Researchers prospectively follow a group of 100 vegetarians and 200 non-vegetarians.

After
30 years of follow-up, 8 of the vegetarians and 20 of the non-vegetarians develop heart
disease. The 95% confidence interval on the relative risk of 0.8 ranges from 0.6 to 0.9.
A. Vegetarians were 80% less likely to develop heart disease during 30 years of follow-up
compared to non-vegetarians.
B. The researchers should have calculated an odds ratio rather than a relative risk.
C. The relative risk of 0.8 is not statistically significant as the 95% confidence interval
contains the value 0.8.
D. Vegetarians were 20% less likely to develop heart disease during 30 years of follow-up
compared to non-vegetarians.
ANSWER: D

Which of the following is not true about propagated/Progressive epidemics?

A. Occur as a result of transmission from one person to another
B. Lasts for more than one incubation period
C. Cases develop within one incubation period
D. Epidemic curve-initial slow rise, succession of several peaks and usually sharp fall
ANSWER: C

In an intervention study which of the following is a good strategy for dealing with confounding
when no limitation exists with the number of people available for the study?
A. Matching
B. Randomization
C. Restriction
D. Blinding
ANSWER: B

One of the following threats to study validity can be minimized by increasing the precision of
measurement
A. Chance
B. Selection bias
C. Information bias
D. Confounding
ANSWER: A

Which of the following is not a key feature of a high quality clinical trial?
A. Analysis by intention to treat
B. Triple blinding of allocation arms
C. Randomization to intervention or control
D. Use of placebo
ANSWER: D

The essential difference between ecological study and cross-sectional study is that in
ecological study:
A. The study population is matched
B. Data is collected prospectively
C. Data is collected from groups
D. The investigator determines the study area
ANSWER: C

If the Ministry of Health receive a large quantity of new drug that cures AIDS and use that for
two years in Hossana, which of the following may occur in Hossana?
A. Prevalence of the disease will increase
B. Incidence and prevalence of the disease may decrease
C. Prevalence of the disease will remain the same
D. Incidence of the disease will increase
ANSWER: B
Five published case control studies produce the following odds ratios: 1.5 (95%CI: 0.9, 2.4),
1.8(95%CI: 0.9, 2.9), 1.5(95%CI: 0.9, 1.7), 2.0(95%CI: 1.0, 2.8), and 1.0(95%CI: 0.7, 1.3). Choose
the best appropriate criterion for establishing a causal relationship that can be assessed
using these studies.
A. Strength of association
B. Biologic plausibility
C. Dose-response relationship
D. Consistency of results
ANSWER: D

Which of the following relative risk shows a significant harmful association?

A. RR=2.6 (0.5, 4.5)
B. RR=2.6 (1.5, 4.5)
C. RR=0.6 (0.3, 0.9)
D. RR=9.6 (0.8, 17.5)
ANSWER: B

Identify the measure of strength from the following

A. Attributable risk
B. Disease specific mortality
C. Incidence density
D. Relative risk
ANSWER: D

Distortion of the estimated effect of an exposure on an outcome, caused by the presence of

an extraneous factor associated both with the exposure and the outcome:
A. Effect modification
B. Independent variable
C. Confounding
D. Interaction
ANSWER: C

Which of the following is correct about possible outcomes in studying the relationship?
A. Relative risk =0 shows Positive association between exposure and disease
B. Attributable risk =1 shows no association between exposure and disease
C. Relative risk > 1 shows positive association between exposure and disease
D. Odds ratio <1 shows positive association between exposure and disease
ANSWER: C

The ability of the test to separate those who have the condition sought from those who do
not is:
A. Reliability
B. Validity
C. Reproducibility
D. Repeatability
ANSWER: B

Which one of the following is SMART objective?

A) To assess predictors of preoperative anxiety among surgical patients in NEMMH, 2017
B) To assess predictors of preoperative anxiety among surgical patients in NEMMH, July 10-
20, 2017
C) To assess predictors of preoperative anxiety among surgical patients, 2017
D) To assess predictors of preoperative anxiety among surgical patients in NEMMH, 2017
ANSWER: B

A researcher selected the study participants based on their exposure status of the outcome
variable. What type of study design is appropriate study
A. Case control
B. Cohort
C. Comparative cross-sectional study
D. Randomized Clinical trial
ANSWER: B

Which one of the following is the limitation of a case control study design?
A. Is inefficient for the evaluation of rare exposures
B. Is inefficient for the evaluation of rare diseases
C. Is efficient for the evaluation of rare exposures
D. Validity of the results can be seriously affected by losses to follow-up
ANSWER: A

A probability sampling is best when the sample size is small

A. Simple random sampling
B. Systematic random sampling
C. Quota sampling
D. Multistage sampling
ANSWER: A

A non-probability sampling technique used when the researcher is interested in sensitive or

hidden population:
A. Snowball sampling
B. Convenience sampling
C. Quota sampling
D. Purposive sampling
ANSWER: A

If sampling interval, K=4 from 20 students in the class, if a researcher is interested to take
only five students. Which one of the following is not included in the study from the list
A. 1,5,9,13,17
B. 3,7,11, 15,19
C. 1,3,7,11, 15
D. 4,8,12,16,20
ANSWER: C

All subjects in any research project should always be told the truth is the ethical rule of---
A. Veracity
B. Fidelity
C. Privacy
D. Confidentiality
ANSWER: A

Which one of the following is not included in writing of a research report?

A. Title and cover page
B. Methods and materials
C. Work plan
D. References
ANSWER: C

Which one of the following is not included in writing of proposal?

A. Methodology
B. Discussion
C. Objective/s
D. Significance of the study
ANSWER: B
Keeping our promises and avoiding negligence with information is the ethical rule of –
A. Veracity
B. Fidelity
C. Privacy
D. Confidentiality
ANSWER: B

Data collection method inappropriate for qualitative research is:

A. Self-administered questionnaire
B. Focus group discussion
C. In-depth interview
D. Observation
ANSWER: A

In research the first and foremost step is

A. Defining objective
B. Defining research problem
C. Selecting appropriate study design
D. Deciding on reference population
ANSWER: B

One of the following data collection methods is dependent on the educational level of the
respondent
A. Self-administered questionnaire
B. Highly structured interview
C. Direct personal observation
D. Abstracting from already existing document
ANSWER: A

Which of the following is true about sample size?

