4 1._A 26 year-old female presented with two months of excessive menses and gum bleeding, Physival examination revealed pale conjunctiva, petechiae’ and ecchymosis. Which of the following is the most likely diagnosis? es A, Hemophilia BO Idiopathic thromboeytopenie purpura. GC Sey, Spt, D. Vitamin K deficiency A 21 year-old woman presented with fatigue and light headedness. Physical examination 2 showed marked conjunctival and palmar pallor. Which of the following physical findings is most likely to be seen in this patient? A. Apical diastolic murmur 4 ie) sige Ejection systolic murmur ae en ae ) G. Narrow pulse pressure J Cee | TRC LU a ee D. Rumbling mid diastolic murmur 3. A health officer was evaluating an anemic patient. Laboratory test revealed: Hyb = 7 p/dl, J MCV 77 1, WBC = $400/j1, Platelet = 650, ,000/4d. Which ofthe following isthe mos diagnosis? ar ob oO A. Acute myelogenous leukemia ser > Aplastic anemia Pree of 7 h a Miceocyne Iron-deficiency anemia @ 5 ~—D, Megaloblastic anemia Rigpeenrors S- 4, A 45 year-old woman presented with fatigue and orthostatic dizziness of two months duration, She has conjunctival pallor. Complete blood count revealed: Heb = 8 g/dl, WBC = 4200/1. and. platelet 7170,000/p1. Which of the following co-morbidities is LEAST tikely? ‘A, Chronic kidney disease -#@“f< wishin Ansa os Chronic obstructive lung disease | — % : C. Colorectal cancer gfe bxKt x ispieens Bay 1D. Disseminated tuberculosisy4- Lo" 5, A 7 year-old man is admitted to the Medical Ward with hemorchagic stroke, Afler a week the Fete patient suddenly developed plueritic chest pain and shortness of breath: Physical examination revealed : signs of respiratory distress anda ‘swelling involving his rahagpente What is + the most likely cause for his deterioration? lial infarction *7 & A 25 year-old man with rheumatic heart disease came for follow-up. He has active precordium and rumbling. ec aE valvular lesion is most likely in this patient? ©? ~ A. Aortic regurgitation ee B, Mitral regurgitation £ Mitral stenosis D. Tricuspid regurgitation 7. A65 year-old male with type 2 diabetes mellitus presents to the Emergency Department with a squeezing, retrosternal chest pain of one hour duration. He has vague discomfort in his right arm and shoulder. The physical examination is notable for diaphoresis and mild tachycardia. Which of the following is the most likely diagnosis? Ac Acute coronary syndrome B, Acute pericarditis, €. Aortic dissection D. Pulmonary embolism 8. Which of the following is a major criteria for the diagnosis of rheumatic fever? A. Elevated ESR. B. Fever C. Prolonged PR segment ~ 2. Polyarthralgia A 29 year-old woman came to the OPD with shortness of breath and body swelling of three weeks, On physical examination she has raised JVP, accentuated P2 and grade LV diastolic ‘murmur at the apex. Which of the following drug delays disease progression? A. Frusemide B. Penicillin _® Enalapril D. Digoxin 10. A 45 year-old male with heart failure is comfortable at rest. He develops dyspnea and fatigue to walk to a nearby shop and is forced to rest for five minutes before symptoms improved. What is the stage and functional status of this patient? A, Stage A, Class I]y yo y 12, A40 year-old man presented with fever, shaking chills of three days duration, He also has non- productive cough and right-sided pleuritic chest pain, He has no significant past medical history. Physical examination revealed crepitation on the posterior right lower chest. Which one is the best initial investigation to confirm the diagnosis? JS Chest X-ray B. Culture of sputum C. Gram stain of sputum D. White blood cell count 13, A 25 year-old woman who was diagnosed with pulmonary tuberculosis and started anti- tuberculosis treatment two weeks ago is found to be HIV positive on screening, On physical examination, she has pale conjunctiva and laboratory investigation shows CD4 count of 100cells/j11. Which one is the most appropriate first line antiretroviral regimen for this patient? A. ABC/3TC/NVP BeTDFISTC/EFY™ C. AZTSTC/EFV D. D4TTCINVP 14. A 24 year-old man has generalized lymphadenopathy, aphthous ulcers, and gray-white plaques around his scrotum. Dark field microscopic examination demonstrates spirochetes, Which of the following is the treatment of choice? A. Ceftriaxone (2 Penicillin B, Erythromycin D, Tetracycline 15. A 30 year-old prisoner presents with intermittent fever and headache of wo days duration, He claims that thye of his roommates had similar symptoms and were treated in the prison. Blood film examination showed a spirochete. Which one of the following is the most appropriate antibiotic choice for this patient? A. Ceftriaxone & Procaine penicillin B, Ciproflocacillin D. Vancomyein 16. A 20 year-old male patient presents with abdominal swelling of three weeks duration. She lives in a rural village where the water source used is river water. Ultrasound examination reveals peri-portal fibrosis. Which one of the following is most likely cause for the patient’s condition? A. River blindness C. Leishmaniasis B. Ascariasis BF Schistosomiasis HIV positive patient who presented with shortness of breath was suspected to iroveci pneumonia but he has no signs of respiratory distress and his CD4 following drugs is recommended for p this patient? C. Prednfsoloneyo J Wig 18, A 60 year-old male had cough for five years with clear sputum production and shortness of breath: He has smoked a pack of cigarettes per day for 20 years, Laboratory examination reveals haemoglobin of 19 g/dl. X-ray of the chest shows hyperinflation without infiltrates, Which of the following is the most likely diagnosis? A, Bronchial asthma 3X Chronic obstructive pulmonary disease C. Interstitial lung disease D. Pulmonary Tuberculosis 19. A 40 year-old alcoholic develops productive cough and fever. Chest x-ray shows an air-fluid level in the superior segment of the right lower lobe. Which of the following is the most appropriate pharmacotherapy? A. Ceftazidime and ciprofloxacillin B. Ceftriaxone and gentamycin A. Metronidazole and crystalline penicillin D. Vancomycin and chloramphenicol 20. A 25 year-old man presents with abdominal pain, headache and fever of five days duration. ‘The Health officer suspected the diagnosis of typhoid fever .Which of the following investigations confirms the diagnosis? A, Stool examination B. Blood culture C, Weil-Felix titer r Widal test 21. A 27 year-old man complains of fever, rigors, productive cough with rusty-coloured sputum and pleuritic chest pain. Chest examination reycaled increased tactile fremitus and dullness to percussion ig the right lower lung field. What is the most likely diagnosis (AC Lobar pneumonia B. Bronchopneumonia & - Av C. Lung abscess D. Pleural effusion 2. A 35 year-old woman presented with trismus for a day. She also has shoulder and back pain SShe reported that she sustained a puncture over the left foot a week ago. She s fully conscious. Which of the following is the most appropriate pharmacotherapy?. 