National licensing exam 2011 first round medicine MCQ

1. First line treatment for PID( inpatiant) a. ceftra + metro b. cefotetan +doxy c.ampicillin +
gent
2. Management for CO poisoning
3. PID ( case asking for diagnosis)
4. WHO growth curve
5. What is the age( if the child can wear with help, go upstair ,know his age and gender, feed
himself) a.2yrs b.3yr c.4yr
6. Case asking for acute bacterial rhinosinitus
7. Case asking for PSGN complication
8. Best diagnostic modality for loculeted pleural effusion a.CT b. PA CXR c.lateral CXR d.chest
U/S
9. Dm screening method in pregnant mother a. 50g glucose tolerance test b. 100g po tolerance
test
10. Best time to start fetal survalaince in DM mother a. 26 b.32 c.33 d.36
11. Type of epidemics a. mixed b. propagated c.continues common source d.common source
12. Which study design is best for rare occurance a.cohort b.case control
13. Case control
14. Ulnar shaft fracture + radial head dislocation a.galazzie b.montagia
15. Strangulated SBO( hx suggest SBO + mild tenderness around the umblicas)
16. First management in pt SBO.
17. Gunshot case …protruded Bowel .what is management a. conservative b. explore c. local
exploration under local anesthesia
18. Pelvic trauma …after 4bag of crystalloid still BP <90/60 what is next a.send for CT b. transfuse
whole blood c. more crystalloid
19. 20 yrs old young presented with sudden onset of scrotal pain of 3hrs, cremastiric reflex absent ,
pain exarcabate with elevation what is next a. explore b. send for Doppler c. antibiotics and
analgesic
20. 24 yrsold present with rummy nose, low grade fever , cough ..P/E erythmatous nasal fold . what is
management a. reassurance
21. Complication of parapneumonic effusion.. it was tapped and frunk pus
a. Thocacentesis b. thoracostomy
22. Hx suggestive of Acute pyleonephtritis: U/A leucocyte +ve , nitrite +ve ..antibiotics of choice
a.cephalexin b.cipro c.cotrimoxazole d. amoxicillin
23. Acute otitis media,Antibiotics a.augmentin
24. Case asking Tb lymphadenitis
25. 65yrs old male known asthmatic pt presented with recurrent attack of Right middle lobe
pneumonia … he is alcoholic, he smoke 30 pack yr,
What is the top cuase of his recurrent pneumonia
a. Asthma b. airway obstruction c. immunocompromise
26. 24 yrs old para I on her 4th post op( CS) day presented with sign and symptoms peripartal
infection .. labor stays 28hrs and rupture of membrane is 20hr
What is the single most important cuase of her endomtritis
 a. CS delivery b. prolonged rupture of membrane c. multiple digital exam c. prolonged
labor
27. Cause otitis media in Swimmers
a. Pseudomonas b. S.aureas c.streptoccocos d. E.choli
28. Nasal bleeding from anterior plexus case ….bleeding doesn’t stop after cuatery ..what is next step
A. Anterior nasal Packing b. Embolization c. surgery
29. Stage IIA cervical ca mgt a. radical hysterectomy c. radiation therapy c.
30. 34yrs old women unable to concise for the last 4yrs 1.which investigation you sent first U/S is
normal
a. Follicle stimulating hormone b. progesterone c. salpingohysrogrphy d.CT
31. 50yr old with breast lump …swelling in the right upper outer quadant, involve the skin ..what is
the minimum stage
a.IIIA b. IIB

32. pt with head trauma scalp laceration sutured with lidocaine . What is the earliest sign lidocaine toxixty

A. SEIZERU B. DISOREINTATION C.SLURRED SPEECH D. tongue

33. bilateral submandibular swelling………..luwding angina

34. 50yr old male presented with painless preauricular swelling w/c is mobile,firm ,non tendor

A. PLEOMORFIC PAROTIED ADENOMA B. PAROTID CA C.WARPHir tumor of parotid D.

TUMOR OF THE

PAROTID

35. Case Diabetic retinopathy: w/c needs urgent referral to ophthalmologist

A. Neovascularization B. Retinal aa narrowing C. Hemorrhage D. Occular spoting

36. A 25yr old pt presented with loss of vision 5 days duration BP=170/110mmhg w/c of the ff is save his
vision if managed first

