tetracycline
20 A man travelled to Ethiopia and had rice and cold water and ice cream. He is now having severe
watery diarrhea and severely dehydrated, what is the most likely he has:
A. Vibrio cholera B. clostridium difficile C. Clostridium perfringens D. Dysentery E.Shigella
21. A 55 years old complain of dyspnea, PND with past history of mitral valve disease, the diagnosis is
A. Left side heart failure B. Right side heart failure C. pneumothorax D. Pulmonary Embolism
22. 45 yrs old male come with CHF & pulmonary edema, what is the best initial therapy
A. Digoxin B. Furosemide C. Debutamine D. Propranolol
23. The best anti HTN drug in patients with hyperaldosteronism & HTN is:
A. Spironolactone B. Verapamil C. Nefidepine D. metoprolol
24. Patient has neck stiffness, headache and petechial rash. Lumber puncture showed a high pressure,
what would be the cause?
A. group B streptococcus B.Neisseria meningitides C.M.tubecrlosis D. staphylococcus aureus

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25. 87 years old who brought by his daughter, she said he is forgettable, doing mess thing in room, do not
maintain attention, neurological examination and the investigation are normal, what is the diagnosis?
A. Alzheimer disease B. Multi-Infarct Dementia C. Depression D. Anxiety
26. Patient is complaining of irritation, tachycardia, night sweating, labs done showed TSH: Normal, T4:
High, diagnosis is:
A. Graves’ disease B. Secondary Hypothyriodism C. Hashimoto’s thyroiditis D. Anemia
27. Obese patient recently diagnosed to have type II DM. He is following a diabetic diet regimen and he
exercises regularly. When he came to you in the next visit... His blood sugar was high and he gained 5
kg... He was also complaining of thirst and hunger, what would you give him:
A. Long-acting insulin B. Metformin C. Short-acting insulin D. Sulfonylurea
28. Female with history of left flank pain radiating to groin, symptoms of UTI, what is diagnosis?
A. Appendicitis B. Diverticulitis C. Renal colic D.Renal cancer
29. Male patient present with prostatitis such as urgency, frequency and burning sensation during
urination culture showed gram negative rods. The drug of choice is:
A. Ciprofloxacin B. Cloxacilin C. Erythromycin D. Trimethoprime
30. 75 years old man came to ER complaining of acute urinary retention. What will be your initial
management?
A. Send patient immediately to OR for prostatectomy
B. Empty urinary bladder by Folley’s catheter and tell him to come back to the clinic
C.Give him antibiotics because retention could be from some sort of infection
D. Insert Foley’s catheter and tell him to come to clinic later
31. A 30 yrs old man IV drug abuser was presented by fever, arthralgia and conjunctival hemorrhage,
what is the diagnosis?
A. Bacterial endocarditis B. Rheumatic fever C. SLE D.Valvular heart disease
32. The standard starting regimen for acid-fast bacilli smear–positive active pulmonary tuberculosis is
A. isoniazid B. isoniazid, rifampin
C. isoniazid, moxifloxacin, pyrazinamide, ethambutol
D. isoniazid, rifampin, pyrazinamide, ethambutol
E. rifampin, moxifloxacin, pyrazinamide, ethambutol
33. A 20-year-old female is 36 weeks pregnant and presents for her first evaluation. She is diagnosed with
Chlamydia trachomatis infection of the cervix. Upon delivery, what complication is her infant most at
risk for?
A. Jaundice B. Hydrocephalus C. Hutchinson triad D. Conjunctivitis
E. Sensorineural deafness
34. Previously unvaccinated health care worker incurs a needle stick from a patient with known active
hepatitis B infection. What is the appropriate management for the health care worker?
A. Hepatitis B immunoglobulins B. Hepatitis B vaccine
C. Hepatitis-B vaccine plus hepatitis-B immunoglobulins
D. Hepatitis B vaccine plus lamivudine E. Lamivudine plus tenofovir
35. Patient 22 years old with unilateral headache attacks:
A. Cluster headache B. Migraine C. Tension headache D. None
36. A middle age man presented with severe headache after lifting heavy object. His BP was high. He was
fully conscious. Examination was otherwise normal. The most likely diagnosis is:
A. Subarachnoid hemorrhage B. Central HTN C. Tension headache D. Migraine
37. Regarding the Glasgow Coma Scale, which of the following statements is false?
A. The maximum score for verbal response is 5 B. The total score is 15
C. The patient scores 5 if able to localize pain in the best motor response subset
D. The patient scores 4 if able to open eyes to Pain in the eye-opening subset
E. The patient scores 1 if not able to respond verbally at all in best verbal response
38. A 34-year-old woman, gravida 5, para 4004, at 30 and 2/7th weeks of gestation presents to labor and
delivery reporting vaginal bleeding. She reports vague back pain. Her blood pressure is 110/78 and her
pulse is 106. She has slow, continuous bleeding from her vagina. Her cervix appears long and closed on
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Student Name ______________________________________ ID. No. _________________