23, A'30 year-old man presented with epistaxis, easy fatigability and intermittent fever for one month. Physical examination revealed hepatosplenomegaly. Which of th i investigation to confirm the diagnosis? oF the following isthe best A. Blood culture 48” Bone marrow aspiration C. Stool examination D. Ultrasound of abdomen 24, a 60 year-old man presented with sudden onset of right sided weakness on both upper and Owsr extremities before a day. The weakness is maximal at onset and during sleep. He is hypertensive but does not take medications. What is the most likely diagnosis? A. Hemorrhagic stroke “B. Ischemic stroke C. Subarachnoid hemorrhage D. Transient ischemic attack 25. Which of the following is the most common cause of hemorthagic stroke in Ethiopia? A. Aneurysm B. Anticoagulation C. Brain tumor OY Hypertension 26. A 24 year-old HIV positive woman presents with fever and skin rash over the left chest wo days ago. The rash is vesicular and follows dermatomes (T4-5). Ske is confused and meningeal signs are pesitive. Which of the following is the most likely diagnosis? ‘A. Fungal meningitis B. Pyogenic meningitis C. Tuberculos meningitis ‘B. Viral Meningoencephalitis 27. A 30 year-old male presented with headache, fever and progressive weakness on the left side of his body two weeks ago. He has right ear discharge since two months. On physical examination BP=140/80 mmHg, PR=102/min, T=39°C. He is mentally alert and power on the left and lower extremities is 3/5. What is the most likely diagnosis?y A 23 A 60 year-old alcoholic patient presented with fever, headache and neck pain of two days duration. On examination body T=39°C and has neck stiffness, Bacterial meningitis was suspected but lumbar puncture was deferred because he has papilledema. Which of the following is the best empiric therapy for this patient in addition to Ampicill A. Vancomycin and Cholramphenicol “B Cefiriaxone and Vancomycin C. Ceftriaxone and Chloramphenicol D. Cloxacillin and Ciprofloxacin 29. A 36-year-old male presented with fatigue and tea-colored urine for five days. Physical examination revealed jaundice and tender Hepatomegaly. Laboratory investigation revealed Aspartate aminotransferase (AST) = 2400 U/L, Alanine aminotransferase (ALT) = 2500 U/L, Alkaline phosphatase=210 U/L and total bilirubin = 8.6 mg/dl. Which of the following is the LEAST likely cause for the patient’s condition? A, Acetaminophen poisoning B. Acute Viral hepatitis YB Alcoholic liver disease D, Ischemic liver injury ozs t eat 30. A 56 year-old man presented with progressive abdominal distension and leg swelling of two months duration. He is a known patient with cirrhosis for the past one year on follow up but not on medication. On examination, he was not in distress and has moderate ascites and bilateral leg swelling. Which of the following is the best initial management? A. Furosemide + Furosemide and Spironolactone C. Hydrochlorothiazide D. Paracentesis and Frusemide : rks 31. Which of the following is the most common complication of Peptic ulcer disease’ “i. Hemorrhage B. Gastric outlet obstruction C. Malignancy _D. Perforation 32. A 50 year-old woman presented with fever, cough and chest pain for two days. Chest X— ray showed pleural effusion. Pleural fluid analysis showed: WBC = S,000/mm’, with 90% neutrophils, PH = 7.2, blood culture was positive for streptococcus pneumonia. What is the next best sepia management of this patient besides antibiotics? a F Selina:y ys ‘a 4¢ yearsold mun is brought fo the Emergency Department because he was vomiting fresh J flood. He reports that he has no abdominal pain or nausea. On physical examination; BP=70/40 mmHg, PR=118/min, RR= 24/min, He also has gynecomastia, dilated abdominal veins and ascites. Which of the following is the most likely cause of the bleeding? = C. Mallory Weiss Esophageal cancer LB toniac varices D. Reflux esophagitis 54. A.47 year-old man comes to a Hospital complaining of epigastric pain that is exacerbated by cating, Antigenic test for Helicobacter pylori is positive. Endoscopic examination reveals a duodenal ulcer. Which of the following is the most appropriate therapy? A. Amoxicillin, clarithromycin and omeprazole . Amoxicillin, metronidazole and anti-acid C. Omeprazole and anti-acid D, Ranitidine, amoxicillin and metronidazole 35. A 29 year-old man with HIV infection presents with chronic diarrhea associated with anorexia, abdominal cramps and significant weight loss. His recent CD4 count =20 cells/mm3. A modified acid-fast stain of a stool specimen shows 4-6 jim oocysts. Which of the following is the most likely cause? ryptosporidium parvum C. Mycobacterium avium complex . Microsporidia D. Pneumocystis jiroveci 36. Which of the following is the best early indicator for diabetic nephropathy? A. Rising blood urea nitrogen GB) Albuminuria C. Hypertension D. Rising creatinine level 37.A 35 year-old man presents with generalized body swelling of two months. examination reveals BP=120/70mmHg, ascites and +3 pretibial edema. Protein = 4.5g/24hour urine collection, Which of the following is the most likely diagnosis? “A, Chronic Tiver disease B. Heart failure Nephrotic syndrome D. Glomerulonephritis Physical the Emergency OPD because of excruciating pain in his right gouty arthritis. Which of the following is the mostys J a 2 year-old lactating woman presented to the emergency OPD with a complaint of right east pain of five days duration. On examination body T=38°C with right breast tenderness put no fluctuation. What is the mos! likely diagnosis? * A. Breast Abscess C. Fibroadenoma B, Breast Cancer D. Fibrocystic Change 40.4 32 yeatcold man presented to the surgical OPD with complaint of neck mass of one year duration. On examination he | as a hoarse voice and a solitary 2cm x 2cm thyroid mass on the right side which has firm ¢ ynsistency and fixed to underlying structures. There was no lymphadenopathy. What is th : most likely diagnosis? A. Thyroid adenoma C. Thyroiditis CB) Thyroid cancer D. Toxie Nodule 41, A 35 year-old man with a chronic peptic ulcer disease presented with features of acute abdomen and chest Xeray revealed pneumoperitoneum, His symptoms lasted for six hours and his vital signs were stable af er infusion of one liter of Normal Saline solution. What should be the next step in the manage: nent of this case? A. Barium meal study C. Triple therapy B. Endoscopy > Laparotomy 42. A.50 year-old woman brou sht an ultrasound imaging result which showed Gall Bladder Stone. She has no abdominal pan and no known medical illness. Which of the following is the recommended management? A. Cholecystectomy B. Extracorporal Shockwave Lithotripsy (ESWL) Zee .. Ursodeoxycholic acid 43, A 68 year-old man is admitted to a Hospital with complaint of intermittent lower abdominal pain, bowel habit change and rectal bleeding of one month duration, He has tenesmus and incomplete sense of defecation and had lost weight. What is the most likely diagnosis? A. Amebic dysentery « B) Colorectal cancer C. Sigmoid Volvulus D. Ulcerative colitis 44, A 55 year-old man presented to the surgical OPD with a complaint of rectal bleeding of one month duration. He has no protruding mass per rectum and digital rectal examination was non- ‘revealing. What is the investigation of choice? \ Scany jo yeircold man was seen at the Pmergency surgical OPD with perianel pain of two days fation. He has fever and chills, He has left perianal induration with tendemess but no iuctuation, What is the most likely diagnosis? A. Anal fissure C. Perianal fistula C& Perianal Abscess D. Thrombosed Hemorthoids + 46, A 20 year-old man was seen at the emergency department following road traffic accident of one hour duration. He has sustained trauma to the abdomen. On examination; Vital signs: BP= eet) mmHg and PR=120/min. He has tire marks on the abdomen and it was tender. The patient is started! on IV fluids, What is the next step in the management? : A. Abdominal CT-scan C. Observation CBD Exploratory laparotomy D. Plain abdominal x-ray 47, A 50 year- old man came complaining of fatigue and dyspepsia of three months duration. Physical examination revealed a pale conjunctiva with a palpable mass at the epigastrium that moves with respiration. What is the gold standard diagnostic modality? A. Abdominal Ultra sound CQ Upper GI Endoscopy B. CT scan of the abdomen D. Plain abdominal film 48. A man was stabbed to the abdomen and presented to the Health Center with eviscerated small bowel which was getting dark. Which of the following is the correct initial measure before referral? » Pepy ArCover the intestine with saline gauze tise B. Refer to a nearby hospital without intervention C._ Replace the intestine back into the peritoneal Cavity D, Widen the stab wound under local anesthesia year-old