A. controlling sysytemic BP B. decreasing ICP C. Refer to ophthalmologist

37. Case of s.malaria with COMA + p.falcifurum

A. COMA CARE +ARTISUNATE+ANTIBIOTICS

B.COMA CARE+ ARTISUNATE

C. COMA CARE+ QIUNINE

D. COMA CARE+ ARTHEMETER

38. A 12wk pregnant mother wants go to malaria endemic area. w/c prophylaxis you prefer

A. Doxycycline B. Quinine C. chloroquine D. Mafloquine

39. A 9 day neonate surgery was done for meningocele,afer 4 day he presented with bulged

fontanel,incrseaed H.C ,sun set appearance

A. Hydocelaphalus . B. Meningitis

40. 20yrs male pt fall from 10m high ,presente with head CT Showed brain contution. After 4 days he

developed persistent head beside analgesia ,vomiting .P/E no focal neoroligic deficit, he has

bradycardia and irregular respiration

A. ICP B.brain herniation C. Subdural hematoma

41. A 30yr old known RVI pt presented with fever,head ache 15 days duration. CT normal,CD4

100,CSF –opening pressure 200,glucose 20,protein 100,WBC 100. The most likely DX

A. Toxoplasmosis B.Cryptococcus C. Bacterial meningitis

42. Newly RVI DX pregnant 3wks back mother gave birth to neonates , she is on HAART 3wks back

43. a 7 YRS OLD MALE PT partially treated meningitis presented with same complain . CT shows 2x2
enhancing lesion on frontal lobe. What is mgt

A. Cefrtiaone +vaco+metro

B. Ceftra +vanco

44. An 19yr old female presented with the complain of amnorrhea of 2month duration after she got
pregnant from her brothers close friend without her willing. What is legal base to terminate?

A. Rape B Incest C age

45. A60 yr old known hypertensive on HCT and strict diet modification presented to OPD. On PE BP is
159/100mmHg. What is next plan?

A. Increase dose of HCT B. salt restriction same dose of HCT C, HCT +Amilodipine D. Enapril

46. Safety triangle case

47.Case of lefort fructre

48. A45 yr old female presented complaining with failure to close her mouth that occur after yawing.
What is the Dx

A. TMJ dislocation B. Mandibular fracture

49. A 13 day old male neonate presented with right leg and thigh swelling. PE swollen right thigh and leg
with limitation of knee joint. DX
A. septic arthritis B myositis C. Pyomyositis

50. A 20 yr old male pt presented with complain of preiumbilical pain of 4days wich shifted to RLQ later.
He treated with antibiotics .PE 4x5cm firm slightly well demarcated mass

A appendiceal mass B Appendiceal abscess

51.perforated PUD case

52. testiculat torsion Case

52 which is not routine in basic neonatal care

A. suction B, breart feeding, C TTC

53.Neonatal sepsis Case

54. Case of apnea of prematurity

54. Neonatal hypoglycemia with Seizure mgt. Ten percent glucose 4mg/kg then 10% glucose
maintenance

55. A 30yr Fe pt presented with diarrhea vomiting abdominal pain of 20days. Lab Na is 120meq/mol

What is the cause of hyponatremia

A. vomiting B. Diarrhea

56. Lab K 3meq/l what is abnormality

A. hypokalemia B hyponatremimia

57 case of acute pyscotic disorder

58. case of post truomatic depression

59. A25 yr old para II mother who is on levothyroxine presented with hypothyroid symptoms

Lab TSH is 6(high) what is mgt

A. increase levothroxine B. PTU

60.Which antipsychotic drug needs regular TFT checkup

A. Lithium B.Sodium valporiate C. Carbamezapine

61. Side effects of anti depressent

62. Pt presented with tonic clonic sz of right side of the body late involved whole body, loss of
consciousness. What is Dx

