Name

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1. A 30 years old mother who gave birth to a live male neonate 2 weeks ago, presented to
OPD with right breast swelling and pain of 03 days duration. Associated with this she had
high grade intermittent fever, chills, and rigors. on P/EBP=110/70 PR=108 RR=24 T=38.2.
She had grossly swollen breast with point tenderness on 3 0'clock 3 cm from the nipple and
puss through the nipple. which one of the following is not an option to manage this patient?
A-antibiotics C-incision and drainage
B-cold compression D-analgesics
2. Among the following statements which one is false?
A. In the case of acute abdomen don’t give narcotics or analgesics until diagnosis is
made
B. Somatic pain occurs when nerve fibers within the parietal peritoneum are irritated
C. Visceral pain is poorly localized
D. Surgical intervention is must for all acute abdomen cases
3. A 25 years old male patient presented with poorly localized abdominal pain over the peri-
umbilical region of two days duration which later shifts to the right iliac fossa associated
with anorexia, nausea and one episode of vomiting. Which one is the most likely diagnosis
of this patient?
A. Intestinal obstruction C. Acute cholecystitis
B. Acute appendicitis D. Acute pancreatitis
4. A 65-year old female patient presented with a sudden onset right upper quadrant
pain(RUQ) accompanied by rigor, fever and vomiting. On P/E BP=100/60 mm Hg with PR
of 96 beats per minute. She had RUQ tenderness and inspiratory arrest with deep
palpation. Which one is the best diagnostic investigation modality for this patient?
A. Abdominal ultrasound
B. Erect chest X-ray
C. Upper Gastrointestinal endoscopy
D. Plain abdominal film
5. A victim of road traffic accident is brought to the emergency room by a Policeman. The
patient was unconscious. The first step in the management is
A. Secure IV line and put on fluid C. Neurologic evaluation
B. Establish adequate airway D. Skull X-ray

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6. A 23 year old medical student sustained car accident while crossing road and bleeds
profusely from his right leg ,physical examination at emergency department is PR 110bpm,
BP= 80/60 RR= 20 GCS =14/15(E4V5M5) , and active bleeding from right lower leg how
do you manage this patient at first ?
A. Send the patient for X-ray to rule out fracture
B. Take detailed history and physical examination
C. Arrest bleeding, secure double Iv line and put on crystalloids fast.
D. After determining Hematocrite, transfuse him with crossed matched blood
7. A 70Kg male adult working at mining industry sustained flame burn to his both legs
circumferentially and on physical examination there is painless white to brown leathery
wound with marked edema , how much ml fluid are you going to give in the first 8 hour?
A. 12580 ml C. 6290 ml
B. 10080 ml D. 5040ml
8. An 18 year old male student presented with pain while micturation which radiate to tip of
penis and reddish discoloration of urine. he mentioned that voiding improve with change of
position the most likely diagnosis is
A) Urethral stricture C) Bladder cancer
B) Bladder stone D) BPH
9. which one of the following do not need antibiotic prophylaxis
A) Deep puncture wound
B) Wound with the area of vascular compromise
C) Wound over the hand and face
D) Hernioraphy wound
10. Patient come by ambulance after he sustained car accident and he was moaning, he has no
eye opening and extension for pain. What is his GCS and type of head injury
A. His GCS is 4 and severe Head injury
B. His GCS is 8 and moderate head injury
C. His GCS is 5 and severe head injury
D. His GCS is 6 and severe head injury

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11. A 25 years old male patient presented in the EOPD with a complaint of productive cough
of a week duration ,with associated high grade fever. On examination his RR=34,BP=80|50
mmHg, PR=116 T=39.2 0c, and there is course creptation on posterior basal lung field.
Which one is not true regarding the management of the above patient?
A) Antipyretics have a role in this patient
B) He should be admitted
C) He can be managed in outpatient with PO antibiotics
D) Oxygen supplementation is important if he desaturates
12. A 40 years old known asthmatic patient on per need Salbutamol puff came in to EOPD
with a complaint of exacerbation of shortness of breath of a day duration. He also
complained low grade fever and intermittent dry cough since 03 days . on examination
BP=130/85,PR=110 ,RR=34, T=38.20 c, oxygen saturation =82%.There is diffuse wheeze
on the posterior chest. Which one is the initial step in the management of these patient ?
A) Investigating the patient with CBC and CXR
B) Putting him in 100% oxygen
C) Giving parenteral corticosteroids
D) intiation of broad spectrum antibiotics
13. A 45 years old female known cardiac patient complained shortness of breath while going to
toilet, but she is comfortable at rest. Her leg swelling also worsened since a week. What is
the stage and functional status of this patient?
A. NYHA class-IV stage-C congestive heart failure
B. NYHA Class-II stage-C congestive heart failure
C. NYHA class-III stage-D congestive heart failure
D. NYHA class-III stage-C congestive heart failure
14. Abebe is a 35 year old farmer .He presented with bilateral leg swelling of a month
duration. On examination he has raised JVP and diastolic murmur at the apex .which of the
following drug is important to delay disease progression?
A) Spironolactone B) Enalapril
C) Digoxin C) Aspirin