A. A sample size is possible to be more than the number of the source population
B. Sample size is the highest number we can use for data collection
C. Sample size is not important to reduce our cost for collecting the whole population
D. Data that was collected from sample will be generalized for the sample population
ANSWER: B

A 17-week pregnant women come to the ANC clinic with a complaint of slight vaginal
bleeding. She also has lower abdominal cramps and backache: on physical examination, her
BP is 110/60 mmHg, and she has a mild uterine contraction, closed cervix, and intact
membrane. What is the most likely diagnosis of the woman’s condition?
A. Incomplete abortion
B. Missed abortion
C. Threatened abortion
D. Inevitable abortion
ANSWER: C

According to WHO Classification, Adolescents are

A. 15-24 years old
B. 10-25 years old
C. 20-25 years old
D. 10-19 years old
ANSWER: D

The criteria for Lactational ammenorhea(LAM) are:

A. Fully or nearly BF, less than 6 months postpartum, menses not yet returned and baby is
fully or nearly fully breastfed and is fed often, day and night
B. Fully or nearly BF, less than 6 months postpartum, menses not yet returned and baby still
feeds at least once during the day
C. Fully or nearly BF, less than 4 months postpartum, menses not yet returned and baby is
fully or nearly fully breastfed and is fed often, day and night
D. Fully or nearly BF infant who is 6 weeks or less
ANSWER: A

Which one is correct about the clinical manifestation of primary syphilis?

A. The average incubation period is 3weeks
B. Chancroid is the typical lesion manifested during primary syphilis
C. Chancre at a late stage is characterized by maculo-papular lesion
D. Chancre at the early stage is clean based, painless and indurated ulcer
ANSWER: D

Surgical Method of contraception

A. It involves surgical procedures to remove testicles/ fallopian tube
B. It is permanent method of contraception done both for men and women
C. They prevent transmission of STIs, including HIV
D. They do affect sexual function and sexual drive
ANSWER: B

Which one is true about Emergency Contraception?

A. It prevents possible unwanted pregnancy from unprotected intercourse
B. It increase needs for abortion
C. ECPs can be used by women in the first five days following unprotected sex
D. They do affect sexual function and sexual drive
ANSWER: A

Safe mother initiative was the program that initiated in Nairobi in 1987 to half maternal
mortality by year 2000. All of the following are components of this initiative except,
A. Safe and clean delivery
B. Safe postnatal care
C. Family planning
D. Intensive neonatal care
ANSWER: D

Which one is wrong about basic emergency obstetric care?

A. Provided at the health center level.
B. The care should include parenteral antibiotics.
C. Manual removal of placenta is done when necessary.
D. Obstetric Surgery has to be included
ANSWER: D

Which one is wrong about reproductive tract infections?

A. STIs are Infections transmitted through sexual activity with an infected partner
B. Iatrogenic infections get into the reproductive tract by clinical procedure
C. Endogenous infections are contracted from unsterilized instruments
D. Endogenous infections are those resulting from normal flora found in the vagina
ANSWER: C

Young people tend to be at higher risk of contracting STIs/HIV/AIDS, because of

A. Intercourse often is unplanned or unwanted.
B. Often do not plan for condom or other contraceptive use.
C. The immaturity of their reproductive system.
D. Little knowledge of STIs
ANSWER: C
All are the leadership practices except
A. Inspiring
B. Focusing
C. Scanning
D. Implementing
ANSWER: D

The gap between the current health of a population and an ideal scenario where everyone
complete their full life expectancy in full health is
A. Marginal cost
B. Measure of disease
C. Burden of disease
D. Cost analysis
ANSWER: C

Which of the following is incorrect regarding health insurance

A. Offers a more predictable source of funding for health
B. Allows for cross-subsidies
C. Increase access to quality health care
D. Lead to impoverishment as a consequence prepayment
ANSWER: D

Smoking results in adverse effects not only on the health of a smoker but also on the health
of other people. This is an example of
A. Negative consumption externalities
B. Negative production externalities
C. Positive consumption externalities
D. Positive production externalities
ANSWER: A

A health center manager notices that childhood immunization rates in their catchment area
have been declining over the past few months. To improve effectiveness, the manager sets
an objective to increase immunization coverage by 10% in the next quarter. They plan
activities like immunization drives and home visits by health workers to achieve this goal.
This demonstrates the principle of
A. Management by objectives
B. Unity of command
C. Delegation
D. Efficiency
ANSWER: A

A hospital administrator realizes that energy costs for the facility have shot up in the past
year. To promote economy of scarce resources, they decide to switch to energy-efficient LED
lighting and optimize the heating/cooling schedule to reduce electricity usage. This is an
example of
A. Effectiveness
B. Economy of scarce resources
C. Substitution of resources
D. Efficiency
ANSWER: C

The head of a public health department conducts monthly reviews of performance statistics
for disease prevention programs. By periodically evaluating the gap between program
objectives and actual achievements, they are able to identify issues and improve activities.
This illustrates the principle of
A. Management by exception
B. Short decision path
C. Learning from experience
D. Convergence of work
ANSWER: C

Which one is not true about supply curve

A. Slopes downward from left to right
B. The price of the good is independent variable
C. Quantity supply shown on horizontal axis
D. As a price of a product increase the quantity supplied increase
ANSWER: A

The situation when quantity supplied equals quantity demanded at a particular price is known
as
A. Perfect competition
B. Elasticity
C. Market Equilibrium
D. Supply schedule
ANSWER: C

Which of the following is traditionally main source of finance for health in developing
countries
A. National health service system
B. Health insurance
C. Direct purchase by consumers
D. Payroll taxes
ANSWER: A

All of the following factors of demand cause a shift in an entire demand curve, except
A. Test of consumer
B. Preferences of a good
C. Income of a consumer
D. The prices a good
ANSWER: D

The most comprehensive and theoretically sound form of economic evaluation is:
A. Cost effectiveness analysis
B. Cost utility analysis
C. Cost benefit analysis
D. Cost minimization analysis
ANSWER: C

Which of the following is an example of a positive economics?

A. Business firms ought to contribute more to charities.
B. Government should not redistribute income.
C. The foreign sector should be tightly controlled.
D. Aid and donations are the primary source of Ethiopia healthcare financing.
ANSWER: D

“Lower the price, greater the quantity demanded, keeping the other factors constant”. This
inverse relationship is called
A. Scarcity
B. The law of demand
C. The law of supply
D. Supply schedule
ANSWER: B

What does unity of command mean?