A primary seizure B. secndory generalized C. status epilepticus

63.Gardiasis Rx A. Tinidazole B. paromycine

64. pt presented bloody diarrhea + vomiting , S/E: puss cells

what is Rx

a. ORS + cipro b. albendazole c. ORS alone

65. case of brief psychotic disorder
66. Delirium, case
67. Case of vaginal candidiasis .. What is treatment?
68. 34wks pregnant mother come for ANC, no bleeding and other complain. U/S shows placenta previa
Totalis.. plan
a. do CS at 37weeks b.do Cs at 38 weeks c. wait for labor
69. 20yrs old mother comes with pushing down pain,p/E membrane intact, cervix 6cm , contraction
3’10’35’’ what is Dx a. latent b.active first stage c.2nd stage
70. 24yrs old female presented with pushing down pain
P/E on digital examination you palpate mouth and the chin is toward the rectum
What is the presentation
a. mentum anterior face presentation
b. mentum, posterior face presentation
c. mentum anterior brow presentation
d. mentum posteriot brow presentation

71. 20yr old male presented with perianal pain and fever P/E … there tender, indurated mass on the
posterior part of rectum ..what is management

a. I and D b. antibiotic analgesic with close follow up c. Send home with Po antibiotics

72. 3month baby presented with recurrent vomiting, significant weight loss .P/E visible peristalsis with
palpable mass on epigastric area … which investigation do you send first

a. abdominal U/s b. plan abdominal X-ray c. barium enema D.CT

73. 40yrs old presented with abdominal pain and melena .Which of the following the best investigation to
confirm a.sigmodoscopy b. colonoscopy c.CT d. Endoscopy

74. Case DVT in post operative

75. HIV with DVT management

76. Case of CHF….which of the following drug decrease progression of disease in CHF

a. Beta blocker .b. digitalis c. loop diuretics c. calcium channel blockers

77. 7yr old male pt presented with swelling on un erupted upper canines…it was tapped and mucus
content
Management a.mursupilization and follow b. dissimpaction c.enuclation

78. 21yrs ol male pt presented with swelling and pin on the 3rd molar. On exam there un erupted wisdom
teeth ,tender ,swollen .what is management

a.antibiotics , analgesic + follow up

79. Drug reaction case ( see type of drug reaction like fixed drug reaction, TEN, Erythema multiforme )

80. case of cervical insufficiency

81. the neonate borned at 32weks and wt 900g …diagnosis

a. preterm + extremely very low birth weight

 National Licensing Exam for Med - second round November, 2012 E.C

SECOND ROUND COC EXAM FOR MEDICAL STUDENTS

NOVEMBER, 2012

“’MED STAR 6”’

“’MED STAR 6”’

ARBAMINCH UNIVERSITY “’MED STAR 6”’ 1

 National Licensing Exam for Med - second round November, 2012 E.C

1. A 9 month old infant presented with execive crying, bloody diarrhea, abdominal distention and
swelling, at health center given cotri and ors and no improvement... Dx

A. Idiopathic intussusception

B. Intussusception with mekel diverticulitis

C. Intussusception with polyp

D. Intussusception with lymphoma

Part 2

2. Appropriate time for Hepatitis Immunoglobulin for newborn

A. 72 hrs

B. 12Hrs

C. 1 hrs

D. 24hrs

3. which of the following confirm Dx of CML

A. Philadelphia chromosome

B. aures rod

C.***

4. about Tx of neonatal menigitis..

5. 11yr old male child who presented with 8month duration of progressive hoarseness of voice, difficulty
of breathing and hx of decrease air entry, on indirect laryngoscopy there is strawberry soft tissue lesion
on vocal cord

A. laryngeal papilloma

B. laryngeal carcinoma

C. laryngeal Web

D. laryngocele

6. 40 years old Patient with POP, a physician wants to see the maximum protrusion of the mass, what
position is preferred

A. Lying on her back

B. Trendelburg

C. Left lateral

D. standing

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 National Licensing Exam for Med - second round November, 2012 E.C

7. female pt referred from health center after presented with cc of dyspnea. All P/E, cxr and Echo are
normal, what investigation rule out heart failure

A, d dimer

B, c reactive protein

C, Cardiac troponin

D, natriuretic peptide

8. pregnant mother presented with urine frequency, dysuria on urine analysis pyuria and on culture no
organism

What is the causative agent?