speculum examination. Fetal monitoring reveals one uterine contraction every 30 minutes, and the fetal
heart rate is reassuring. Transabdominal ultrasound demonstrates a complete placenta previa. The most
appropriate next step would be:
A. Magnesium sulfate B. Cesarean delivery C. Betamethasone D. Discharge home on bed rest
39. The probable age of a developmentally normal child who is just able to sit without support, can
transfer objects from hand to hand, and speaks in a monosyllabic babble is:
A. 3 month B. 4 month C. 9 month D. 6 month
40. You are seeing a 4-year-old child in the emergency department with abdominal pain, and acute onset of bloody
diarrhea. Due to a recent outbreak in the community related to a popular fast food restaurant, you suspect E coli
0157:H7. Which of the following is seen most commonly as a complication of Shiga-toxin-producing E coli
(formerly known as enterohemorrhagic E coli) diarrhea?
A. Meningitis B. hemolytic-uremic syndrome C. chronic diarrhea D. endocarditis
41. A previously well 3-year-old child has a temperature of 104°F (40°C), headache, and stiff neck. He
has a 2-day history of upper respiratory tract symptoms and is now vomiting. This clinical presentation
most likley represents which of the following diagnoses?
A. brain tumor B. optic neuritis C. subarachnoid hemorrhage D. meningitis
42. A 3-year-old boy appears with a barking cough, hoarseness, low-grade fever, and dyspnea for the last
6 hours. The child has been suffering from rhinorrhea, mild cough, pharyngitis, and fever for the last 3
days. His condition worsens with agitation and crying. A physical examination reveals tachypnea, mild
retractions, inflamed pharynx, coryza, and hoarse voice. The most likely diagnosis is:
A. Acute epiglottitis B. Spasmodic croup C. Croup D. Acute pharyngitis
43. Pink newborn with HR of 88/min is actively gasping , he has good muscle tone and respond to nasal
catheter stimulation with facial grimace, the APGAR score is:-
A. 5 B. 6 C. 7 D. 8
44. A 3-month-old infant has had upper respiratory symptoms for a few days and presents to
the emergency department with respiratory distress, wheezing, and hypoxia. You diagnose
bronchiolitis. What is the most common cause of acute bronchiolitis in infants?
A. respiratory syncytial virus B. parainfluenza virus C. cytomegalovirus D. influenza virus
45..A 4 -year-old child presents to your office with fever, and increased work of breathing manifested by
tachypnea and retractions. A chest x-ray confirms lobar pneumonia. What is the most likely etiology of
pneumonia in this child?
A. Mycoplasma pneumonia B. Streptococcus pyogenes C. Chlamydophila pneumonia D. Streptococcus
pneumonia
46. A 4-month-old infant born with perinatally acquired HIV infection presents with fever, grunting, and
hypoxia. Influenza and RSV testing are negative. Which of the following is the likely opportunistic
infection in this infant with perinatally acquired HIV infection?
A. Pneumocystis pneumonia B. disseminated cytomegalovirus infection
C. disseminated toxoplasmosis D. cryptococcal meningitis
47. A 4-year-old presents for a well-child visit. The parents state their family has practiced a strict vegan
diet since the child was 2 years of age. Of the following, which is most likely to be deficient now or in the
near future?
A. Vitamin C B. Folic acid C. Vitamin B12 D. vitamin B6
48. The father of a 26-week-gestation infant, whom required intubation at birth, is asking why the infant’s
lungs were not mature. Which of the following is the pathophysiology mechanism of respiratory distress
syndrome in the premature infant?
A. increased production of pulmonary surfactant B. decreased production of pulmonary surfactant
C. increased metabolism of pulmonary surfactant D. decreased metabolism of pulmonary surfactant
49. An infant is born to a mother who is HBsAg positive. What should be the next step?
A. Check hepatitis B serology on infant and give hepatits B immune globulin if indicated
B. Give infant hepatitis B immune globulin C. Vaccinate infant with hepatitis B vaccine
D. Give infant hepatitis B immune globulin and hepatitis B vaccine