A. Using a centralized hierarchy
B. Receiving orders from one manager
C. Standardizing procedures
D. Having a clear organizational structure
ANSWER: B

Case scenario: You are a physician leading a team of medical residents. One of the residents
on your team is highly knowledgeable and skilled in their area of specialty. Other residents on
your team frequently seek this resident's advice on complex medical cases. Question: Which
type of power is the resident demonstrating in this scenario?
A. Legitimate power
B. Expert power
C. Coercive power
D. Reward power
ANSWER: B

Which style of leadership is characterized by a hierarchical structure, where the leader makes
all decisions without input from their team members?
A. Autocratic leadership
B. Democratic leadership
C. Laissez-faire leadership
D. Transformational leadership
ANSWER: A

One is false concerning governance of health system in Ethiopia

A. Ministry of health is responsible for major policies and guideline
B. Ministry of health gives technical guidance and coordinate donor support
C. Regional councils decide on the budget allocated the regional health activities
D. Zonal health department has a direct administrative link with regional health bureau
ANSWER: D

The matrix structure violates which of the following principles of management?

A. Unity of command
B. Unity of direction
C. Division of labor
D. Span of management
ANSWER: A

Which one of the following is not cause of change in organizational structure?

A. Change in government policy
B. Change in organizational objective
C. Efficient outcomes
D. Contraction of the organization
ANSWER: C

Identify the correct steps in team development

A. Forming storming Adjourning Performing norming
B. Forming storming norming Performing Adjourning
C. Norming Forming Performing storming Adjourning
D. Forming norming Adjourning Performing storming
ANSWER: B

The approach of evaluation which answers the question “how can the interventions are
modified to achieve its outputs and outcomes?” is
A. Normative evaluation
B. Summative evaluation
C. Formative evaluation
D. Outcome evaluation
ANSWER: C

All of the following are factors antecedents to the COVID- 19 mask wearing practice except
one. Which one?
A. New skill
B. Resource
C. Policy
D. Friends
ANSWER: D

Which one of the following differ the rest

A. Emphasizes on the importance of matching multiple determinants of behaviors with
multiple learning experiences
B. Matching multiple determinants of health with multiple interventions.
C. Understanding and acceptance of the purpose of the action without use any manipulative
approaches
D. It is not incidental learning experiences
ANSWER: B

Which one is miss- matched

A. A person who has been harmed due to a car accident- Physical Health
B. A secondary school student, while sitting for an exam, started to cry uncontrollably-Mental
health
C. Mr. X going to a football match- Mental health
D. A pregnant woman celebrating festivals within community- Social health
ANSWER: C

Mr. X is asking advice from his family about his head ache and fever. This is ___
A. Sick-role behaviors
B. Compliance behaviors
C. Preventive health behavior
D. Utilization behavior
ANSWER: A

All of the following are incorrect combination except one. which one?
A. Educating pregnant woman about Antenatal care follow up -indirect communication
B. Educating pregnant woman’s husband about her Antenatal care follow -indirect
communication
C. A Pregnant woman buy Iron Folate –indirect communication
D. Educating pregnant woman’s friends about her Antenatal care follow -direct
communication
ANSWER: B

Which one of following is different from the rest?

A. A mother knows in general about using oral rehydration salts when her child is
dehydrated due to diarrhea
B. I don’t believe that exercising daily will improve my health
C. A woman may feel that using contraception is unacceptable
D. A breast feeding mother well trained on positioning and attachment of her baby
ANSWER: D

One the following different from the other

A. supported socially after behavior occur
B. Make the healthier choose, the easier choice
C. Subsequent to the behaviors
D. Provide continuing reward to behavior
ANSWER: B

Engaging in a multiple sexual practice where youth imagine they chance of getting HIV/AIDS
is an example of how to implement what key HBM concept?
A. Perceived susceptibility.
B. Perceived severity.
C. Perceived benefits.
D. perceived barriers
ANSWER: A

Which of following statement is about understands the message stage failure?

A. The immunization poster lacking striking features and doesn’t stand out compared with
attractive commercial advertisements
B. Immunization Poster is placed at the health centre and only seen by mothers who have
immunized their children
C. People believe that measles is caused by witchcraft and do not believe the immunization
poster even though they understand the message
D. The immunization Poster showing large hypodermic syringe held by smiling doctor was
thought by the community to be a devil with a knife
ANSWER: D

Which of the following is correctly matched

A. Contemplation- Making plan to change
B. Contemplation- Encourage to make specific plans.
C. Pre-contemplation- Thinking about change in the near future
D. Action- Assist in developing concrete action plans
ANSWER: B

Of the following which is not about linear model of communication?

A. Dominated by the senders knowledge
B. It doesn’t Consider feedback and interaction
C. Learning is authoritative
D. It is better to bring behavioral change
ANSWER: D

Which of the following false about Early adopters in the adopter category classification
A. May be interested in innovation, but will need some external motivation to get involved.
B. Serve as role model for other members
C. Very interested in innovation, but they do not want to be first to be involved.
D. Opinion leader
ANSWER: A

Assist in developing concrete action plans of the innovation on large scale

A. Decision
B. Persuasion
C. Trial
D. Adoption
ANSWER: D

A six pregnant woman goes to nearby health center for Antenatal care follow up. During her
visit to health she sees a poster about danger sign of new-born at the Antenatal clinic. This
statement most likely ----------
A. improving health
B. Reaching the audience
C. Getting acceptance
D. Changing behavior
ANSWER: B
Which one of the following is true about early adopter and late adopters of innovation?
A. Adoption process is the same for both categories of adopters
B. Late adopters are more exposed to social system than early adopters
C. The rate of discontinuance is more in early adopters than late adopters
D. Late adopters are higher in socio-economic than early adopters
ANSWER: A

Assessment and measurement of health problems in an entire community in terms of

mortality, morbidity, and ratios is
A. Clinical diagnosis
B. Community diagnosis
C. Clinical intervention
D. Diagnosis process
ANSWER: B

All of the following are core activities in public health except;

A. Preventing epidemics
B. Activating community action
C. Changing lifestyle of human behaviors
D. Exposing working environment & human behaviors
ANSWER: D

A whole society approach that includes health promotion, disease prevention, treatment,
rehabilitation and palliative care is
A. Maternal & child healthcare
B. Primary healthcare
C. Safe motherhood care
D. Essential healthcare
ANSWER: B