A. E. coli

B. Proteus

C. Kleibsella pneum

D. Chl.trochamitis

9. 10 years old child come to ER complaining SOB, no history of fever. WBC 7000/ml with 40 so2 85
percent neutrophils HGB 25 mg/dl PLT 600,000, what is the best management

A. Give INo2

B. Phlebotomy with N/S

C. Partial volume Transfusion

D. Antibiotics

10. A 45 yrs old male pt was presented with a complint of dyspnea on minimal exertion and cough
productive of tenacious sputum. He has sneezing and hx of allergy. He has smoked for 30 pack yrs. The
GP had difficulty to differentiate b/n Asthma and COPD, what favors dx of COPD.

A. Seasonal variation of z symptoms.

B. marked response to bronchodilator.

C. lung function after bronchodilator FEV/FVC<70.

D. marked response to prednisolone for 2 weeks duration

11. couples came to gyn OPD for a compliant of failure to conceive of 2yr duration. z female has prior
hx. of STI txt 1yr back. z husband semen analysis is normal. wat is best next Ix modality for z girl...

A. estrogen.

B. hysterosalphingography

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 National Licensing Exam for Med - second round November, 2012 E.C

C. progesterone.

12. 70 yrs man with tinnitus, vertigo and easy fatigability was admitted and transfused with 3 unit blood
for severe anemia overnight and then he develop distress and irritability, on CXR he has peripheral
haziness &...

Whats the likely Diagnosis...

A. ARDS

B. acute lung injury

C. volume overload

D.....

13. A 55year old known Parkinson's disease on medication presented with lower abdominal pain and
failure to pass feaces and flatus of one day duration...most likely DX

A SBO

B, oglives syndrome

B LBO

Part – I

14. A 67 year old male patient on his seventh post op day after right hemicolectomy plus ileotransverse
anastomosis done who has been on ceftriaxone 1gm IV BID and metronidazole 500 mg IV TID developed
fever, diarrhea and abdominal distension. What is the initial step in managing this patient?

A) Stop ceftriaxone and metronidazole

B) Obtain abdominal ultrasound

C) Do stool culture

D) Provide loperamide

15. Patient diagnosed with TB meningitis treated with antitb and steroid for three weeks. what most
likely complication is anticipated

A, hypernatremia

B, hydrocephalus

C, hypokalemia

D, brain abscess

16. 75 yrs old male pt presented with bloody vomiting of 24 hrs duration his vs at presentation bp 60/30
pr 110 rr 25 t 37 he was resussusutated with NS, catheterized, NG tube inserted, transfused. his V/S

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 National Licensing Exam for Med - second round November, 2012 E.C

become BP 90/60 PR 100 RR 20 has adequet UOP. endoscopy done shows clean base ulcer with visible
blood vessel at pasterior part of first part of doudneum.whatis the most appropriate next step mangit

A. high dose ppi infusion

B. emergency laparatomy

C. close observation at hospital

D. do emergency upper gi endoscopy

17. 32 yrs old female pt comes to derma opd comlaining rash wich occurs after she take self prescribed
po medication for her respiratory symptom. the rash is erythematous maculopapular. which one is most
likely drug she took.

A. ampicillin

b. diclofenac

c. metronidazole

d. bisacodyl

18. 45 yrs old , an epileptic pt presented wz productive cough, Low grade fever, with poor epilepsy
control.... chest normal, x-ray multiple cavities and air fluid level..... wc one is choice of AB..

A, Clindamycin

B, ceftra

C, metro

D, penicillin G

19. 33-A 4day neonate present with failure to pass meconium and abdominal distension, he urinate a
clear urine which is multiple time, he has features of down syndrome, no anal opening, Dx?

A, imperforate Anus with no fistulas

B, Imperforate Anus with rectovestublar fistula

C, Imperforate Anus with rectovaginal fistula

D, Imperforate Anus with perianal fistula

20. G4p3 mother with pushing down pain of 6hr duration, cervix-6cm, station -1 after 4hr evaluations
cervix still 6cm, station 0. dx?