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50. A 2-year-old boy appears with fever, watery diarrhea, shock, encephalopathy, severe DIC, renal
dysfunctions, and hepatic abnormalities. The body also developed seizure activities. The most likely
diagnosis is:
A. Hypovolemic shock B.Septic shock C. Cardiogenic shock D. Distributive shock
51.Which of the following medications, when given before & during pregnancy may help to protect
neural tube defects?
A. Vitamin B6. B. Iron. C. Folic acid. D. Zinc..
52. A 17-year-old girl appears with a severe itching, tearing, and burning of both eyes throughout the
year. A physical examination reveals injected and chemotic bulbar conjunctivae, and eyelid eczema that
spreads to the periorbital skin and cheeks with an erythematous, thick, dry scaly lesion. This condition is
most commonly associated with:
A. Sinusitis B. Otitis media C. Allergic food reaction D. Atopic dermatitis
53. A 25 year-old G3 P1+1 presents to the emergency room complaining of lower abdominal crampy pain
6 weeks form he last normal period. She had significant vaginal bleeding but no passage of tissue &
pregnancy test is Positive. The patient's most likely diagnosis is:
A. Incomplete abortion B. Ectopic pregnancy C. Missed abortion D. Threatened abortion
54. A 33 year old woman at 37 weeks gestation confirmed by early sonogram presents with moderate to
sever vaginal bleeding, and is note by sonogram to have placenta previa, which of the following is the
best management for her.
A. Induction of labor B. Give tocolytic drugs C. Caesarean section D. Expectant management
55 .A full-term newborn is born by a NSVD with Apgar scores are 9 and 9 at 1 and 5 minutes
respectively. Both the baby and the mother are asymptomatic. The mother wanted to breast feed the baby.
Breast feeding should begin preferably.
A. within 1 hour B.Within 2 hour C. within 3 hour D. within 4 hour
56 A 22-year-old G1 at 14 weeks gestation presents to your office with a history of recent exposure to her
3-year-old nephew who had a rubella viral infection. In which time period does maternal infection with
rubella virus carry the greatest risk for congenital rubella syndrome in the fetus?
A. Preconception B. First trimester C. Second trimester D. Third trimester
57. A healthy 20-year-old G1P0 presents for her first OB visit at 10 weeks gestational age. She denies any
significant medical history both personally and in her family. Which of the following tests is not part of
the recommended first trimester blood testing for this patient?
A. Complete blood count (CBC) C. One-hour glucose challenge testing
B. Screening for human immunodeficiency virus (HIV) D. Blood type and screen
58. 30 weeks pregnant primigravida presented with raised blood pressure of 150\95 mmHg and
proteinuria +3, which one of the following is done :
A. Immediate caesarian section.
B. 24 hour urine collection for protein, CBC. LFT, uric acid and coagulation profile.
C. Send her home and to be seen after 4 weeks. D. Advice to not get pregnant again.
59. The drug of choice to prevent convulsions in eclampsia is:
A. Magnesium Sulfate. B. Hydralazine. C. Labetalol D.Methyldopa
60. Which of the following contraceptive methods should NOT be used by a patient with coronary heart
disease?
A. Combined oral contraceptive pills B. Male condom C. Female condom D. Diaphragm
61. You diagnose a 21-year-old woman at 12 weeks gestation with gonorrhea cervicitis. Which of the
following is the most appropriate treatment for her infection?
A. Doxycycline B. Chloramphenicol C. Tetracycline D. Minocycline E. Ceftriaxone
62. Fetal death at 15 weeks gestation without expulsion of any fetal or maternal tissue for at least 8
weeks
A. Complete abortion B. Incomplete abortion C. Threatened abortion D. Missed abortion
63. A 27-year-old has just had an ectopic pregnancy. Which of the following events would be most likely
to predispose to ectopic pregnancy?
A. Previous cervical conization B. Pelvic inflammatory disease (PID)
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C. Use of a contraceptive uterine device (IUD) D. Induction of ovulation