Which of the following is the process of encouraging individuals to be more attentive to and
better maintain their health?
A. Prevention of disease
B. Promotion of health
C. Prevention of exposure
D. Prevention of health
ANSWER: B

Which one of the following vaccine is given to new born babies to prevent risk of getting
Tuberculosis (TB)?
A. Pneumococcal Conjugate vaccine (PCV)
B. Bacilli Calmette- Guerin (BCG)
C. Rota Vaccine
D. Oral polio vaccine (OPV)
ANSWER: B

Which of the following is a condition that must be present for a disease to occur?
A. Sufficient cause
B. Extrinsic cause
C. Necessary cause
D. Intrinsic cause
ANSWER: C

Normally distributed data are normally referred to as:

A. Bell-shaped
B. Asymmetrical
C. Skewed
D. Peaked
ANSWER: A

A researcher studies the factors that determine the number of children future couples decide
to have. The variable ‘number of children’ is a :
A. Discrete variable
B. Continuous variable
C. Categorical variable
D. Ordinal variable
ANSWER: A

Which of the following is true about the standard deviation of x?

A. It increases as n increases
B. It decreases as n increases
C. It stays the same as n increases
D. It is an estimate of the standard error of x
ANSWER: B

What are two characteristics of rating scales that allow some researchers to use these values
on an interval scale of measurement?
A. Values on an interval scale have order and differences.
B. Values on an interval scale have differences and a true zero.
C. Values on an interval scale are equidistant and have a true zero.
D. Values on an interval scale are equidistant and do not have a true zero
ANSWER: A

The mean of a distribution is 9, the median is 18, and the mode is 27. It is most likely that
this distribution is:
A. Negatively skewed
B. Positively skewed
C. Symmetrical
D. Asymptotic
ANSWER: B

In a perfectly symmetrical distribution

A. The range equals the interquartile range
B. The interquartile range equals the arithmetic mean
C. The median equals the arithmetic mean
D. The variance equals the standard deviation
ANSWER: C

Which one of the following is sensitive to extreme values?

A. The median.
B. The interquartile range.
C. The arithmetic mean.
D. The 1st quartile
ANSWER: C

A researcher was interested in testing a certain hypothesis at a 95% confidence interval. After
performing all the required steps he found a P-value is 0.06. What should be his conclusion
based on this information?
A. Accept the alternative hypothesis
B. Accept the null hypothesis
C. Reject alternative hypothesis
D. The difference between the sample value and the population is merely by chance
ANSWER: B
A researcher was interested in investigating the prevalence of HIV/AIDS among female
students who are going to spend nights with sugar daddies at Wachemo University. Which
sampling method is appropriate for this study?
A. Modal instance sampling
B. Quota sampling
C. Simple random sampling
D. Snowball sampling
ANSWER: D

One of the following is false regarding random sampling techniques.

A. Random selection of individuals
B. Known chance of inclusion
C. Unrepresentative
D. Generalizability of findings is possible
ANSWER: C

If a participant’s attitude toward the death penalty is assessed on a scale that consists of
strongly opposed, somewhat opposed, slightly opposed, neutral, slightly for, somewhat for,
and strongly for, which of the following types of scales is being used?
A. A nominal scale
B. An ordinal scale
C. An interval scale
D. A ratio scales
ANSWER: B

Which one of the following is true about positively skewed distribution?

A. Mean is smaller than median.
B. The majority of scores are at the right end of the curve.
C. Median is greater than mode.
D. Few extreme scores are scattered at the left end
ANSWER: C

One of the following is the source of primary data except?

A. Interview
B. Hospital record
C. Self-administered questionnaire
D. Focus group discussion
ANSWER: B

Which one of the following data compilation tools is appropriate for categorical variables?
A. Histogram
B. Polygon
C. Pie-chart
D. Ogive curve
ANSWER: C

One of the following data collection techniques is not appropriate in the presence of illiterate
respondents.
A. Observation
B. Interview
C. Self-administered questionnaire
D. Focus group discussion
ANSWER: C

Application of two or more food preservation technique to overcome the problem of microbial
growth in food is known as ____________
A. HACCP
B. Bio-preservation
C. Canning
D. Hurdle technology
ANSWER: D

Which of the following hierarchy is appropriate in controlling public health important vectors?
A. IRS –Repellents-environmental sanitation –genetic control
B. Environmental sanitation-ITNs-Genetic control-IRS
C. Genetic control - IRS –Repellents-environmental sanitation
D. IRS –Repellents-environmental sanitation -Genetic control
ANSWER: B

Choose the best order among the following integrated solid waste management components
A. Sanitary land fill-Source reduction- Treatment-transportation
B. Source reduction -Sanitary land fill- - Treatment-transportation
C. Reducing-Recycling &Recovery –Treatment-Sanitary land fill
D. Transportation- Sanitary land fill-Source reduction- Treatment
ANSWER: B

All are way of administrative control of occupational hazard except

A. Changing work schedule
B. Changing a work process to a shift when few people are working
C. Renewal of working process with safer application
D. Provision of health & sanitary facilities
ANSWER: C

One of the following is ergonomic hazard

A. Impairment of ear because excessive noise at work place
B. Injury of hands by strong acid in soap factory
C. Acquiring hepatitis B virus through needle injection during health care provision
D. Back pain because of standing for a long time by collecting cardboard in a factory
ANSWER: D

A 37 year old G2P1 mother, at 35 weeks' gestation presented to the ER with, dark, vaginal
bleeding and abdominal pain for one hour. Previous delivery was via LUTS cesarean section
for an indication of NRFHRP. The patient has a history of hypertension and has been non
adherent with her medication. On P/E PR= 90/min, RR=16/min, and BP is 145/90 mm Hg.
The abdomen is tender and hypertonic contractions can be felt. The fetus is in a breech
presentation. The FHR is 180/min with recurrent decelerations. Which of the following is the
most likely cause of fetal compromise?
A. Rupture of the uterus
B. Placental tissue covering the cervical os
C. Detachment of the placenta
D. Abnormal presentation of the fetus
ANSWER: C

Uterine tachy systole is defined as:

A. More than 5 contraction in a 5 minutes period
B. More than 6 contraction in 10 minutes period
C. More than 5 contraction in 10 minutes period
D. More than 6 contractions in 5 minutes period
ANSWER: C

One of the following is not affected by normal physiologic adaptation of pregnancy

A. respiratory rate
B. pulse rate
C. blood volume
D. visual acuity
ANSWER: A

A 25 years old woman presents with nausea and vomiting which worse in the morning. She
has decreased in appetite. Her last menstruation was 2 months ago. What is the best initial
Workup for this patient?
A. CBC
B. urine analysis
C. serum electrolyte
D. urine HCG
ANSWER: D

A 20 years old primigravida lady at 30 weeks of gestational age complains mild dyspnea on
exertion, frequent urination, high grade fever and lack of energy at her ANC follow-up. Which
of her compliant is not associated with a normal pregnancy?
A. mild dyspnea on exertion
B. frequent urination
C. high grade fever
D. lack of energy
ANSWER: C

Which one of the following is the earliest sign of pregnancy?