farmer presented to the OPD with abdominal pain and frequent vomiting of one day duration. On examination the abdomen is slightly distended and has visible peristalsis. Plain abdominal x-ray showed step ladder pattern air-fluid level. Which of the following is the most likely diagnosis? A. Caecal Volyulus C. Sigmoid Volyulus B. Compound Volvulus CD, Small bowel Volvulus oe wy 50. A 65 year-old man was seen at the Emergency OPD with abdominal pain, distension and failure to pass feces and flatus of two days duration. He had two similar attacks in the last three years and was successfully treated with rectal tube deflation. On Examination BP=90/60 mmHg and PR=110/min, The abdomen was tender and bowel sounds were absent. Which of the following ¢ avoided? IV fluid (D>? Rectal tube deflation by NBE, ily 2015Ji a a a5 yoarcold housewife presented with progressive submandibular swelling of wo daysag ‘uration. She visited a dentist and undergone 1ovth extraction a day prior to the start of her symptoms. Examination showed tense, shiny bilateral submandibular swelling with no area of fluctuation. She also has drooling of the saliva and protruded tongue. What is the diagnosis of this patient? Ludwig's angina €, Submandibular cellulites Periodontal abscess D. Submental abscess 52. A 20 year-old man presented to the OPD. forty minutes after he sustained siab injury to his left posterior chest. He has shortness of ‘breathing, He is acutely sick looking; BP= 110/60 mmHg, PR= 90/min, RR=26/min. He has decreased air entry on the lower left chest with visible air rush through the stab wound. What is the best first step in the management of this patient? A. Apply airtight dressing CB. Apply triangular dressing C. Suture the wound D. Take chest X-ray 53, A 35 year-old male patient came to emergency OPD 12 hours after he started to have sudden ‘onset of epigastric pain. He has long standing history of dyspepsia for which he has been taking anti-acids repeatedly. Examination revealed tachycardia, rigid and tender abdomen. What is the appropriate imaging study to reach a definitive diagnosis? ‘A. Barium follow through B. Barium meal hest X-ray in tibdominal X-ray 54, A 27 year-old patient was involved in a road traffic accident. He was brought to the Hospital by the driver He is agitated; PR=140/min and fecble, BP=80/40 mmtig. He has pale etiva and his chest is clear with good air entry. He has an echymosis over hhis left flank ollection of fluid in his abdomen. conjun area, Abdominal Ultrasonography showed a significant What is the most likely diagnosis? A. Cardiogenic shock Hemorrhagie shock D. Septic shock ; 55 A 64 year-old male patient presented to the Emergency OPD after he failed to pass urine for a day, He had difficulty of urination for the last one year. The previous night he took seven On examination he is acutely sick looking and in pain. Bladder is C. Neurogenic shock bottles of beer with friends. ki i d é i t likel: for acute urinar \ 10 em above the pubic bone and tender. ‘What is the most i ‘ely cause for acut yy Yi ea C. Bladder stone D. Urethral Stricture 10 by NBE, uly 2015Ts ys ‘5, An 18 years ‘old male presented, with right scrotal swelling of 1 day duration. He also has associated pain and it started while he was asleep, it woke him up. He also has fever and pain during urination. On examination right testis is tender, hot to touch, swollen, and the testicular cord is not thickened. What is the most likely diagnosis? : A. Testicular torsion C. Infected hydrocele (Bkpididymo-orchitis D. Testicular tumor STA a year-old male patient came with difficulty of urination for the last two years, He had previous history of whitish urethral discharge for which he was treated with tablets and injections, What is the most likely diagnosis? A. Benign prostatic hyperplasia B. Prostatic Cancer C. Sexually transmitted disease Do Urethral Stricture 58. A 43 year-old male patient came to the Emergency OPD after being involved in a road traffic accident before a day. He has failed to urinate since the incident and is unable to move his right lower limb. On examination his vital signs are normal, there is right pubic tenderness and blood on the penile meatus. What should be the next step in management? A, Decompress with percutanous needle puncture B, Do image-guided catheterization C. Inset a folley catheter to decompress the bladder Perform emergency suprapubic cystostomy 59. A 24 year-old man came to the Emergency OPD with severe pain originating in the flank, radiating inferiorly and anteriorly. He also has nausea and vomiting. His vital signs are within normal limits. Abdominal examination showed marked costovertebral angle tendemess. Urinalysis showed microscopic hematuria. What is the most likely diagnosis? C. Pyonephrosis A. Cystitis B, Pyelonephritis 8) Ureteric colic 60. A 60 year-old female patient presented with right sided flank pain and hematuria of one month duration, She also has significant weight loss, night sweats and malaise. On physical examination, she is chronically sick looking with normal vital signs, a bimanually palpable mass on the right flank, What is the most likely diagnosis? A. Chronic pyelonephritis Neuroblastoma il cell car iff i 56 year-old man presented with a serotal mass of three months duration, Physica examination revealed a 3cm x 4 cm firm mass on the lower pole of the right test hes ultrasound showed a well-defined hypoechoic lesion within the testi, Sun mace elevated, What is the most likely diagnosis? ee & bee F @© Testicular Tumor Ly D. Testicular torsion was 62, A 35 year-old male patient presented to the Emergency Room after sustaining a bullet i his left forearnr three hours back. Up on evaluation vital signs were normal ane ee 2 rotated forearm, intact distal neurovascular examination. X-ray showed comminuted di ane radio-ulnar fracture, Which of the following is a temporary means ofimmobilization? A. Apply POP cast ss, B.)Extermal fixation . Lateral arm traction D. Plating and screw 63. A 65 year-old male patient sustained a fall down accident three hours prior to presenting to the Emergency Room. He fell down with the arms extended. On examination vital signs were normal with a right wrist deformity, X-ray showed displaced Colle’s fracture, Which one is the best management option? A. Application of a POP Cast “B. Closed reduction and casting ~C. Open reduction and plating D. Skin traction for few days then casting 64. A 20 year-old male patient had an external fixator applied for a compound comminuted right tibio-fibular fracture three weeks prior to presentation. He now complains of pain at the pin site. On examination there is seropurulent discharge from the two distal pins. Which of the following is the best diagnosis? A, Cellulitis C. Osteonecrosis B, Osteomyelitis CD) Pin tract infection 65. A 20 year-old male patient came to you with right knee pain of five days duration, On examination BP=120/70 mmHg, PR= 84/min. The knee is swollen and tender with signs of knee effusion, X-ray showed a wide joint space. Joint fluid analysis revealed turbid fluid with 100,000WBC/mm?, Which of the following is the most likely diagnosis? A. Acute osteomyelitis B, Osteoarthritis ce Pyogenic arthritis D. Tuberculos arthritis 12ia 3g year-old primigravida comes for a routine vi Af na Bee isan soso ne fe @ routine visit at 39 wecks of gestation. Her blood i Fiverwise unremarkable, and she is completely asyimpomatic. Hor ce oe mination is 90% effaced, vertex presentation and at station. CoV 82 om dilated and Which of the following is the most appropriate aie deiscce Rae most appropriate management option for tis cae? B. Immediate cesarean section C, Outpatient follow-up till 40 weeks 96 ao cint induction of aber year-old primigravi 7 i ane Bae , aoe cone Ou Peseater of fetal movement of four days duration at Bea ree Meeks from LNMP. Shes otherwise symptomatic and has