64. A woman with a history of deep vein thrombosis for above female patient seeking contraception,
select the method that is medically contraindicated for that patient.
A. Oral contraceptives B. IUD C. Condoms D. Laparoscopic tubal ligation
65 You are evaluating a 19-year-old woman for a sexual assault. She denies any medical problems or
allergies to medications. Her pregnancy test is negative. Which of the following antibiotic prophylaxes do
you recommend for sexually transmitted infections?
A. No antibiotic prophylaxis is indicated B. Metronidazole 500 mg PO twice daily for 7 days
C. ceftriaxone 250 mg IM D. Doxycycline 100 mg PO twice daily for 7 days plus ceftriaxone 250 mg IM
66. Effective prevention of miscarriage in women with threatened abortion includes which of the
following?
A. Bed rest B. Mc Donald cerclage C. Progesterone vaginal suppositories D. antibiotics
67. Which of the following is the most common cause of postpartum hemorrhage?
A. Uterine atony B. Lacerations C. Retained placenta D. Coagulopathy
68. If you find that a 25 –year- old patient with amenorrhea of 18 weeks duration had an elevated serum
hCG, and absent fetal heart & movement and uterine size 28 weeks which of the following would be the
most likely diagnosis ?
A. Normal pregnancy B. Hydatiform mole C. Twin pregnancy D. Missed abortion
69. A 29 year old primigravida woman at 16 weeks of gestation reports irritability, palpitation and
difficulty in gaining weight. Physical examination is normal except for a pulse of 104 beats/min and lid
lag. Laboratory studies reveal Hb of 10.1g/dl, serum free thyroxin of 10 ng/dl and thyrotropin of 0.1
mU1ow. What is the most likely diagnosis?
A. Thyroid storm. B. Hypothyroidism. C. Depression. D. Hyperthyroidism.
70. A 24-year-old man complains of colicky per umbilical pain then shift to right lower quadrant
abdominal pain of 24 hours duration. He complains of anorexia and nausea. His temperature is 37.7°C.
Which of the following is the most likely diagnosis?
A. Acute appendicitis B. Gastroenteritis C. Acute pancreatitis D. Intussusception
71 A 71-year-old man is being treated for congestive heart failure with a combination of drugs. He
complains of nausea and anorexia, and has been puzzled by observing yellow rings around lights. His
pulse rate is 53/minute and irregular and blood pressure is 128/61 mmHg. Which of the following
medications is likely to be responsible for these symptoms?
A. Lisinopri B. Spironolactone C. Digoxin D. Furosemide
72. 35 years old lady complaining of breast tenderness and diffuses nodularity, during the physical
examination you found 3 cm tender mobile right side mass, what you will do next?
A. FNA with cytology B. Mammogram C. Biopsy D. Follow up for next cycle
73. Lady with 3 cm breast mass, solid non tender, mobile, persist during menses, slightly increased in
size:
A. Fibroadenoma B. Fibrocystic C. Ductal carcinoma D. Papilloma
74. Lactating women 10 days after delivery developed fever, malaise, chills, tender left breast with
hotness and small nodule in upper outer quadrant with axillary lymph node, Leucocytes count was
14,000/L diagnosis?
A. Inflammatory breast cancer B. Breast abscess C. Fibrocystic disease D. Fibroadenoma
75. A 10 years old boy came to the ER with right scrotal pain and swelling, on examination: tender right
testis, with decreased flow on Doppler study. Your diagnosis is:
A. Hernia B. Hematocele C. Testicular torsion D. Orchitis
76. 8 months old baby presented with history of recurrent crying with on & off jelly stool. The diagnosis
is:
A. Intussusceptions B. Intestinal obstruction C. Mickle's diverticulum D. Strangulated hernia
77.48 year old woman presented with right abdominal pain, nausea & vomiting. On examination she had
tenderness in the right hypochondrial area. Investigations showed high WBC count, high alkaline
phosphatase & high bilirubin level. The most likely diagnosis is:
A. Acute cholecystitis B. Acute appendicitis C. Perforated peptic ulcer D. Acute pancreatitis
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78. Patient with right upper quadrant pain, nausea and vomiting, pain radiating to back. On examination
Grey-Turner's sign and Cullen's sign, what is the diagnosis?
A. Acute pancreatitis B. Acute chlocystitis C. perforated PUD D. Acute Appendicitis
79. A 30 year old man presented with feeling of heaviness in the lower abdomen. On examination he had
a small bulge palpable at the top of the scrotum that was reducible & increases with valsalva maneuver.
The most likely diagnosis is:
A. Indirect inguinal hernia B. Femoral hernia C. Hydrocele D. Varicocele
80. Patient was presented by constipation, vomiting, abdominal distension, with old scar in the lower
abdomen; X- ray showed dilated loops with air in the rectum, what is the best initial management?
A. NGT decompression and IV line. B. Rectal decompression and antibiotics.
C. Suppositories D. Observe the patient
81. A patient with penetrating abdominal stab wound. Vitals are: HR 98, BP 140/80 and RR 18. A part of
omentum was protruding through the wound. What is the most appropriate next step?
A. FAST Ultrasound B. DPL (Diagnostic peritoneal lavage)
C. Explore the wound D. Exploratory laparotomy
82. 50 years old patient come with history of weight loss, palpitation, cold preference and firm neck
swelling, the diagnosis is:
A. Simple goiter B. Toxic nodular goiter C. Parathyroid adenoma D. Thyroidit
83. 21 years old is involved in a head-on collision as the driver of a motor vehicle. He is noted to be
severely tachypneic and hypotensive. His trachea is deviated to the left, with palpable subcutaneous
emphysema and poor air entry in the right hemithorax. The most appropriate first treatment procedure should
be:
A. Arterial puncture to measure blood gases B. Stat chest x-ray
C. Intubation and ventilation D. Needle thoracocentesis/tube thoracotomy prior to any investigations
84. Old lady, with 3 days history of perforated peptic ulcer, presented semi comatosed, dehydrated,
febrile. The appropriate management:
A. NGT with suction , systemic antibiotics and observe
B. NGT with suction, blood transfusion ,rehydration, systemic antibiotics and closure of perforation
C. Vigotomy and drainage procedure, NGT with suction D. Hemi-gastrectomy
85. The single blood test performed by a good laboratory that would be expected to be the most sensitive
for determining whether the patient is euthyroid, hypothyroid or hyperthyroid is:
A. Free T4 B. Total T3 C.Total 4 D. TSH
86. An 80 year old male presented with dull aching loin pain & interrupted voiding of urine. BUN and
creatinine were increased. US revealed a bilateral hydronephrosis. What is the most probable Diagnosis?
A. Stricture of the urethra B. Urinary bladder tumor C. BPH D. Renal stone
87. 20 years old man involved in RTA brought to ER by his friends. On examination, found to be
conscious but drowsy. HR 120/min, BP 80/40. The MOST urgent initial management measure is:
A. CT brain B. X-ray cervical spine
C. Rapid infusion of crystalloids D. ECG to exclude hemopericardium
88. A 70 yrs Old male chief complaint knee pain on walking with crepitus x-ray show narrow joint space
and subchondoral sclerosis:
A. Rheumatoid arthritis B. Osteoarthritis C. Gout D. Osteomyelitis
89. 30 years old male with history of pain & swelling of the right Knee , synovial fluid aspiration showed
yellow colour, opaque appearance, variable viscosity, WBC 150,000, 80% poor mucin clot , Diagnosis is:
A. Gout Arthritis B. Meniscal tear C. Rheumatoid Arthritis D. Septic Arthritis
90. The most helpful diagnostic radiographic procedure in small bowel obstruction is:
A. CT of the abdomen. B. Contrast study of the intestine.
C. Supine and erect x-rays of the abdomen. D. Ultrasonography of the abdomen
91. Someone was involved in accident, with trauma on face, the first thing you do in the scene is:
A.Stabilize cervical spine B. Maintain breathing C. Maintain circulation D. Expose
92. All pregnant women are advised to take folic acid supplements (0.4 mg, once daily)