A, protracted cervical dilatation

B, Arrest of Cervical dilatation

C, protracted descent

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 National Licensing Exam for Med - second round November, 2012 E.C

D, Arrest of descent

Part two

21. 4 Yrs old male child presented wiz new onset of shortness of breath. He has no hx of body swelling,
fever, chills. On examination he has clubbing, cyanosis wiz saturation of 80% at atmospheric pressure.
He has follow up for congenital heart disease. Lab result is wbc-7000 wiz N-70 %, Hg-25mg/dl, wiz Mcv -
71fl,

Which of z following is z best management

A, starting 5mg/kg of iron

B, phlebotomy

C, put on INO2

D,

22. A four yr old male child was brought by his mother with a compliant of decrease hearing

Of voice of four days duration. the mother also told that her child has snoring and opening of mouth
during night time for the past two years. on otoscopic examination there is dull, red bulged tympanic
membrane bilaterally. What is the diagnosis for this patient ????

(A) Chronic otitis media

(B) Acute otitis media

(C) Choleasteatoma

(D) Glue ear

23. A 60 yr old known hypertensive and type 2 diabetic who was on antihypertensive and oral
hypoglycemia agent presented with progressive decrement of his visual function.

Of the following one is LEAST likely cause of his visual impairment???

(A) Cataract

(B) Glaucoma

(C) Maculear degeneration

(D) Hypertensive retinopathy

24. A three yr old male child was presented with in 15 minute after a single episode of tonic clonic
seizure, on examination T-38.4'c and runny nose. CSF analysis was done with protein of 35mg/dl with no
cell seen. What is the most likely diagnosis?

(A) Febrile seizure

(B) Encephalitis

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 National Licensing Exam for Med - second round November, 2012 E.C

(C) Meningitis

(D) Malaria

25. 3 yr old male child with weight for height less than -3 SD. most likely diagnosis

A) SAM

B) MAM

C) ……

26. A 23yr old female patient presented with inability to open mouth.14 yr back he had history of facial
trauma where he was not treated promptly. he had also characteristic bird's eye appearance

What is the most likely in this patient??

(A) TMJ subluxation

(B) TMJ ankyloses

(C) Myofacial pain syndrome

(D) TMJ dislocation

27. A post partuem women was reffered from district hospital after 15hr labor. then after 1hr of delivery
she develope PR-120, BP-70/50, GCS-15/15. What is most likely

(A) Eclampsia

(B) Syncopal attack

(C) PPH

(D)

28. A 10yr old female child presented with itchy crusted scaly skin lesion over the head. she had also
history of lymphadenopathy over the neck. The most likely diagnosis

(A) Black dot tinea captis

(B) Gray patch tinea captis

(C) Superinfected tinea captis

(D) Superinfected S.dermatitis

29. HIV positive patient while he was in the ward he develops shortness of breath and cough. he also
develops violaceous papule, macule, plaque, vesicle. What is most likely diagnosis??

(A) Histoplasmosis

(B) Kaposi sarcoma

(C) M.tuberculosis

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 National Licensing Exam for Med - second round November, 2012 E.C

(D) Avium mycobacteria infection

30. A three years old lady presented with white spots on the eye. he had also leukoria, strabismus.....

(A) PVPV

(B) Cataract

(C) Coats disease

(D) Retinoblastoma

31. A girl took self-prescribed drug. For her URTI... and presented with maculo papular rash on her
body...most probable drug is...?

A. aspirin
B. diclofenac
C. Ampicillin
D. Metronidazole

32. a 36 years old female pt with congenital nevus on her eye lid recently noticed increment in size and
irregular border.

What malignancy may arise from this lesion

A, marjolin'$ ulcer

B, squamous cc

C, malignant melanoma

D, me......

