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

SECOND ROUND COC EXAM FOR MEDICAL STUDENTS

NOVEMBER, 2012

“’MED STAR 6”’

“’MED STAR 6”’

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 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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(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