no medial frei acne signs, symphysio-fundal height of 34ems, no uterine ich of th ing is the initi < eee ee pits initial best step in the management of this patient? B. Do coagulation profile Prophylactic antibiotics 49. goa litasoud for confirmation . A OT year- i ee pee a Ho! jppropriate management for this patient? B. Kegel’s exercise C. Pessaries D. Vaginal hysterectomy 80.A21 year-old GII PI mother at 24 weeks gestation complains of sever vulvar itching and cotton cheese like discharge. A wet mount slide show no clue cells but hyphae. Which of the following is the most likely diagnosis? ‘A, Bacterial vaginosis “andida albicans Chlamydia trachomatis 'D. Trichonomas vaginalis 81. A 29 year-old woman presents with vaginal pruritus associated with white ourd like discharge. On examination there is erythromatous macular lesion but no vesicles. Investigation shows no clue cell, negative whiff test. Which of the following is the treatment of choice for this case? A. Azithromycin C. Metronidazole a Fluconazole D. Oral acyclovir 82. A 26 year-old GIP! woman at 26 weeks of gestation from her LNMP, comes for ANC follow up. She hasn't appreciated fetal movement yet, She had one episode of bleeding a month back ‘and noticed failure of increase in uterine size. Her uterine size measures 20 weeks and you are unable to hear fetal heart tone. ee Which of the following is the most descriptive diagnosis? A. Incomplete abortion B. Inevitable abortion = Notionel Licensing Examination for Health Professionals by NBE, Aly 2015 fas 15i Sa gp year-old healthy nulliparous woman has a firm, ih = ~ » irregular shaped, 12 week-sized midline {vnich of the following is the best initi i i i pe Beves: itial step in evaluating this patient? B. CT scan Cc. MRI €.D? Ultrasound 4 84. Which of the following is NOT aco: a Pais es he ponent of active third stage management? CBO Nipple stimulation C. Uterine massage ne Oxytocin provision AGI ini 1 PIT mother came to a clinic at gestational age of 16 weeks for ANC follow up. Which of the following i: ance Reni a. likely to be requested a5 part of a routine work up? Ultrasound C. Urinalysis D, VDRL 86. A primigravida was admitted to a Health Center due to pushing down pain of 6 hours. Physical examination; vital signs were normal, uterine size 36 weeks, longitudinal, cephalic, FHR=146/min, two contractions in 10min each lasting for 30-45 seconds; cervix is 3 em dilated and 60 % effaced, After 4 hours she was reevaluated and had same findings except the cervical effacement changed to 75 %. Which of the following’ts the best management option? A, Augmentation B. Rehydration C. Referral to hospital Q) Closg follow up 87. ObstGtric forceps was applied to effect delivery of an alive female neonate at station +2 in tert oceipito-anterior position with a 45°rotation. Which of the following best describes this type of forceps delivery? A. High B. Low C._ Midpelvic Outlet gg. ASregnant lady had a uterine size which is five centimeters less than the stated LMP. Which of the following is LEAST likely as a possible cause for this discrepancy? A. Fetal infection B, Congenital malformation C.. Wrong date Concealed abruption ; cot 89. Which of the following is an essential prerequisite for application of forceps? ‘A. Cervix more than 8 cm B. Gestational age beyond 37 weeks Ruptured membranes . Vertex presentation 16 -) icensing Examination for Health Professionals by NBE, July 2015y pit mother who gave birth to an alive health ; J ies be restless and pale. On physical ete ee ape Chee em bate ns oun gjmin, T=36°C; uterus 2 week and soft and ative ea oe ae PR Be ie latina is the ride appropeite a active vaginal bleeding nin, ent irst step in the management of this patient? B. Administer intra-nasal oxygen C. Blood transfusion > Call for help 9f- th the active management of third thir i pau vee ird stage of labor, placenta failed to be delivered by controlled Which of the following is the 3 A i Mruaccne 2 next best step in management? <3> Manual removal of placenta C. Pitocin IV drip D. Wait for spontaneous expulsion 92. -old gi ce oe girl came to Gynecology OPD with a complaint of abdominal pain of six months guralon, The pain is crampy and recurrent. She had never seen menses before, On examination ere is a central 14 week-sized abdomino-pelvic mass ‘Which of the following is the most likely diagnosis? A. Dermoid cyst B. Full bladder imperforate hymen Myoma 93. A 32 year-old nulligravida woman came to gynecology OPD with a complaint of © A erate flow of one year duration. She also gave history of constipation and pet Deas epesilure to conceive of four years duration. On examination there is central, 12 weeks size firm abdomfno-pelvic mass. Which one is the most likely diagnosis’ ‘4, Endometrial hyperplasia B,_Ovarian tumor “Uterine myoma =D. Uterine sarcoma 94, 4.35 year-old GVPIV mother at gestational age of 8 weeks presented to gynecology OPD with {complaint of vaginal bleeding of four days uration. She had excessive vomiting her uterus is big-for-date. Which of the following 's the most likely diagnosis? ‘A. Cervical polyp B. Ectopic pregnancy C. Incomplete abortion Q Molar pregnancy ¢ 95, Which of the following contraceptive methods is the most effective? ‘A. Combined oral ‘contraceptive pills B.. Female condom Intrauterine contraceptive device D. Medroxy progesterone acetate National Licensing Examination for Health Professionals by NBE, Aly 201517 year-old student came 10a Clinic seeking pregnancy : yy age of LO weeks. She gave a history of sexual assault nn SmMiNétion service at gestational which of the following is the best method of terminati f pres ki Cp Biaaten al cicenye ‘rmination of Pregnancy for this case? . Intramuscular methotrexate . Manual vacuum aspiration Mifepristone and misoprostol 97. A’24 Year-old primigravida who came for @ routin. i Should a health officer initiate ARV drugs for this ee oe a Vie ae pea cere : C, At 28 weeks of gestation Buk Re ee st nen D. At 36 weeks of gestation ; nic with a complaint of lower abdominal pain of one day du at GA of 22. weeks. She has previous history of excess Paine which was not treated. On examination Vital signs-within normal limits » No contraction FHR- 150bpm Which of the following is the most likely diagnosis in this case? a A. Abdominal pregnancy B. Acute appendicitis D. Ovarian cyst torsion 99. A Para III mother who Gave birth to an alive male neonate at home before one hour brought to a Hospital because of restlessness and protrusion of mass per vaginum, On examination she is acutely sick looking, BP is not recordable, PR=132/minute and feeble RR=20/mis 1, T=36°C. Abdomen-uterus not palpable, globular fleshy mass with minimal bleeding protruding through the vaginum, Which of the following is the most appropriate initial management of this case’? A. Intra nasal oxygen 6 L/minute B. Reposition the uterus €. Resuscitation with IV fluids D. Start oxytocin drip i Degenerative myoma rH rimigravida at 38 weeks was admitted in second stage of labor and stayed ie sure Ree eat 1 faugicg between 80 — domi, vertex presentation wih he occiput direct anterior, station +3, grade-I molding, no capit and grade-I meconium staines fluid, Which of the following is the next best step in management ‘A, Expedite delivery right away by vacuum ‘B. Refer her for cesarean section C. Re-position her into the left lateral position P D. Secure IV line and await spontaneous vaginal delivery ae -) iabetic patient is admitted to ER with the diagnosis of sever id has ee soed insulin for the last 3 hours. Which of the following electrolyte abnormalities is expected? ‘*Hypocalcemia » Hypokalemia . Hyponatremia * D. Hypophosphatemia 18 National Licensing Examination for Health Professionals by NBE, July 2015A 18 pynpared with standard WHO oral rehydration sol which of the following electrolytes is found in high concent rn ; ne ‘ations in ReSOMal wh