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15. Which one of the following is not recommended as management of ischemic stroke
patients?
A. Giving oxygen support.
B. Giving aspirin immediately after diagnosis
C. Lowering blood pressure immediately when it reaches 180/110 mmHg.
D. Putting NG tube after swallow test.
16. This is a 9 year old male patient who presented with a history of class time inattentiveness
and frequent staring, fixed gestures episodes that last a few seconds. He has poor grades.
The likely cause of these symptoms is...?
A. Generalized tonic clonic seizure C. Absence seizure
B. Syncope D. Atonic seizure
17. Empiric treatment for community acquired meningitis patient includes the following drugs
in a patient <55 yrs old and >3 months old except...?
A. Ceftriaxone C. Ampicillin
B. Acyclovir D. Dexamethasone
18. All of the following describe the natural history of CKD except
A. Hyper filtration of non injured nephrons cause eventual sclerosis
B. Hypertension develops as a result of CKD
C. Onset of proteinuria is reflective of worsening of kidney disease
D. Proteinuria itself contributes to glomerular damage & progression of kidney disease
E. Progression of CKD is reversible depending on the underlying cause
19. A 48 year- old- man is referred to the clinic by his primary care provider after recent
laboratory studies showed glomerular filtration rate, calculated using the modification of
diet in renal disease (MDRD) study equation, of 55ml/min/1.73 squared meter. Medical
history includes diagnosis of Type 2 diabetes mellitus 10 years ago and diagnosis of
hypertension five years ago. Current medications include carvedilol 12.5 mg BID, lisinopril
20mg daily, and glipizide 5mg daily .Recent laboratory studies of serum show hemoglobin
A1C of 8.0% and potassium level of 4.5mEq/l. body mass index is 24.2 kg / squared
meter .Pulse rate is 64/min, and blood pressure is 124/64 mmHg .Physical examination
shows no abnormalities .To prevent further decrease in this patient’s glomerular filtration
rate, which of the following changes to his drug regimen is most appropriate?

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A. Increase the dosage of carvedilol to 25 mg twice daily
B. Increase the dosage of glipizide to 10 mg twice daily
C. Increase the dosage of lisinopril to 40 mg daily
D. Replace glipizide with metformin 500mg twice daily
20. Which of the following is most easily monitored immediate effect of iron deficiency
treatment?
A. increase in the MCV
B. increase in the Hct/Hgb
C. increase in the reticulocyte
D. increase in the MCHC
21. 26 years old pregnant lady who was ammenhoric for 5 months visit your health center &
you determined the hematocrit & found to be 30%. What is the next step?
A. refer her for transfusion
B. admits & resuscitates her with fluids
C. gives oral iron & link to ANC
D. urgently refer her for gynecology evaluation
22. A 25 yr old male from Arba Minch came to EOPD with chef compliant of headache, high
grade fever and vomiting of 5 days duration with associated malaise. What diagnostic
investigation would you do first?
A. CXR B. Blood film C. ultrasound D. blood chemistry
23. Who has complicated severe malaria?
A. a patient with asexual form of p.falcifarum and RBS of 60 mg/dl
B. a patient with gametocyte stage of p.falcifarum and HCT of 12%
C. a patient with asexual form of p.falcifarum and Cr of 3.5 mg/dl
D.apt with trophozoite form of p.ovale and RBS of 38mg/dl
24. All are correct about enteric fever, except
A. it is caused by non capsulated, gram negative motile bacteria
B. common manifestation of the disease is typhoid psychosis
C. gastric perforation is one complication
D. All complications can be prevented by proper diagnosis and treatment