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pre-pregnancy and antenatally. Nonetheless, which of the following groups of women is a dietary
supplementation using a higher dose of folic acid (5 mg once daily) recommended?
A. BMI < 30 B. History of spina bifida in partner’s family
C. Impaired glucose tolerance D. Previous pre-eclampsia
93. A 9 years old patient come with ear pain, red tense tympanic membrane, and negative Rhine's test
with positive Weber test with lateralization (conductive loss) for two days only?
A. Otitis media B. Otosclerosis C. cholesteatoma D. Mastoditis
94. 50 years old male , smock 40 packs / year develop painless ulcer on the lateral border of the tongue
which is rolled in with indurated base and easily bleed what is you diagnosis ?
A. Squamous cell carcinoma B. Aphthous ulcer C. Syphilis D. Candidiasis
95. 70 yrs Old patient presented with Ear pain, headache , hemiparesis, most likely cause:
A. Epidural abscess B. Spinal abscess C. Subd Subdural hematoma D. Epidural hematoma
96. Patient had seasonal runny nose, itching and nasal obstruction, treated many times with broad
spectrum antibiotics. The most EFFECTIVE therapy is:
A. Antibiotics. B. Nasal decongestant. C. Antihistamines. D. Topical Corticosteroids
97. A.3months Child with low-grade fever, wheezing. CXR shows hyperinflation and some infiltrate
what’s the diagnosis?
A. Croup B. Epiglottitis C. Bronchial asthma D. COPD
98. A 69-year-old man has lost a friend to prostate cancer, and would like to be evaluated for the disease.
He has no urinary symptoms. Which of the following tests is most likely indicated to screen him for prostate
cancer?
A. Prostate ultrasound B. digital rectal examination (DRE)
C. DRE and prostate specific antigen (PSA) D. Alkaline phosphatase
99. 24-year-old woman (gravida 1, para 0) at 37 weeks’ gestation was noted to have a 3KG weight gain
and an increase in blood pressure from 120/70 to 145/90 mm Hg in the past week. She also has 1+
proteinuria. The examination was repeated 6 hours later and the same results were obtained. Which of the
following is the best diagnosis?
A. normal pregnancy B. preeclampsia C. eclampsia D. gestational hypertension
100. A Doctor was called to the nursing home to see a 75-year-old man with dementia and severe
pruritus. On examination, he had excoriations over his trunk and limbs. There was some scaling over his
palms, most prominently in the web spaces. Which is the most likely diagnosis?
A.Iron-deficiency anaemia B.Chronic renal failure C.Diabetes
101. The over all importance of learning biostatistics for students to be health care
providers/proffesionals?
A.To assess health status of population B. Health program evaluation C. For planning resources D.All of the
Above
102. What is the ultimate goal of collecting, analyzing and intepritations of data in health sector?
A. To produce relevant information for evidence based decision B.To store measured values in office
C. To save data for mining so that others use it in the future D. None
103. What kind of graphical data summarization is paractically used to present health data that had
contnious numerical variables like hemoglobin, blood glucose level, and the like
A.Pie chart B. Bar chart C. Histogram D. Multiple barchart
104. For the above senario (Q#3), which numerical data summarization/presentation method is better
used
A. Median/intequartile rage B. Mean /IQR C. Mean/standard deviation D. All
105. To collect data on sesetive issues (e.g. how many sexual partner do you have in your life?), which of
the following data collection method better used?
A.Self-administered B. interviewer administered C. telephone call D. Mail/postal
106. If you are given an assignment to study “The impact of culture on food intake of adolecent girls”,
that is to explore some thing unknown about impact of cculture, which questionnaire type better employed to
ivestigate the issue?
A.Structured questionnaire B.Unstructured questionnaire C. all type equaly used D. none
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 Student Name ______________________________________ ID. No. _________________