A. Chloride B, Phosphorous \ Potassium D. Sodium 103. An 11-month old male infant is brought Physical examination reveals irtitable i i drink. What is the correct type and Rolucs A. Ringer's lactate , 300ml = B. 0.45% Normal saline,700m1 ae rehydration solution,750m1 an eee lactate 500ml then ORS 500m) old boy is diagnosed with acute rheumatic fever three weeks afier an episode of sore throat. Which dru; fe shot ive fever? ig should have been given for the sore throat to prevent the rheumatic A. Clindamycin within 11 days B. Cloxacillin within 7 days C, Erythromycin within 16 days & Penicillin within 9 days t to ith we a Sy Rn eae diarrhea of 2days duration, » Sunken eye : of ud for this infant? Se" tee 2 is men old infant is brought to ER with fever, cough, and fast breathing of three days on E er inquiry reveals history of repeated chest infection, interruption during breast eding and poor weight gain. Precordial examination reveals active precordium and pan systolic murmur at lefi lower sternal border. : Which of the following heart lesions most likely explains these findings? A. Atrial septal defect B. Tetralogy of Fallot C._ Tricuspid atresia Nentricular septal defect 106. AWAvéek old girl who was apparently healthy two days ago is brought to the ER. She is pale and has dyspnea with RR=80/min, T= 37.7°C, PR=193/min, heart sounds are distant, a gallop is heard, liver is 6 cm below right costal margin. Chest X-ray shows cardiomegaly and echocardiogram reveals poor ventricular function and dilated lefi heart chambers. Which of the following is the most likely diagnosis based on this clinical scenario? CA” Dilated cardiomyopathy C. Myocarditis D. Pericarditis B. Endocarditis 107, An 8-year old boy known cardiac patient on follow up has a 3-week history of low-grade fever of unknown source, fatigue, weight loss, myalgia, and headaches. On repeated examinations during this time, he is found to have developed a new heart murmur, petechiae, and mild splenomegaly. Which of the following is the most likely diagnosis? A. Acute rheumatic fever m B. Rheumatic recurrence fective endocarditis . Dilated cardiomyopathy - National Licensing Examination for dtealth Professionals by NBE, July 2015a -yeat old boy is diagnosed with acute rhe ory polyarthritis, fever, elevated ESR. faccion. Which of the following is the appropri tient? ® A. Amoxicillin for 7 days Aspirin CG Penicillin prophylaxis life long . Prednisolone 109. Aft i i ro , Pen pasos =f ash 8 toddler, the parents are worried about the transmission rs, ophylaxy? ch house hold members should receive erythromycin leumatic fever wi and evidence late regarding th ith the following fi Of preceding strep, 1 management of the above ndings: A. All house hold members B. Immuno-compromised C. Unyaccinated against pertussis D> ¥ounger than 7 year 110. | Which of the following clinical conditions that appear after pertussis vaccination is an absolute contraindication to subsequent administration of the vaccine? A. Fever and convulsion within three days B. Immediate anaphylactic reaction . Inconsolable cry longer than two hours D. Shock-like state after two days 111, Which of the following vaccine should NOT be given for an infant with severe immune suppression? A. Hepatitis B B. Measles C. Megingococcal D. Pneumococcal vaccine , 112. You are evaluating an HIV exposed neonate immediately rhe mo proper ANC follow up and was managed according PMTCT option B+. Which of the following is the appropriate recommendation for this newborn? after delivery. The mother had A. Avoid breast feeding : e B. Cotrimoxazole prophylaxis within the first week of life DNA- PCR test within 48 hours (D) Nevitapine for 6 weeks 113, A3 month old infant has thinorrhea, reveals RR=72/min, PR=142/min and a ie chest retraction. What is the most likely diagnosis’ / Bronchiolitis : * , Gastroesophageal reflux disease C. Hyper active airway disease D. Severe pneumonia cough and noisy breath, Physical examination 37.8°C. He is irritable and has diffuse wheezes and 20 Examination for dealth Professionals by NBE, July 2045 National Licensing"which of the following best describes clin; a es Ascending symmetric Paralysis tee G Asymmetric Paralysis an sh ic Symmetric paralysis and cal features of Gi It Sensory ch : ¥ chan d sensory change ee cranial nerve palsy Sensory changes uillain-Barté syndrome? 115. A5 year-old boy with HIV. infe He presents with progyyssive diff He has no history of fever Oxygen saturation is 10 %, What is the most likely diagy A. Heart failure (_B. Pneumocystis pneumonia ~C. Pulmonary tuberculosis D. Severe bacterial pneumonia ing Zidovudin edi culty of breathing for three nese and Nevirapine. Chest radio, ¥ ly dingnosig? Ph 116. The recommended time to start folate myelomeningocele to prevent its recurrenc A. At the first missed period ve ~End of first trimester oll ie One month before conception . Third trimester 117, Which of the following CSF profile is expected in a child with meningooncephalitis? A. Leukocytosis with neutrophil predominance B, Normal protein level Z& Normal or slightly reduced glucose level D. Organism on Gram stain 118, A 12 hour old neonate presented with a boggy diffuse s Forceps was applied for prolonged second stage of labor. On examination he is in respiratory distress, grossly pale, and the capillary refill was 5 seconds. What is the most likely explanation for supplementation for a mother who had a baby with ¢ in future pregnancies is: ‘ Ip swel the above scenario? C. Intracranial hemorth: D,) Subgaleal hemorrhage high grade fevér three hours after he took the first @ vaccine .On examination he is febrile and What is the most appropriate A. Caput succedaneum B. Cephalhematoma 119. A 6 week-old infant presented with of his scheduled vaccines. He was well before thi irritable otherwise there are no findings in the other system. management of this infant? C. Investigate for infection GB Paracetamol suppository profiles suggests pyogenic meningitis in neonates? A. Admit for observation B. Initiate oral antibiotics 120. Which of the following CSF C. Low glucose count * pee D. Positive gram stain . High protein 2 tion for dtealth Professionals by NBE, uly 2015 Notional Licensing Exomina! eold boy bled from multiple sites after he sus ‘Onexamination he has tachycardia and the blood press Mne correct amount of crystalloid yoy ta ined an accident while riding u ure is not recordable. Whi ood pressu at will Will administer as the initial Boles? A_10 mlkg ' ee mallkg C. 30 milky 122. ‘A'S year-old bo: i Badait non peateld boy presented tote OPD with abdominal swing ire rie ae is normal, PR=100/min, RR= 42/min. He has sony dale asco leh Pe en shifting dns and Mid til on bon . ¢ ing, pedal edema, Urinalysi: ie following serum levels should you measure? ysis showed protein 4+. Which one of the A. Alanine transaminase “C, Cholesterol B. Bilirubin D. Creatinine 123. 4.36 month-old male infant presented with high grade fever and vomiting of 1wo days duration. He has right costovertebral angle tenderness. White cell count showed leukocytosis with left shift and blood film is negative for hemoparasite. Urine is positive for nitrite and leukocyte esterase. What is the most likely diagnosis in this child? LA, Pyetonephritis C. Appendicitis ~~ B. Hepatitis D. Lobar pneumonia 124. _A S-ycar old boy sustained a penetrating injury to his right leg. Two weeks later he fever. X-ray of the affected limb. developed swelling of the injured leg and high grade Showed features of acute osteomyelitis. What is the most likely etiology? ‘A. Pseudomonas aeruginoss B. Klebsiella pneumonia E. Streptococcus pyogenes D. E.coli year-old child has delay in a phaly, severe stunting, Pt o determine serum mile stones for his age. On examination in all developmental bilical hernia and coarse facial protruded tongue, uml 125. A2 level of : he has macroce} features. The best initial test is t A. Cortisol B. Growth Hormone CC. Thyroid Stimulatin “p. Vitamin D g Hormone ote for Malathion poisoning? priate antic C. N acetyl cysteine 126, Which one of the following drugs is an appro! Se aeaonit il D. Naloxone Flumazen! 