33. a 28 years old primigravida mother peresented to center of labor and delivery with pushing down
pain of 12 hours, on P/E vital signs are in normal range, 38 weeks garavid uterus, cervix is 6 centimeter,
grade 1 Meconium and being followed by parthograph after 4 hour on PV cervix is still 6 cm, grade 3
molding, and Excessive caput

What is the DX and next mng.t

A, protracted cx dilatation and

B, CPD and c/s

C, arrest of CX dilatation and augmentation

D, arrest of CX dilatation n c/s

34. A 30 yr old p5 mother was reffered from health center who had a diagnosis of polyhydraminos
antenatally after 0ne hr of delivery at which time she develops vaginal bleeding.

The most likely cause of her presentation??

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 National Licensing Exam for Med - second round November, 2012 E.C

A. Cervical tear

B. Uterine atony

C. polyp

35. 34 year old G-III P-II mother from rural area present at GA of 44 weeks from LNMP. GA from obs U/S
36 weeks with RBPP. What is most likely cause for the discrepancy in GA?

A) Male sex

B) wrong dating

C) multiparity

D) Previous history

36. Child on 3rd day of antibiotics for pneumonia. Still febrile, dullness on percussion and decreased air
entry, anticipated complication.

A, lung abscess

B, empyema

C, pneumothorax

37. mother on coc.. . Havin discomfort..mild symptoms..mgt?

A, switch TO...

B, Stop...

C, tx mild sx......

38. 65 years old male pt presented with a c/c of loin pain and hematurea of 2 weeks duration. V/S BP
160/110, PR 86, T 37.9 U/A;- blood, S/E;- hypocalcemia. Best Dxs is?

A, Pyelonephritis

B, Renal cell Carcinoma

C, Renal failure

thanks to all the AMU Medical Graduates of

2012 E.C who participated in collecting this
Questions. Specially Dr. H. A. and
MEMBERS OF DORM NO-09, BLOCK-303
H@nke 2012
GOD BLESS ETHIOPIA!

ARBAMINCH UNIVERSITY “’MED STAR 6”’ 9

National Licensing Exam – Medicine, 2019 G.C

``XANTHRONS” – St. Paul’s Class of 2019

1. A pt in minor OR given LA-lidocaine. In which system is the earliest complication (Toxicity)

seen? A. GIT B. CVS C. CNS
2. A mother of 2 yrs old male child notices the absence of Rt testis in the scrotum and she
brought him to the hospital. Upon examination he has an inguinal Rt testis which descend to the
scrotum up on manipulation. Dx?
A. Undescended testis B. Retractile testis
3. A case of perforated PUD (Hx & PE). What is the best initial step in approaching this pt?
A. Erect chest x-ray B. Resuscitate with Ns C. Take the pt to OR
4. A case of breast abscess in a lactating mother. Dx?
5. A pt presented to u with a compliant of sensory loss in the superiomedial aspect of the thigh
after he had Bassini inguinal hernia repair. Which nerve was injured during the surgery?
A. Genital branch of genitofemoral nerve B. Femoral bran of genitofemoral nerve

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National Licensing Exam – Medicine, 2019 G.C

6. A case of internal hemorrhoid. Dx ?

7. A pt came to u after he sustained RTA of 2 hrs back and sustained injury to his head. The pt is
conscious with stable V/S and scalp laceration. Immediately after admission, he deteriorates with
GCS - 1 0/1 5 and hemiparesis. Dx ? A. AEDH B. ASDH C. SAH
8. Which one of the f.f is true about x-ray features of SBO?
A. Valvulae conventies B. Haustral markings C. Coffe bean appearance...
9. A pt started to have carpopedal spasm after he had undergone thyriodectomy. Which of the
f.f signs will elicit this? A. Trousser's sign B.
10. A case of Neonatal sepsis. How would u like to manage this ( ampi and Genta - route, dose,
frequancy and duration)
11. A 7 days old preterm neonate admitted to NICU and after 3rd day of admission V/S -
tachycardic, tachypenic and started to develop abdominal distension, hypertympanic to
percussion. CBC; WBC - 1,200, Plt-100,000. What is the most likely dx?
A. HAI B. NEC C. Sepsis
12. A 9 yrs old male child presented with easy fatigability of one month duration. Otherwise he
has no melena, or any bleeding. His dad claims that he has an optimal nutrition. Hgb- 7 g/dl.
What Ix would you like to send? A. Occult stool exam
13. A 2 yrs old child with coarse face, unable to speak and umbilical hernia. What initial Ix
would u like to send for this pt? A. Cortisol B. TSH & T 4
14. A child with signs of raised ICP. What is the dose of mannitol that you will order (it doesn't
specify; loading vs maintenance)? A. 0.25-0.5 g/kg B. 0.5-1 C. 1-2
15. A 12 months old infant with anthropometric measurement of WFL, LFA and HC for age in
Z-score results were mentioned. What is the interpretation respectively?
A. Moderate wasting, Severe stunting, Microcephaly
16. A neonate born from a mother with BG- A neg. The newborn presented with jaundice with
D-bilirubin of 1 8 mg/dl with BG-B positive. What is the cause of hyperbilirubinemia?
A. ABO incompatibility B. Rh incompatibility