107. Which of the following indicate the same location in a given data?
A.Median, 1st quartile, 50th percentile, B. Median, 2nd quartile, 50th percentile,
C.Median, 3rd quartile, 75th percentile, D. Median, 1st quartile, 25th percentile,
108. Assume you want to do some study on a population of X district that had two million peoples,
and draw inference. What statistical techniques are very critical to draw statistical inference for X district
population?
A.Sample size B. sampling method C. A and B D. none
109. If you found proportion of TB in some district to be 11% with 95% CI 8 – 13%, Which of the
following district had significantly higher proportion of TB?
A.District with TB proportion 14% B.District with TB proportion 13%C.District with TB proportion 12%
D.All
110. One important purpose of Epidemiology is to identify and apply different levels of disease
prevention. Accordingly, Counseling mothers for good exclusive breast feeding and complementary feeding is,
A.Promotion B. Prevention C. Secondary prevention D. None
111. If you sent to community and report on Epidemiology of a disease say “Epidemiology of Tuberculosis”,
then what is to mean by Epidemiology of TB /what component to be reported/?
A.Person and time distribution of TB B. Geographic distribution of TB
C.Determinants of of TB infection D.All E. None
112. As health profesional, if you asked to study and model the cuasation /causal chain of chronic
degenerative disease like hypertensionand diabetis, which disease causation model better used to model those
diseases?
A.Epidemiologic triad B. Web causation C. Rothman’s model D. All
113. A researcher followed 200 individual on TB treatment to identify risk factors of extremely drug
resistant TB. Ten of them died and 20 developed XDR-TB at 6 months of follow up. Seven lost from follow up
at 9th month. The rest completed 18 months of follow up. What is the total person-months of follow up?
A.2788person-month B.3177person-month C. 2975 person-month D. 3200 person-month
114. What is the incidence rate of XDR-TB (based on the information provided in question 13)?
A.63/10,000person-month B.165/10,000person-month
C.145/10,000person-month D.630/10,000person-month
115. If you are assigned as coordinator of cholera epidemic control team in some area, which technique do
you use to report the problem in the area?
A.Incidence density B. Cumulative incidence C. Point prevalence D. Attack rate
116. Which of the following are sesitive and practical indicators of population health status and health care
service delivery system access and quality?
A.Maternal and infant mortality B.Crude moratality C.Case fatality and cause speccific mortality D.All
117. Suppose you are going to study risk factors of rare disease like cervical cancer (most studies
report 5-8% of women had cervical cancer), what type of study design better used to study such rare disease?
A.Case report B. Case control C. Cross sectional D. A and B
118. In a study to identify cause of night blindness, 30 of 150 under five years children with night
blindness had no any history of vit A supplementation while 40 of 300 under five years children without
night blindness had no history of vit A supplementation. Identify the study design, draw 2x2 table, calculate
measure of association and interpret the result? (show steps)
119. A researcher followed 300 men who chew khat regularly and 400 men who do not chew khat
regularly. After 30 years of follow-up, 30 of the men in the khat chewing group are diagnosed with
impotence while 50 men in the non-chwers group are diagnosed with impotence. Identify the type of study
design and calculate the measure of association. Interpret the result (show important steps)
120. Assume in population of 1,000 people, 100 have a disease, 900 do not have the disease. But,
using screening test 80 of those who had disease and 100 of who do not had disease tested positive. Using
this scenario, construct two by two table and calculate sensitivity, specificity, PVP, PVN and interpret the
result?

9
 Student Name ______________________________________ ID. No. _________________

121. Assume you are a researcher, and you want to study on “HIV vaccine trial”, which sampling
method do you prefer to use?
A.Volunteer B. quota sampling C. stratified sampling D. simple random
122. Consider the following title
“Mangnitude of preterm delivery, treatment outcomes and associated factors among neonates delivered in
Rift Valley Hospital, 2019”. What is wrong with this title?
A.The title is not focused B.Difficult to measure outcome variable.C.Title is not time specific D.All
123. A researcher wants to conduct a research on “magnitude and risk factors of pneumonea among
adult population of X district”. In writing the backgroung section of the proposal what important message
need to be conveyed?
A.Definition related to Pneumonia B.Concepts about nature of Pneumonia among adult population
C.Background statistics of Pneumonia in adult population D.All
124. In the above senario (Q#23), what is the message organized in the statement of the problem
section?
A.Severity of Pneumonia B.Nsequence of Pneumonia C.Factors associted/contributing to Pneumonia
D.All
125. What is the ultimate importance of literature review in writing research proposal?
A.Improve theoretical knowledge of researcher C.Avoid duplication /plagiarism
B.Improve technical/methodological knowledge of researcher D.All
126. For the senario given above Q#23, which of the following could not be specic objective?

A.Magnitude of pneumonea among adult population of X district from June 1-30/2019

B.Risk factors of pneumonea among adult population of X district from June 1-30/2019

C.Treatment outcome of pneumonea among adult population of X district from June 1-30/2019

D.None

127. For the senario given above Q#23, what study design is appropriate?
A.Cross sectional B. Cohort study design C. Case Control D. All
128. For the senario given above Q#23, what sampling method is possibly applicable to generalize the
result for X district?