A. masks of pregnancy
B. goodwills sign
C. stria gravidarum
D. varicose vein
ANSWER: B

Which of the following is the correct definition of preterm birth?

A. Preterm birth is delivery before 37 completed weeks and after 28weeks
B. Preterm birth is occurring between 34 and 36 completed weeks .
C. Births before 36/7 weeks
D. Births before 28 completed weeks
ANSWER: A

Low birth weight refers to neonates weighing?

A. 2500 -4500gram
B. 1000 -1500gram
C. 1500- 2500 gram
D. >45000gram
ANSWER: C

Correct relations about Short- and Long-Term Problems in Very-Low-Birth weight Infants
A. Bronchodysplasia- Cerebral plasy
B. Intraventricular hemorrhage- pulmonary hypertension
C. Retinopathy of prematurity- Blindness
D. NEC- Hypertension in adulthood
ANSWER: C

True about PROM

A. Exact cause is know
B. Spontaneous rupture of the membranes any time before 28th week of pregnancy but
before the onset of labor.
C. Prolonged PROM:- rupture of membranes for more than 18 hrs
D. 80% of term PROM labor starts with in 24 hrs.
ANSWER: D
The only reliable sign for the diagnosis of chrioamnionitis is
A. fetal tachycardia
B. Maternal tachycardia
C. Fever
D. Leukocytosis
ANSWER: C

The main source of aminotic fluid after 20 weeks of gestation

A. Trans cutaneous
B. lung
C. Trans membranous
D. Fetal urination
ANSWER: D

Complications of PROM and indication of emergency C/S

A. Preterm labour & delivery
B. Chorioamnionitis
C. Sepsis
D. Cord prolapse
ANSWER: D

A 23 year old Primi-gravida lady referred from Homocho primary Hospital after pushing down
pain of 18 Hours duration. Upon arrival her Vital signs, BP 80/40 mmHg ,PR 120 Bm , RR
28 b/m and, on physical examination she has three abdomenial tumor , dry and edematous
vulva , Molding +++, moderate caput, the diagnosis of this women is
A. Uterin rupture
B. CPD
C. Obstructed labour
D. Hypotension
ANSWER: C

Of the following one is NOT severity features of preeclampsia;

A. Right upper quadrant pain
B. HEELP syndrome
C. Elevated serum creatinine level
D. Generalised body edema
ANSWER: D

A 21 year old Pregnant mother whose LNMP was on tir 21 come for regular ANC follow up.
She has no subjective complaint. On physical examination BP is 145/90, PR is 88, RR is18, &
Temperature is 36.6?C. She has trace pedal edema. Her CBC shows WBC of 10,000 and
platelet count of 105,000. Other investigation results are unremarkable. Which one is true
about this patient?
A. She has preeclampsia with severity feature & needs admission
B. She has preeclampsia without severity & needs frequent follow up.
C. She has Gestational HTN & needs frequent follow up
D. She has chronic HTN & needs frequent follow up
ANSWER: D

One of the following is NOT a risk factor for preeclampsia

A. Multiparty
B. DM
C. Advanced maternal age
D. Multifetal gestation
ANSWER: A
Which one of the following is false about preeclampsia?
A. Characterized by intravascular volume depletion
B. Characterized by extravascular over hydration
C. The etiology is usually known
D. characterized by haemoconcentration
ANSWER: C

One is NOT a complication of preeclampsia

A. Placental Abruption
B. Polyhydramnious
C. Oligohydramnious
D. DIC
ANSWER: B

All of the following could be a possible finding in patients who have HELLP syndrome
EXCEPT;
A. Increased serum haptoglobin level
B. Increased serum bilirubin level
C. Thrombocytopenia
D. Anemia
ANSWER: A

True statement about hypertensive disorders of pregnancy

A. Preeclampsia is totally preventable
B. Eclampsia is preventable
C. Salt restriction is important part of management of Preeclampsia
D. Usually causes fetal macrosomia
ANSWER: A

Commonest fetal heart beat abnormality in a mother who is in labor & fetus with nuchal cord;
A. Late deceleration
B. Variable deceleration
C. Early deceleration
D. Acceleration
ANSWER: B

Compared to the use of the vacuum extractor, forceps are associated with an increased risk
of which of the following complication?
A. Cephalohematoma
B. Perineal laceration
C. Jaundice
D. Intracranial hemorrhage
ANSWER: B

A 27-year-old woman, gravid 2 para 1, at 40 weeks gestation has a forceps-assisted vaginal

delivery over a second-degree perianal laceration. Thirty minutes after the perineal laceration
is repaired, the patient's blood soaks the bed sheets. Her temperature is 36.8 0C,
blood pressure is 120/ 70 mm Hg, and pulse is 112/ min. Which of the following is the
best next step in management of this patient?
A. Administer broad-spectrum antibiotics
B. Administer uterotonic medications
C. Bimanual massage
D. Genital tract inspection for missed laceration
ANSWER: D

A 20 year-old primigravida at 38 weeks was admitted in second stage of labor and stayed for
90 minutes. Fetal heart beat is raging between 80-90/min vertex presentation, station +3, no
cuput or molding and grade- II meconium stained fluid. Which one of the following is the next
best in management?
A. Expedite delivery by operative vaginal delivery right away using vacuum
B. Prepare her for cesarean section
C.Re-position her into the left lateral position
D. secure iv line and await spontaneous vaginal delivery
ANSWER: A

A 28 years old patient complains of amenorrhea after having dilatation and curettage. The
most likely diagnosis
A. Kallman's syndrome
B. Turner s syndrome
C. Asherman s syndrome
D. Pelvic inflammatory disease
ANSWER: C