2 Examination for Health Professionals by NBE, bly 2015 * National Licensingfe old bo: nt i C jt PE veces et 4 complaint of intense Prucitis wo rexaminatio esicul Papular eruptions at the interai, OFse at night, On the best treatment for this child? ¢ inlerdigital spaces. Which one : is A. Acyclovir B. Erythromycin C. Mebendazole 128. A 2-hour term neonate is delive CD. Pernethrin red by elective CVS f ang tive CIS for placenta previa. On physica and oxygen saturation of 80% . €spiratory distress in this neonate? examination PR=1 70 fmin, RR=72/mi What is the most likely cause of r A. Congenital Pneumonia B. Perinatal Asphyxia ue Masai tary distress syndrome } ‘Transient tachypnea of the newborn i ee a sue perce oe difficulty of breathing of 2 hours. Mother reported that he fee ial ons voice in the last wo days, On physical exam he is agitated i Fest and lower chest indrawing. What is the most likely diagnosis in this child? (CA~ Croup syndrome C, Pertussis B. Foreign body aspiration D, Severe pneumonia 130, A 7-year old female patient who is on follow-up for bronchial asthma presented with shortness of breath of three hours, On physical examination she is conscious, able to talk in complete sentence, RR= 46/min and PR=110/min. Chest examination reveals diffuse expiratory wheeze, What is the initial best step in the management of this patient? A. Aminophylline B. Magnesium sulphate C. Oral prednisolone _(D Salbutamo! puff 131. A 3 year-old boy is brought to the ER with high gr two days. On physical examination RR= 62/min, T \ bilateral basal coarse crepitation. The chest X-ray showed left basal lung pneumatocele Which of the following is the most likely etiology? ade fever and shortness of breath of 9°C, lower chest indrawing with C. Streptococcus pneumonia A, Haemophilus Influenzae D. Streptococcus pyogenes sf B Sisphylococens aureus ith high gffade fever of 5 days. He has : 13- old street boy presented to the ER with high gf ‘ ) eile eee ‘and headache, On physical examination heart rate 120/min, respiratory rate 23 : % National Licensing Examination for dealth Professionals by NBE, July 2015 onal Licenp, temperature 39°C and has petechi a . ial : “initial test for diagnosis? “Sh On trunk. Which of the following is the best A. Blood film B. Complete blood count © CSF analysis E. Widal test 133, in} i alte ald phases may haye more than one mode of transmission, The number of modes ae san Eto on the control, elimination or eradication of that specific disease, perspective, which of the following diseases is more difficult to control? A. Pulmonary tubereulosis C. Syphilis B. Relapsing fever D. Trachoma 134, a health Officer is delegated to lead a team travelling to West African countries to control the epidemic of Bbola Virus Disease (EVD). The role of the team includes giving supportive care to the cases of EVD and teaching them to avoid contact with the rest of the community members. To which prevention level (s) can this be categorized? A. Primary prevention both to the patients and the community B. Primary prevention to the patients but secondary prevention to the community C. Primary prevention to the community but secondary prevention to the patients D, Primary prevention to the community but tertiary prevention to the eases 135. _ Anestimated 90 people out of 100 cases of Ebola die. What does this proportion show” A. Cause specific mortality rate B, Case fatality rate C. Proportionate mortality ratio D, Crude death rate 136, Suppose psychosis is ot study whether khat chewig causes psychosis in this countr designs is most appropriate to assess this association? a rare health problem in a specific country. Researchers want to yy. Which one of the following study C. Cohort study D. Experimental study for which of the following health problems is A. Cross sectional study Bw Case control study 137. Considering the nature of the diseases, screening LEAST recommended? Screening for HIV infection ee women for syphilis 24138. Suppose “Test X” is used as a seree) : of “Test X° are 90% and 80% respectiver eye Dis ope CASEY". The sen these findings? Pectively. Which of oe he following s NY and speci S Correct interpreta A. ‘Test X° can correctly identify 90% of individuals with B. “Test X’ can correctly identify 90% of ind C. “Test X? can correctly identify 80% of in; D. 20% of the individuals with ‘Disease y> Widuals without ‘Disease y> dividuals with “Dj Y “Disease Y’ will be missed by 7 oer Test x” 159. Patients may be grouped based on different characteristics for reporting, Wh following grouping represent ordinal data? & Which of the A. Blood group &. Disease severity B. Ethnic group D. Sex 140. A researcher is interested to determine whether there is malaria outbreak in a given zone 0 region. Which method is the best to collect data for the intended purpose at community i A. Conduct Sample Survey i B. Conduct Census ©, Review record of patients in all providers D, Focus group discussions 141. Which of the following diagrammatic presentation turns cumulative frequency disiribution in to graphs? A, Ogive curve Frequency polygon C. Stem and leaf plot D. Histogram f 1 142. ‘The dietary assessment on patients from a refugee camp shows many of the patients subsist on a diet of corn meal and boiled greens. They have little appetite for food and altemate between diarrhea and constipation. They also have scaly dermatitis. What is the most probable dietury deficiency in these patients? ff Niacin B. Pyridoxine C. Vitamin B D. Vitamin K 143, The serum level of 1, 25 di-hydroxy vitamin D in adolescent girls is believed to be normally distributed with mean 65 pg/ml and standard deviation 12.5 pg/ml. What percent of adolescent girls will have a level higher than 65 pg/ml? A. 10% B. 25% Cc. 50% = D. 100% tianal Licensing Examination for dealth Professionals by NBE, July 2015A. Simple random sampling B, Cluster sampling ©. Stratified sampling ae D. Quota sampling en aah ae eee et ioe aly from cereals and legumes. She usuelly uses ee ne = e hardly gets vegetables and fruits foods in the icy is this family likely to face? A. Cholecalceiferol B. Folig acid C. Niagin D. Pyridoxine 146. A large number of under-five children were diagnosed with serious neurological problems and anemia in a certain Woreda, The families of these children were strictly vegetarian. What is the most likely nutritional deficiency of this community? A, Vitamin B12 ZS Folic acid C. Niacin D. Pyridoxine 147. A four year-old child is brought to the Health Center with acute respiratory tract infection for the first visit. What dose of vitamin A will be given for this child? A. 50,000 B. 100,000 1U C. 200,000 1U D. 400,0001U 148. A patient admitted to a Hospital ate a 57 gram serving of whole-wheat spaghetti containing 8 {grams protein, 40 grams carbohydrate and 2 grams fat, What is the estimate of energy intake of this patient in Keal? A, 200 ©. 