B.Purposive B. Simple random C. Multistage stratified sampling D. None

129. For the senario given above Q#23, what ethical question is primarily asked?

A.What intervention need to be applied for those identified to have pneumonia

B.Obtaining permision letter from the woreda administrators

C.Interviewing the participant in the village D. None

130. Assume cholera epidemic rumor heard from some district you are assigned as district health
office head. Then, you want to establish epidemic control and prevention team. Who should not be the
member of the team?

A.Woreda administrator B.Community representative C.Microbiologist D,Environmental expert D.None

131. A Health manager and his teamhave been running a project on HIV/AIDS prevention and control
program in AdamiTulluworeda. The program manager wanted to measure the efficiency of their work in the
area. Which of the following best measures the efficiency of theproject?
A.Comparing the achievement of the program with the plan of the project

10
 Student Name ______________________________________ ID. No. _________________

B.Assessing to what extent resource was wisely or properly utilized to achieve the intended objective/goal
C.Involving different stakeholders in the planning process of the project
D.Providing job description to each member of the team before starting the project
132. Suppose Ato Chala is the Deputy Country director of a company. He has an excellent skill in
formulating the vision and mission of his company;what will happen to his company in the coming 10 years
and contextualizing his company with global and other external organizational context. Therefore AtoChala
has an excellent
A.Human skill B. Technical skill C. Conceptual skill D. None
133. It is clear that measuring the degree of severity of problems is among the most important criteria
to prioritize community health and health related problems. Which of the following one can use as tool to
measure the severity of problem?
A.Case fatality rate of the problem B.The prevalence rate of the problem
C.The incidence rate of the problem D.Service utilization and coverage
134. Suppose you are assigned as a Head of a Health center and you are asked to formulate a SMART
objective specifically about child immunization program for this year. Which one of the following can be
considered as a clear, complete and well defined objective?
A.By the end of 2019 75% of children will be immunized for measles in ZewayDugdawereda
B.75% of children will be immunized for measles in ZewayDugdawereda to reduce transmission of
measles
C.Children will be immunized for measles in ZewayDugdawereda to prevent measles epidemics
D.Immunization of children in ZiwayDugdawereda is an important strategy to reduce measles death in
children.
135. You as a Health manager are assigned in remote area of Guji zone. You are new for the area and
you have no data/information about the area. Therefore you faced challenges to develop a plan for the area.
To solve these challenge what are you going to do?
A. Coping the previous plan of the area B.Conducting situational analysis
C.Asking the administrator of the Zone to provide you a plan document D.Doing SWOT analysis
136. Which of the following is wrong statement about lipids?
A. The majority of its digestion takes place in the small intestine
B. Majority of plant source lipids are unsaturated
C. They provide the highest calorie of energy
D. Important for the structural and functional integrity of cell membranes.
E. None
137. High consumption the following lipids increase the risk of getting coronary heart disease and
atherosclerosis with the exception of?
A. High density lipoproteins and poly unsaturated fatty acids
B. Low density lipoproteins
C. Very low density lipoproteins
D. Cholesterol
E. None
138. Select the wrong match of vitamins with their respective deficiency disease
A. Pyridoxine----------------------- Pellagra
B. Thiamin------------------------- Beriberi
C. Vitamin C ---------------------- Scurvy
D. Cobalamin ( vitamin B12)------ Megaloblastic anemia
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 Student Name ______________________________________ ID. No. _________________

E. None
139. Which of the following is wrongstatement?
A. A diet which contain all the essential amino acids are complete proteins
B. High consumption of dietary fibers increases the risk of cancer and cardiac diseases
C. Amylopectin is a polysaccharide starch with straight chain glucose molecules
D. Starch is the most abundant carbohydrate that we get from plants
E. None
140. AtoKebede is a 40 years old adult came to your health center and measured his weight and height.
The weight and height of the person was 80kg and 160cm respectively. What was his BMI in Kg/m 2?
A. 31.5 B. 21.3 C. 0.5 D. 2
141. According to question 10 AtoKebede has
A. Normal BMI B.Underweight C. Obesity D.Chronic under nutrition
142. A 5 years old child came to your clinic with edema on the lower extremities and abdomen up on
inspection it was found that no renal problem was identified on the child. His weight for age found to be
70%. According to the well-come classification of malnutrition which nutritional problem of the child
is___________
A. Marasmus B.Kwashiorkor C.Marasmic- kwash D.Under weight
The total population of a given area was 250,000 in 2018. The total number of birth and death in the area
in the same year were 15000 and 2000 respectively. The total number of female births from the total birth
was 6000. In the same year about 1000 people migrated in to the area and 200 people migrated out of the
area. Based on the these information answer Q 13 and 14

143. What is the net migration of the area

A. 800 B. 1200 C. 1000 D. 20000
144. What is the rate of natural increase in population of the village?
A. 2.3 B. 5.5 C. 3.2 D. 1.5
The national statistical agency of a country conducted population survey of a given nation and identified
the following population pyramid in indicated below. Based on the population pyramid shown below answer
Q15- Q17

145. A population pyramid shown above best describes a population characteristics of ___
A. Uncivilized and Poor countries