A 13 years old girl who has not started menstrual cycle yet presented with a compliant of
cyclic lower abdominal pain with associated with difficulty of urination. On physical
examination there is uterine tenderness and there is a visible distension at the introitus. The
most likely diagnosis is
A. Transverse vaginal septum
B. Imperforate hymen
C. Premature ovarian failure
D. Cervical stenosis
ANSWER: B

A 55 year- old male comes to emergency OPD because of excruciating pain in his right big toe.
He was diagnosed to have gouty arthritis. Which of the following is the best initial
pharmacotherapy?
A. Ceftriaxone
B. Allopurinol
C. indomethacin
D. Morphin
ANSWER: C

A health officer treating a 74 years old man who was admitted with shortness of breathing
and fever. His temperature on admission was 39 0c.on physical examination he is sick
looking and has decrease air entry at the right basal lung field, the chest x-ray shows an
infiltrate at the right lower lobe. What is the most likely causative organism?
A. streptococcus pneumonia
B. Legionella pneumophila
C. viral pneumonia
D. klebsiella pneumonia
ANSWER: A

A 45 years old HIV positive man with a presumptive diagnosis of pneumocystis jiroveci
pneumonia has no signs of respiratory distress. Which of the following is the most
appropriate pharmacotherapy?
A. Fluconazole
B. fluconazole and prednisolone
C. Cotrimoxazole
D. Cotrimoxazole and prednisolone
ANSWER: C

A 35 year- old woman presents with fever and acute lower left quadrant pain. She states
that it began last night and began in the back and radiates to the lower left quadrant. She
also has dysuria and urinary frequency. Her body temperature is 38.9oc. There is lower left
quadrant tenderness and left cost vertebral tenderness. What is the most likely diagnosis?
A. Diverticulitis
B. Volvulus
C. Ovarian torsion
D. pyelonephritis
ANSWER: D

A 47 year old man comes to the hospital complaining of epigastric pain that is exacerbated by
eating. A test for helicobacter pylori turned positive and endoscopy confirmed a duodenal
ulcer. Which one is the most appropriate therapy?
A. amoxicillin,clarithromycin and omeprazole
B. metronidazole and anti-acids
C. omeprazole and antiacids
D. rantidine,amoxicillin and metronidazole
ANSWER: A

60 year old man who had been smoking a pack of cigarettes daily for the last twenty years
presented with one year history of increasing dyspnea on excretion and Accumulation dry
cough. Chest examination reveals hyper resonance all over the lungs and decreased breath
sounds. Which of the following is most likely diagnosis?
A. Bronchiectasis
B. Asthma
C. Emphysema
D. chronic bronchitis
ANSWER: C

A health professional has committed a community survey for malaria prevention. The major
problems identified was stagnant water and improper waste disposal. The professional
suggested draining the water and to have waste disposal pit.What level of prevention is this
A. secondary
B. tertiary
C. primary
D. primordial
ANSWER: C

A 28 year-old man brought in to the hospital with a clinical sign and symptoms of polydypsia,
polyphagia, and polyuria and weight loss. After detailed diagnosis, the physician recommends
lifelong insulin therapy.Which type of diabetes mellitus is most likely diagnosed?
A. Gestational Diabetes Mellitus
B. secondary Diabetes Mellitus
C. Type I Diabetes Mellitus
D. Type II Diabetes Mellitus
ANSWER: C

A 20 year-old man comes to a Hospital with Diabetes Mellitus. After arrival and detailed
assessment, the patients every organ system of the body become Affected. Which one of the
following is macro vascular complication?
A. Coronary artery disease
B. Diabetic Nephropathy
C. DIabetic Neuropathy
D. Diabetic retinopathy
ANSWER: A

Most people with newly discovered type II DM are overweight. The important management for
such type of patients is diet and exercise. In addition to this, which of the following Oral agent
is recommending as first line therapy?
A. Meglitinides
B. Metformin
C. Satagliptin
D. Sulfonylureas
ANSWER: B

Which one of the following Insulin injection area has the greatest speed of absorption from its
site?
A. Abdomen
B. Arms (posterior surface)
C. Hips
D. Thighs (anterior surface)
ANSWER: A

You explain to the patient about hypothyroidism that the symptoms should resolve as the
medication reaches an appropriate level. Which of the Presenting signs and symptoms of
hypothyroidism include:
A. Fatigue and cold intolerance.
B. Polydypsia and polyphagia.
C. Tachycardia and diarrhea.
D. Weight loss and hyperglycemia.
ANSWER: A

A 25 year-old man with known type I DM is brought to a hospital. He is also a known

hypertensive patient. His blood glucose level is 800 mg/dl, urine keton 3+, and PCO2 is
10mmHg. Which one of is the following fluid is most appropriate to be given to this patient?
A. 0.45% sodium chloride solution
B. 0.9% sodium chloride solution
C. DNS solution
D. Dextrose 5% solution
ANSWER: B

Which one of the following doesn t precipitate hepatic encephalopathy

A. Low protein diet
B. hypokalemia
C. GI bleeding
D. Peritonitis
ANSWER: A

Cholera toxin causes

A. secretory diarrhea
B. osmotic diarrhea
C. functional diarrhea
D. bloody diarrhea
ANSWER: A

A 22yr old female clinical 2 student came to the emergency OPD with a complaint of
epigastric pain and tenderness associated with profuse vomiting, the most likely diagnosis is
PUD. Which of the following is true about the management?
A. H.pylori test should be send before any type of intervention
B. It is good to exclude malignancy by doing barium meal right away
C. Cimetidine is more effective than omeprazole and should be started right away
D. She should be admitted and resuscitated first then give PPI
ANSWER: D

Serum ascetic albumin gradient greater than 1.1 gm, with an ascetic fluid total protein of 2.5
gm/dl is a feature of:
A.Cardiac cirrhosis
B.Post necrotic cirrhosis
C.Tuberculous peritonitis
D.Nephrotic syndrome
ANSWER: A

All are true about variceal bleeding Except

A. The bleeding correlates with high portal pressure
B. Bleeding often occurs without precipitating factor
C. Endoscopy is preferred for evaluation
D. Risk of rebleeding is high
ANSWER: B

Which one of the following is the most common cause of acute pancreatitis in female?
OCPs/Drugs
A. Gall stones
B. Trauma
C. Alcohol
D. ERCP related
ANSWER: A

Which of the following favors Crohn s disease over ulcerative colitis?