280 D. 400 B, 210 149. A health officer aims to initiate a behavioral change among individuals by considering the socio-cultural factors after identifying the personal characteristics of the people. Which one is the best theory or model to apply? ‘model150, While giving health education to a grou fe how fs sto whish ofthe lowing eaming mats ae psn) an Pam 4 Model : B, Photograph C. Poster D. Real object 151. Which of the following sites is ideal place to display a message using information education communication materials to create awareness of a new family planning method in a rural village? A. Homes W. Market places 152. Some community-based preventive interventions initiated by the government have failed to ‘meet the desired objectives even though they have good plans. Which of the following is the main reason for the failure? A. Absence of appropriate technology B. Higher cost of interventions C, Lack of good policy in the country D. Lack of planning with the community 153. A communal well water source development project was planned to be developed in a rural village. For the outcome of the project to be effective, what needs to be identified in the process? é. Acceptance of the water source by the community Cost of materials for development purpose €, Electrolyte composition of the water source D. Lgvel of trace minerals in the water source 154. A report from a health center showed most residents of that district were affected by water related diseases. An assessment in the district revealed that most of the residents drink water from few sources of untreated wells by treating it with Water Agar. But the culture of keeping personal hygiene was poor. Which water related discases would affect the residents of the district most? ‘A. Water arthropod disease C. Water impounding disease B Water borne infection D. Water washed disease 155. Hazardous waste disposal was found to be a critical problem in a Health Center. A disposal options for hazardous wastes was required for a public health action. Which waste disposal option is the most appropriate for the health center? C. Incinerating A. Burying B, Composting D. @ffsite Disposal 27 National Licensing Examination for Health Professionals by NBE, July 2045 ¥epidemic? A. Application of outdoor residual spray B. Destruction of Mosquito breeding sites C. Enforce usage of insect repellants 2 D. Timely treatment of cases . ale aie vee an ordinary millhouse is known for recruiting uneducated, economically baat ee * 8 Permanent employees. The employees do not use any kind of Personal ive Equipment. Which of the following is the most effective inter ev Spree amneatle 1g st effective intervention to prevent A. Early diagnosis and treatment B, Enforce earmuff usage ©. Noise-proofing the mill D, Reduce working hours 158. Reproductive health experts use maternal mortality as indicator of maternal health status although it has limitations, What is the main limitation of using this indicator? A. Mis difficult to measure it at community level B, Itis not standard measure of deaths C. Itover-represents maternal health problems D. Itunder-represents maternal health problems 159. The 2011 Ethiopian demographic and health survey reported that iustitutional delivery service utilization was 10% which was unacceptably low, What was the most important reason reported by women for not delivering in a health facility? A. High cost of delivery services B. Lack of access to health services C. Lack of awareness D. Lack of transportation 160. If an organization wants to design a strategy targeting the most important direct cause of maternal mortality globally, Which cause should get the first priority’? A, Abortion A. Hemorrhage C. Hypertension D. Sepsis 161, A health officer wants to know risk of maternal death due to level of fertility and risk of maternal death per pregnancy or per birth. Which measure of maternal mortality should he/she use? A. Life time risk of maternal mortality es B. Maternal mortality rate C. Maternal mortality ratio D. Proportion maternal 28 National Licensing Examination tor dHealth Professionals by NBE, July 2064 Emergency obstetric care C. Family planning —_D. Nutrition intervention . A manager of a He er wi aa Be ‘ foe Center wants to provide BCG vaccine for infants on Fridays. Which g is the best management function that the manager used? ae A. Organizing ve B. Planning ft Controlling 'D. Implementing 164. A Hospital manager allocated . a budget for three different activities. Whicl eae ec different activities. Which of the following A. Designing strategy B, Prioritizing problem 165. An EPI coordinator of a district and his subordinates were implementing the program for according to national standard of EPI coverage, Which one is the best method to assess their performance at the end of six months? A. Comparing performance against the standard B. Implementing controlling process C. Measuring actual performance C. Setting objective D. Situational analysis D. Standardization of performance 166. A zonal Health Department head assigned a budget for different tasks for a fiseal year. Which decisional rple did he play? ‘A. Negotiation role CC. Resource allocation role D. Monitoring role B. Dissemination role 167, The total population of certain locality was around 25, 000. Which of the following health to that community? facilities is suitable to provide health service ‘A. District hospital C. Health post B. Health center D. Health station 168, A college dean who has experts in different professions as employees left them to do their jetivities, What leadership style did he apply? C, Democratic D. Laissez faire A. Autocratic rent of a certain health facility B, Bureaucratic 169. There was interpersonal conflict in the same deparims the best management option that they do? ‘A. Leave the issue for those involved is fter a month B, Manage the conflict al C. Switch one of them to another department D. Resolve the conflict as soon as possible vis What was NBE, Luly 2015 National Licensing Examination for dealth Professionals by eo170, 424 year-old woman comes to your office for to try to get pregnant and wants to stop takin, attempt and severe peri- management? follow up on her depression, She has devided g her fluoxetine. She had a history of suicidal Partum depression in the past. Which of the following is appropriate , A. Continue to take fluoxetine B. Shift to another antidepressant C. Shift to antipsychotic drug D. Start mood stabilizer I7L. A 26 year-old woman brought by her sister to the Hospital with seven months history of ee ; Gradually develops poor self-care, isolation and sleep problem tears the voices of several people talking to her. His sister says she talks to herself and laughs alone. On mental state examination she has blunt affect, auditory hallucination & has ho insight to her illness. Which of the following isthe most likely diagnosis? A. Delusional disorder B. Schizoaffective disorder Schizophrenia 1. Schizophreniform disorder 172. A 28 year-old man diagnosed as a case of Major depressive disorder with psychotic features He is treated with haloperidol and amitriptyline. Two months later, his mood symptoms have resolved and he is no longer psychotic. Which of the following best describes the next step? A. Both drugs should be tapered and discontinued B. Haloperidol should be tapered and discontinued C, Amitriptyline should be tapered and discontinued Both drugs should be continued for 6 months 173, A 53 year-old man comes to the Hospital complains of poor appetite, loss of pleasure in daily activities, sleeplessness, & decreased libido for 3 weeks. He is contemplating, retiring, expressing concern that his poor performance in his job. On mental state examination he shows empty feeling & makes two errors in subtraction serial 3°s from 20.Which of the following is the most likely diagnosis? A. Bipolar disorder B. Cyclothymia C. Dysthymic disorder D. Major depressive disorder 174. A 35 year-old man diagnosed to have Major depressive disorder was given 75 mg amitriptyline at bed time. On the third day he starts hearing voices which tell him that “he is a bad person”. On mental state examination he feels sad and has auditory hallucinations. Which of the following is the most appropriate treatment? Q) Haloperidol . Diazepam A. Diazepai D. Sodium valporate B, Fluoxetine 30 National Licensing Examination for Health Professionals by NBE, July 2015 eA 20 year-old male brought by oe .. i smoking marijuana he became suspici easily irritable. These behavioral char examination he has thought & Pereepty of the following is the most likely dia, A. Cannabis induced delirium : be ie epee induced Psychosis 4 eae ieee year-old alcoholic is brought to the Emergence: i b 'y Room with a problem of imelevant e days ago he quit alcohol after he was counseled, On mental state examination ial hallucination and agitation. There is h of the following is the most likely his coysi © Hospi ‘ SIN to the Hospital, His cousin SAYS that afle OUS and started to hear Voices is Nges persisted for the last two al disturbance, He has ho iBhosis? 