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 Student Name ______________________________________ ID. No. _________________

B. Civilized and developed nations

C. Developing and civilizing countries
D. All
146. The population pyramid the country shows
A. There is a rapid population growth in the country
B. There is slow population growthin the country
C. There is negative population growthin the country
D. The population is stationary populationin the country
147. Which of the following best describe the country?
A. It has high fertility rate and high life expectancy
B. It has low fertility rate and high life expectancy
C. Ithas high fertility rate and low life expectancy
D. None
148. One of the following is not direct cause of maternal death?
A. Complications of unsafe abortion
B. Post-partum Hemorrhage
C. Previous anemia which is aggravated during pregnancy
D. Antepartum hemorrhage
E. None
149. One of the following is not counted as maternal death
A. A pregnant mother died due to uterine bleeding during pregnancy
B. A woman died 1hr following delivery due to mismanagement of delivery
C. A woman died due to abortion complications
D. A mother died due to road traffic accident while she was pregnant
E. None
150. All are reproductive health indicators except
A. ANC service utilization rate B.Infant mortality rate C.Neonatal mortality rate
D.Maternal mortality rate E.None
151. Atokebede comes to hospital with sudden onsets of watery, generally painless diarrhea,
(sometimes rice-water like) loss of several liters of isotonic fluid within hours causing hypovolemic shock.
According to the above information which of the following is true
A. Ato kebede has relapsing fever B.Ato kebede has cholera
C. The patient needs immediate fluid replacement D.Only B and C E.Only A and C
152. A patient comes to you with initially an acute on set of fever which increase in a step ladder
fashion, associated with chills, dry cough, myalgia, and poor appetite, rash which start appearing on the face
and gradually goes to the shoulder, chest, abdomen and lower extremities. The most probable diagnosis of
the patient is
A. Malaria B.Typhoid fever C.Relapsing fever D.Meningitis E.ANone

153. A 6 years old child came to you with high grade fever, cough with coryza, red eyes and
generalized body rash which initially starts at the face and runs cephalocaudally. The most possible
diagnosis of the child is
A. Pertussis B.Measles C. Meningitis D.Hepatitis E. Malaria
154. Which of the following is not priority for the current Ethiopian health policy?
A. Information , Education and communication (IEC)
B. Control of communicable diseases
C. Family health mainly maternal and child health
D. Encouraging Health insurance scheme
E. None
155. Among the following one is not a strategy to implement the current health policy of Ethiopia?
A. Centralization of health services to the urban C. Intersectoral collaboration
B. Community participation D. None
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 Student Name ______________________________________ ID. No. _________________

Answer sheet
MODEL LISENCESURE EXAM FOR YEAR- IV PUBLIC HEALTH STUDENTS
1. ____ 21. ____ 41. ____ 61. ____ 81. ____ 101. ____
2. ____ 22. ____ 42. ____ 62. ____ 82. ____ 102. ____
3. ____ 23. ____ 43. ____ 63. ____ 83. ____ 103. ____
4. ____ 24. ____ 44. ____ 64. ____ 84. ____ 104. ____
5. ____ 25. ____ 45. ____ 65. ____ 85. ____ 105. _____
6. ____ 26. ____ 46. ____ 66. ____ 86. ____ 106. _____
7. ____ 27. ____ 47. ____ 67. ____ 87. ____ 107. _____
8. ____ 28. ____ 48. ____ 68. ____ 88. ____ 108. _____
9. ____ 29. ____ 49. ____ 69. ____ 89. ____ 109. _____
10. ____ 30. ____ 50. ____ 70. ____ 90. ____ 110. _____
11. ____ 31. ____ 51. ____ 71. ____ 91. ____ 111. _____
12. ____ 32. ____ 52. ____ 72. ____ 92. ____ 112. _____
13. ____ 33. ____ 53. ____ 73. ____ 93. ____ 113. _____
14. ____ 34. ____ 54. ____ 74. ____ 94. ____ 114. _____
15. ____ 35. ____ 55. ____ 75. ____ 95. ____ 115. _____
16. ____ 36. ____ 56. ____ 76. ____ 96. ____ 116. _____
17. ____ 37. ____ 57. ____ 77. ____ 97. ____ 117. _____
18. ____ 38. ____ 58. ____ 78. ____ 98. ____ 118. _____
19. ____ 39. ____ 59. ____ 79. ____ 99. ____ 119. _____
20. ____ 40. ____ 60. ____ 80. ____ 100. ____ 120. _____
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 Student Name ______________________________________ ID. No. _________________

121. _____ 127. _____ 133. _____ 139. _____ 145. _____ 151. _____
122. _____ 128. _____ 134. _____ 140. _____ 146. _____ 152. _____
123. _____ 129. _____ 135. _____ 141. _____ 147. _____ 153. _____
124. _____ 130. _____ 136. _____ 142. _____ 148. _____ 154. _____
125. _____ 131. _____ 137. _____ 143. _____ 149. _____ 155. _____
126. _____ 132. _____ 138. _____ 144. _____ 150. _____

15