A. Pancolitis
B. Rectovesical fistula
C. Predominant rectal involvement
D. Toxic mega colon
ANSWER: C

Which of the following Entamoeba causes disease in human?

A. E hartmani
B. E coli
C. E histolytica
D. E dispar
ANSWER: C

Identify true statement about Helminthic infections

A. Are caused by single-celled organisms
B. Are predominantly intracellular infections
C. Are sometimes associated with eosinophilia
D. Are caused by organisms which replicate by binary fission
ANSWER: C

One of the following is not a cause of iron deficiency anemia

A. Hook worm infestation
B. Bleeding
C. Methotrexate
D. Acute and chronic inflammation
ANSWER: C

All of the following are causes of massive splenomegaly except

A. Polycythemia vera
B. Sarcoidosis
C. Chronic myleougenous leukemia
D. Acute viral hepatitis
ANSWER: D

False statement about spontaneous bacterial peritonitis in cirrhotic patients

A. Is more common in patients with advanced liver disease
B. Worsening jaundice can be the only manifestation
C. Culture of ascetic fluid often grows multiple bacteria
D. Can precipitate Hepatic encephalopathy
ANSWER: C

Which of the following statements about the management of acute upper gastrointestinal
bleeding is true
A. Transfusion should aim to raise the hemoglobin at least 10 g/dl in most patients
B. The insertion of NGT is indicated in most patients, primarily to check for rebleeding
C. The routine use of H2 Antagonists is indicated in most patients to reduce gastric acid
secretion
D. In general 1 unit of blood raises the hemoglobin by 3g/dl in adults
ANSWER: A

True about duodenal ulcer

A. Virtually all patients with duodenal ulcer are colonized by H.pylori
B. Eradication of H.pylori leads to the healing of duodenal ulcer but has no effect on the
incidence of ulcer relapse
C. Patients with duodenal ulcer secret more acid, on average, than healthy people
D. Patients with duodenal ulcer occur more commonly in urban rather than rural population
ANSWER: C

Which of the following statement is true about alcoholic hepatitis

A. Is usually associated with greater serum elevation of ALT than AST
B. Mallory body is almost always found on biopsy
C. Abstinence will assure resolution if the patient survives hospitalization
D. ALT/AST ratio is usually greater than 2
ANSWER: D

False statement regarding peptic ulcer disease

A. It's associated with H.pylori infection
B. Eradication of H.pylori is more important in patients with ulcer than patients with non-ulcer
dyspepsia
C. Gastrinoma associated with Zollinger Ellison Syndrome never becomes malignant
D. Can be associated with hyperthyroidism
ANSWER: C

A 3 years old female toddler presented to ED by her mother after she had fever ,sudden
respiratory distress and noisy breathing .on P/E T0=39.5,RR=55,AUDIBLE STRIDOR and she
has clear drooling with tripoid position. What is the most likely etiology?
A. S. Aures
B. Hemophilus influenza
C. Chylamidia trachomaitis
D. Streptoccocus pneumonia
ANSWER: B

Which of the following are common causes of upper air way obstruction except
A. croup
B. pneumonia
C. bacterial tracheites
D. epiglottitis
ANSWER: B

The age at which the infant achieve early head control

A. 2 mon
B. 4 mon
C. 3 mon
D. 6 mon
ANSWER: C

One of the following are poor prognostic signs of meningitis except?

A. age <6 mo
B. seizure occurring more than four days after treatment
C. immunocompromised
D. those with low concentration of bacteria in their CSF
ANSWER: D

One of the following is a diagnostic investigation modality for identify the defect in patients
with congenital heart disease
A. Echocardiography
B. ECG
C. CXR
D. Chest Ultrasound
ANSWER: A

A 6 months old female infant presented with a complaint of worsening of shortness of breath
of 3 days duration with associated low grade intermittent fever, non-barking non whooping
cough and fast breathing of 1 week. She has history of diaphoresis while breast feeding and
feeding interruption since the age of 2 weeks. She is born from para l abortion ll mother at 8
months of amenorrhea and currently lives at a high altitude region. She has been treated
twice for pneumonia at a health center previously. In this case, all of the following risk factors
goes for Patent Ductus Arteriosus except
A. Her sex (being female)
B. Primiparity of the mother
C. Preterm birth
D. Living in high altitude
ANSWER: B

Which one of the following is the first step in approaching a child presenting with seizure?
A. Giving IV diazepam
B. Search for potentially life-threatening causes of seizure and treating them
C. Evaluating the patient to determine whether the seizure has a focal onset of is generalized
D. Managing the patient according to the ABC approach
ANSWER: D

A patient came to you with abnormal body movement with flexion and extension of one side
of the body which subsequently involves the whole body. In which class of seizure do u
categorize this patient?
A. Complex partial seizure
B. Secondary generalized seizure
C. Status epilepticus
D. Focal seizure
ANSWER: B

Which of the following are consistent with a simple febrile seizure?

A. A 2 minutes seizure in a 3 month old child with a UTI and a temperature of 39?c
B. A single seizure in a 3 years old child that lasts 20 minutes
C. A 6 minutes GTC seizure in an 18 month old child with a temperature of 38?c and signs of
tonsillitis.
D. A brief seizure in a febrile 2 year old who fell of his bicycle and hit his head
ANSWER: C

An injury to the cerebral cortex or motor pathways leads to which type of cerebral palsy?
A. Athetoid CP
B. Spastic CP
C. Ataxic CP
D. Intractable seizures
ANSWER: B

A 4 years old female patient presented with loss of consciousness of 2 hours duration. Her
vital signs are all in normal range. What is the first step you will do in the management of this
patient?
A. Do lumbar puncture and send for CSF analysis
B. Check for blood glucose level
C. Send for brain CT scan
D. Determine serum electrolyte
ANSWER: B

Anticonvulsant therapy is most likely required for patients with which of the following types of
seizure?
A. Febrile seizure
B. Initial seizure
C. Recurrent seizure
D. Seizure due to alcohol withdrawal
ANSWER: C