8, He talks alone and is © days. On mental staie © past psychiatric illness, Which A. Alcohol induced Psychosis B. Alcohol intoxication C. Delirium tremens D. Wemicke’s encephalopathy 17. A 30 year-old woman came to Medical OPD accompanied by her husband. She delivered a healthy baby three weeks ago at a Health center. Her husband reports that she has irritability, tearfulness, & sleeplessness for the last two weeks. The past week she has started to feel worthlessness and have loss of concentration. Which of the following is the most likely diagnosis? A. Dysthymia B. Postpartum blues C. Postpartum depression D. Postpartum psychosis , 178. A 55 year-old man comes to Emergency Room with acute retention of urine for 12 hours. He was suffering from depression and taking drugs for the last ten days, On examination there is distended bladder. No other physical findings, Which drug is the most likely culprit? A. Amitryptyline C. Paroxetine B. Fluoxetine D. Sertraline 179. A patient comes to your clinic with a compliant of hearing difficulty of one month duration, There is only a set of tuning forks for hearing assessment at the Clinic. Which tuning fork should be used for the assessment? . 256 Hz C. 1024Hz 512Hz D, 2048Ez 180. A patient comes demanding for ear wash, Which of the following would be a contraindication for ear wash? A, Beads . B. Chronic otitis media C. Cockroach D, Impacted wax 3)old female child press (a? ee a oom to the Emergency OpD with foreign body in the ee n. On physical examination, there was an all pa button ty inside with discharge and necrotic nasal mucosal i oe Peter cat al surface, What is the best c Give acidic nasal drops for two days and remove it . Give nasal decongestants for two days and remove it C. Immediately removal D. Invigate with saline and give antibiotics 182. A 37 year- i eee ee popu vi a cockroach in the right ear canal, She is so much in i d fement of the insect. On physical examination, the right ear has big a Sentral perforation of the tympanic membrane. What is the management? - Add 3% hydrogen per oxide to kill the insect B. Add ethyl alcohol to kill the insect C. hirigation with warm water D. Take the insect out with a small artery while alive 183. A 22 year- old male patient has left sided ear pain with no discharge. He has no history of trauma and physical examination revealed tenderness over the tragus. What is the most likely diagnosis? ‘A. Acute oti C. Cerumen impaction B. Acute otits media D. Chronic otitis media 184. A 25 year-old man came to a Primary Hospital's OPD after a fertilizer was splashed into his eyes while working in his farm. He has redness on both eyes with photophobia, What is the externa best initial management? A, Take comprehensive history and ocular physical examination B. Refer urgently to the nearest ophthalmologic center C. Wash the eyes with normal saline D. Give anti-inflammatory and antibiotic eye drops 185. Which of the following is a cause for constricted pupil? A. Atropine B, Acute angle closure glaucoma €, Oculomotor palsy D. Organophosphate poisoning 186. During a school survey on refraction, a 6 year-old girl was found to have a refractive error of (+3) on the left eye while the right eye was (+6). If the refractive error is not corrected by spectacles, which of the following is LEAST expected to happen? C. Poor schoo! performance A. Amblyopia B. Floaters D. Strabismus . 187. What is the leading cause of visual impairment globally? A. Cataract C. Glaucoma B. Diabetic retinopathy D. Uncorrected refractive error 32 National Licensing Examination for dealth Professionals by NBE, July 2015Mi What is the most common cause of uni Unilatera Mesbolic/ hilateral cataract in young adults? , Uveitis C. Trauma D. UY radiation A. Age-related macular degeneration B. Astigmatism Cataract CQ) Presbyopia 190, peste: brought her 1 year old boy to the health center claiming the child has poor vision, ich of the following is the least likely to suggest congenital glaucoma? A. Blepharospasm B. Epiphora C. Increased corneal diameter / D. Redness 191, A 55 year-old man came to medical OPD with a chief compliant of pain during mastication for the last one year. Intra-oral examination shows horizontal teeth mobility around Imm, gingival recession with exposed root surfaces, intra-oral periapical x-ray shows alveolar bone resorption. Which of the following is the most likely diagnosis? A. Periodontitis B. Gingivitis C. Pybpitis D. Stomatitis 192. A 30 year-old woman who had tooth extraction four days ago came with severe pain in the socket. On examination the socket is dry with no clot formation. The alveolar margin was tender. What is the best next step in management? A. Apply local paste B. Do Debridement C. Pack with guaze D. Prescribe antibiotics ; 193, A 25 year-old women with gestational age of 11 weeks came to Medical OPD with recurrent toothache. On examination maxillary first molar hopelessly decayed and slightly tender to percussion. Which one of the following is the most appropriate management? A. Extraction B, Pain control C. PO tetracycline D. Root canal therapy - 33 National Licensing Examination for dealth Professionals by NBE, July 2015A. Deviation of chin c oe B. Lateral cross bite D. a rotrusion of chin ee Bi year-old man Presented to the Emergency Department with a chief compliant of jaw ao of! breathing Physical examination showed non-pitting, firm, board like ae ing over the primary mandibular facial spaces bilaterally with raised floor of mouth, dysphagia, tenderness on palpating the area and trismus of mouth. Which one of the following is most likely diagnosis? ee A Ameloblastom C. Ludwing’s angina B. Facial cellulitis D. Submandibular abscess 196. ‘A 25 yeat-old woman presented with gum bleeding and bad breath odor for one month Examination shows interdental papillae full of debris and multiple ulcers, easily bleeding gum, "near erythema and free gingival margin with full of ulcers, What is the mos likely diagnosis? A. Acute necrotizing periodontitis B, Acute necrotizing ulcerative gingivitis €. Chronic gingivitis D. Puberty induced gingivitis 197. A 25 year old women came with chief complaint of swelling related with lower tight jaw of about one week duration. History and clinical examination confirms submandibular space abscess. Which of the following tooth is the most likely cause? C, Lower 1* molar A. Lower canine D. Lower 2" molar B, Lower premolars 198. A 35 year-old woman came to a hospital with a chief compliant of inability to close her eyes. Physical examination shows dropping of the comer of the mouth, leakage of saliva, inability to close the right eye. Deviation of mouth to the right side. Which one of the following is the most likely diagnosis? A. Trigeminal neuralgia C. Glossopharyngeal neuralgia B. Facial nerve palsy D. Trigeminal nerve paralysis 199. A 30 year-old patient came with chief compliant of mobility of teeth. Which one of the following would suggest the diagnosis of periodontitis? C. Gum recession A. False pocket D. Short clinical crown B. Gum growth i a 200. A 25 year-old man presented with fighting accident of 24 hours. Physical examination shows laceration of upper lip, fractured upper incisor. X-ray result shows apical half fracture of the offending tooth. Which one of the following is the best management option? A. Extraction C. Root canal therapy B. Inter-dental wiring D. Splinting 34 NBE: National Licensure Exam for Health Professionals 2015 edition