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National Licensing Exam – Medicine, 2019 G.C

17. The earliest time to diagnose RVI in RVI exposed infant with Ix modality.
A. Antibody test 6th week
B. DNA test at 6th week
C. Antibody test at 9 month
D. Antibody test at 1 8 month
18. A case of RVI exposed neonate. How would you like to manage this neonate?
19. A 5 yrs old child dx with DM with DKA and currently he is out of DKA & u r planning to
discharge him. By how much dose of insulin r u going to discharge him?
A. 0.25-0.5 u/kg/day B. 0.5-0.75 C. 1-1.2
20. A 5 yrs old child presented with sudden onset cough and SOB while he was playing at
school. What is ur dx? A. Bronchiolitis B. Asthma
21. Which one of the f.f are components of Basic newborn care?
22. Case - a newborn who is unable to cry immediately after delivery. True about neonatal
resuscitation steps?
23. A case about preterm feeding
24. A pt who was taking phenobarbital for seizure d/o currently came to you for follow-up. She
has no seizure for the last 8 years. What is the next best step in the mgt of this pt?
A. Discontinue phenobarb B. Taper phenobarb C. Continue same mgt
25. A pt came to u with abnormal body movement (tonic-clonic type) on one side of the body
which subsequently involves the whole body. In which class of seizure d/o do u categorize this
pt? A. GTC B. complex partial seizure C.
26. A case of CNS toxoplasmosis. Dose & duration of Rx- cotrimoxazole?
27. Type of anemia on a pt with an Ix; Hgb-9, mcv-73, mch- 24 and RDW- 15. Dose & duration
of Rx with iron?
28. A pt with CKD have Hgb-6 and symptoms of anemia. How do you manage it?
A. Erythropoietin B. Fe C. Blood transfusion
29. A woman from rural area presented with massive bleeding per mouth of 1 day duration. No
other pertinent hx. Hgb-8 g/dl. What is the most likely dx?
A. Variceal bleed B. Leech infestation C. PUD

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National Licensing Exam – Medicine, 2019 G.C

30. A pt who was Rted for T. Corporis long time ago currently dx with RVI and initiated with
HAART for the last 3 weeks but the skin lesion worsen. What is the next step in the mgt of this
pt?
A. Stop ART
B. Start antifungal
C. Start new regimen of ART
31. Case-IE : 25 yrs old pt with fever, hematuria, splenomegaly. What is the dx?
32. A pt with uncrossed hemiplegia comes to u with sudden onset focal neurologic deficit. What
Ix will u send to confirm your dx?
A. Brain CT scan B. Brain CT with contrast D. Brain MRI
33. A case of sagittal sinus thrombosis. Best Ix modality?
A. MRI angiography B. MRI venography C. Brain CT with contrast
34. A pt with rheumatoid arthritis on NSAIDs for 2 years currently presented with decreased
UOP and raised cr. What is the possible mechanism?
A. Tubular necrosis B. Impaired renal autoregulation
35. A case about portal hypertension causes.
36. A case of cirrhotic ascites. How would you like to manage?
37. A case of RVI. When do we say treatment failure and how to manage it?
38. A 60 yrs old patient presented with sudden onset of heaviness in the chest and
diaphoresis, no hx of HTN, DM; ECG- showed ST- segment depression on lead…, RBS-174.
What is the initial best management option? A. Give insulin B. Aspirin...
39. A case about nerve injury (nerve supplying Achilles tendon). We were given clinical features
and asked the nerve?
40. A spinal nerve root responsible for knee reflex? A. L-4 B...
41. A sero neg pt with sx & symptom of meningitis (no evidence of raised ICP was mentioned).
Then the intern did LP and subsequently the pt deteriorate. What is the possible cause of
sudden deterioration?
A. Brain herniation.... B. The Intern was not focusing b/c he was thinking about strike
42. Which of the following results of pleural fluid analysis necessitate insertion of chest tube in
a pt with pleural effussion? A. PH>7.4 B. ...