A 12 year old male presented with abdominal pain, vomiting and fast breathing of 2 day
duration, also his father said that his child breath smells fruity. He has hx of weight loss for
the past 3 months despite the appetite is increasing. Patient is tachycardia and tachypenic
with feeble pulse, his extremities are cold, capillary refill delayed, abdomen soft and flat
notenderness. How do you approach?
A. patient need U/S urgently and evaluation for surgical abdomen
B. Need to be resuscitated with 20ml/kg of NS,
C. Need potassium chloride infusion
D. regular insulin should be started before initial fluid resuscitation
ANSWER: B

A 12 year old male presented with abdominal pain, vomiting and fast breathing of 2 day
duration, also his father said that his child breath smells fruity. He has hx of weight loss for
the past 3 months despite the appetite is increasing. Patient is tachycardia and tachypenic
with feeble pulse, his extremities are cold, capillary refill delayed, abdomen soft and flat
notenderness. investigation do you want to send, most important for management and
diagnosis settlement?
A. Chest x-ray
B. abdominal u/s
C. RBS, U/A and serum electrolyte
D. Abdominal CT
ANSWER: C

A 4yr old male presented of scaled burn injury involving his left thigh, abdominal area and left
elbow of 2 hr back. There are multiple Blisters Moist, red, weeping Blanches with pressure
lesion over the injury site. Total body surface area of the burn was estimated to be 15% which
one is incorrect?
A. Need potent analgesics like morphine
B. Wound care should be done with topical antibiotics such as silver sulfadiazine
C. Need surgical debridement
D. Need fluid resuscitation and Hemodynamic stabilization
ANSWER: C

The most common cause of hypokalemia in children is

A. Akalemia
B. distal renal tubular acidosis
C. Gastroenteritis
D. Diabetic ketoacidosis
ANSWER: C

The best fluid bolus to give for a child with severe vomiting and diarrhea
A. Normal saline
B. Ringer lactate
C. Half normal saline
D. Hypersonic 3% NS
ANSWER: A

The most common cause of spontaneous and recurrent abortion during 2nd trimester
pregnancy is
A. Bicornuate uterus
B. Unicornuate uterus
C. Cervical insufficiency
D. Cervical cercelage
ANSWER: C

The most common risk factor for pelvic organ prolapse

A. Age
B. Vaginal birth
C. Socioeconomic status
D. Connective tissue disorder
ANSWER: B

Which of the following obstetrics complication is less likely to be associated with multiple
pregnancy?
A. Preterm labor
B. Fetal macrosomia
C. PROM
D. Pre-eclampsia
ANSWER: B

Which of the following is false about twin pregnancy?

A. Dizygotic pregnancy is recurrent
B. The incidence of Monozygotic twin pregnancy tend to be similar all over the world
C. The commonest placentation type of monozygotic twin pregnancy is dichorionic
diamniotic
D. The placentation of dizygotic pregnancy is always dichorionic diamniotic
ANSWER: C

In Monozygotic twin pregnancy, when the time of cleavage of the fertilized ovum is between 4
-7 days the resulting placentation would be:
A. Diamniotic dichorionic
B. Diamniotic monochorionic
C. Monoamniotic monochorionic
D. Conjoined
ANSWER: B

True about multifetal gestation:

A. TTTS is exclusively a complication of dichorionic multifetal pregnancies.
B. Dizygotic twins are at higher risk for adverse outcomes than are Monozygotic twins.
C. The recommended time of delivery for Monoamniotic pregnancy is at 37 weeks of
gestation.
D. The finding of different gender on ultrasound is suggestive of a dizygotic pregnancy.
ANSWER: D

Regarding the clinical picture of Cholera one of the following is not correct
A. Fever is usually high
B. The diarrhea is typically watery white, flecked with mucus
C. Spread is directly from person to person to person by the fecal oral oral route
D. The major cause of death is water and electrolyte depletion
ANSWER: A

Which one of the following is not the component of CURB-65 pneumonia prognostic criteria
A. Convulsion
B. Renal failure
C. Age > 65
D. BP < 90/60 mg/dl
ANSWER: A

Regarding COPD, one of the following is true:

A. Airway obstruction is reversible
B. Passive smoking is not a risk factor
C. More than 50% of smokers develop it
D. COPD can be prevented
ANSWER: D

All except one increase the risk of infection with M.Tuberculosis

A. Exposure to smear positive TB case
B. Long duration of contact with suspected case
C. Decreased level of cell mediated immunity
D. Exposure to infectious nuclei
ANSWER: B

Which of the following is true about the Nephrotic Syndrome in adults

A. Gross edema is always present
B. Is always associated with reduced GFR
C. Is often secondary to systemic diseases
D. Requires renal biopsy for planning definitive treatment and to determine prognosis
ANSWER: B

A mother bring an 8 years old female child to the hospital who is on anti TB treatment ,she
complain her child has been passing red-orange urine for the last few days and that she is
worried. Which of the following drug is the cause of the condition?
A. streptomycin
B. Rifampcin
C. Ethambutol
D. pyrazinamide
ANSWER: B

Which is the commonest complication of TB meningitis

A. Tuberculoma
B. Diabetic insipidus
C. Hydrocephalus
D. Epileptics seizure
ANSWER: C

Which one of the following is not a sign of severe dehydration?

A. irritability, restlessness
B. sunken eyeball
C. unable to drink or drink poorly
D. Skin pinch goes back very slowly greater than 2 sec
ANSWER: A

A 3 years old female toddler presented to ED by her mother after she had fever ,sudden
respiratory distress and noisy breathing .on P/E T0=39.5,RR=55,AUDIBLE STRIDOR and she
has clear drooling with tripoid position. What is the most likely etiology?
A. S.aures
B. Hemophilus influenza
C. Chylamidia trachomaitis
D. Streptoccocus pneumonia
ANSWER: B

The most common cause of spontaneous and recurrent abortion during 2nd trimester
pregnancy is?
A. Bicornuate uterus
B. Unicornuate uterus
C. Cervical insufficiency
D. Cervical cercelage
ANSWER: C

In Monozygotic twin pregnancy, when the time of cleavage of the fertilized ovum is between 4
-7 days the resulting placentation would be:
A. Diamniotic dichorionic
B. Diamniotic monochorionic
C. Monoamniotic monochorionic
D. Conjoined
ANSWER: B

A 24 years old G2P1 mother at 39 weeks of gestation presents with painful uterine
contractions. She also complains of dark, vaginal blood mixed with some mucus. Which of
the following describes the most likely etiology of her bleeding?
A. Placenta previa
B. Bloody show
C. Vasa previa
D. Cervical laceration
ANSWER: B