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43. A pt who was on anticoagulant-warfarin, currently came to OPD for follow-up with
coagulation profile; INR-5, no bleeding compliant. What is the best initial step of mgt?
A. Hold warfarin & send INR B. Give vit K C. Continue same mgt
44. A case of Horner's syndrome with ptosis, dry face and miosis. Dx?
45. A PG lady with GA-1 2 weeks who is a known type-I DM pt came to u for ANC follow-up.
In which category of focused ANC should she be classed?
A. Low risk B. Basic C. Specialized D. High risk
46. A 22 yrs old lady who had 2 ex-sexual partners currently presented with Vx discharge.
Currently she has a smoker boyfriend and she is taking OCP. What is the most important risk
factor for STI in this pt?
A. Having smoker boyfriend B. Multiple sexual partner C. OCP
47. A PG lady with GA 30 weeks presented with RUQ pain and urine protien +2. What is the
dx? A. Preclampsia B. severe GHTN .....
48. MG with GDM at 39 weeks of gestation. Her FBS-169 mg/dl. What is the best option of
mgt?
A. Immediate Induction B. Push the px till 40 weeks C. Do an immediate Cs
49. A PG lady with GA-30 weeks came to u with anterior neck sweling and toxic symptoms. Ix
TSH-0.03, low; T4-11, high. How do u manage this pt?
A. Lugol's Iodine B. Diazepam C. PTU D. Thyroxin
50. A case of AUB. Dx and mgt?
51. Diagnosis and management of normal and abnormal labor(4/5 qns)
52. A case of bipolar-I d/o. Dx? A. BP-I B. Cyclothymia
53. A case of MDD d/o Dx? A. Persistent DD B. Dysthymia
54. A case of anxiety d/o for a pt who presented with excessive fearfullness in gathering
activities. How would u like to manage it? A. BDZ B.
55. A case of ADHD (Attention deficit Hyperactive disorder). Dx?
56. Case upon psychiatric interview the physician said ' I understand that u have suffered a lot'.
What does the physician felt to his pt? A. Empathy B. sympathy...

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57. In a country who has 372 maternal deaths in a year. In the same year, there were 1 00,000
live births and 2500 stillbirths. If there were no pregnancy, how many of maternal deaths can be
prevented? A. 372/1 00,000 B.
58. Doubling time of population growth in a country with CBR - 50/1000 and CDR - 12/1 000,
no migration or immigration.
59. A case of Ludwig’s angina. Dx?
60. A case of pericoronitis. Dx?
61. A case of parotid tumor (malignant one). What to do at first encounter (as GP)?
A. Referral to specialist B. Do excisional biopsy C. Do incisional biopsy
62. A case of Basal cell carcinoma- wound with delayed healing and with irregular margin and
raised. Dx? A. BCC B. SCC
63. About localized cutaneous leshimaniasis on Rx with an intralesional antimonial but doesn’t
respond to it. What is the next option of mgt?
64. A case of Leprosy. Rx?
65. A case about Irritant vs allergic contact dermatitis. Dx?
66. A case of Psoriasis. Dx?
67. A case of T.versicolor, pityriasis. Dx?
68. Fall down accident which result in injury to his eyes….initial best mgt (there were 4 or 5
similar trauma related qns…focusing on best initial mgt options)
69. A case assessing about types of conjunctivitis.
70. A case of chronic otitis media with an ear discharge. Dx?

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