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25. A 24 yr old RVI pt presented with fever& skin rash over the left chest 2 days ago. The rash
is vesicular and follows dermatome. She is confused and meningeal signs are positive.
Which of the following is the most likely diagnosis?
A. Pyogenic meningitis C. viral meningoencephalitis
B. fungal meningitis D. TB meningitis
26. In the second stage of labor fetal heart beat dropped to 100 beat per minute, the
management is:
A. Left lateral position
B. Operative delivery
C. No treatment is needed
D. Fetal scalp blood sampling
27. What is the most common type of fistula in obstructed labor
A. RVF C.UVF
B.VVF D.All
28. Which of the following is the earliest sign for magnesium sulfate toxicity
A. Loss of deep tendon reflex C. CNS depression
B. Respiratory depression D. Cardiac arrest
29. All of the following factors can predispose to abnormal adherence of placenta , except
A. Primiparity C. Previous curettage
B. Previous severe infection D. Previous cesaerian scar
30. Which of the following statement is false regarding the management of uterine inversion?
A. Freshly inverted uterus without placenta can be repositioned immediately.
B. Oxytocin should be given before replacing the inverted uterus
C. surgical intervention is indicated if vaginal replacement fails
D. surgical intervention should be done without any prerequisite
31. True about expectant management of preeclampsia
A. Controlling blood pressure halts the pathophysiologic condition
B. Seizure prophylaxis in preeclampsia without severity feature is not required
C. Sodium restriction and diuretic therapy helps in controlling blood pressure
D. Has more benefits for the mother than the fetus

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32. If the father of the fetus Rh positive and mother of fetus Rh negative,what is chance of
mother to fetus incompatibility
A) 100% C) at least 50%
B) 0 % D) <25 %
33. Obstructed labor account for how many percent of maternal death globally?
A 18%
B 32%
C 13%
D 8%

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34. The clinical findings of a woman with GA=8 wks with the chief complaint of hemorrhage
and clot passing through an open cervix Uterine size isabout 8 wks. What should be done ?
A-No treatment is needed because abortion is complete
B-it is a case of threatened abortion
C-it is an inevitable abortion
D-Obstetrics ultrasound is needed
35. Which one of the following is true regarding syndromic approach of STI?
A-It is important for resource limited countries
B-It is useful to determine prevalence of STI
C-it is the only way to diagnose asymptomatic STI
D-require lab facility
36. which of the following is contraindication for delivery using vacuum extraction
A. Face presentation
B. Second twins in vertex presentation
C. Post term pregnancy
D. Chorioamnionitis
37. Which one is not a contraindication for Intra Uterine Device/IUD/?
A. Pelvic infection
B. Suspected pregnancy
C. Cervical cancer
D. Undiagnosed abnormal uterine bleeding
38. In which type of placenta previa can a women deliver vaginally
A. Placenta previa totalis/Type IV
B. Placenta previa partialis/Type III
C. Placenta previa marginalis/Type II/ anterior
D. Placenta previa marginalis/Type II/ posterior
39. A 25-year-old woman, gravida II, para I, at 36+4weeks of gestation with a history of prior
cesarean section, presents with abdominal pain and vaginal bleeding. She admits to using
cocaine. Her vital signs are significant for T = 99.9, HR = 120, BP = 170/100. Fetal heart
rate baseline is in the 160s with minimal variability and repetitive late decelerations. Her

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blood work up is significant for hemoglobin of 7.5, and platelets of 110,000. The most
likely diagnosis is:
A. Trauma C. Placental abruption
B. Placenta previa D. Uterine rupture
40. A 20 year old woman presents for the evaluation of 3 months of amenorrhea. Her menstrual
periods started at age 13 and had been regular cycle until this time. She complaints of
fatigue, nausea and breast tenderness. Which of the following tests would be the most
appropriate first step in the laboratory evaluation of this patient?

A. serum prolactin C. Serum FSH

B. Pregnancy test D. Serum TSH

41. All of the following are indications for admission in a child with burn injury except:
A. Surface area > 10% C. Burn over the genitalia
B. Involvement of wrist joint D. Scald burn of any severity
42. The best drug that is used as antidote for organophosphate poisoning is:
A. Atropine C. Acetyl salisalic acid
B. Activated charcoal D. Paracetamol
43. A child is found to have feeble pulse, cold extremities and oliguria of 1day and diarrhoea
and vomiting of 5days; what is the 1st action to be taken?
A. Secure Iv line and give 2oml/kg of blood
B. Give steroid
C. Secure Iv line and give 2oml/kg of normal saline
D. Subcutaneous adrenaline
44. A 13 month old child presented to the health center with no immunization at all before;
which vaccines should be given?
A. Pentavalent, measles, OPV1
B. Pentavalent, measles
C. Pentavalent, OPV1
D. measles, OPV1

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45. A 2yrs old 10 kg child is assessed as having some dehydration because he is irritable and
has sunken eyes. How do you manage him?
A. ORS 1000ml over 5hrs C. ORS 750ml over 4hrs
B. RL 750ml over 5hrs D. RL 1000ml over 4hrs
46. Which one of the following is not true?
A. all patient with sever pneumonia need admission
B. for patient with foreign body aspiration bronchodilators are indicated
C. chronic Otitis media is ear discharge for 14 days or more
D. pneumonia can present only with fast breathing and cough
47. A 3yrs old child sustained a 2 nd scald burn of 20%; his body surface area is 0.5 and his
weight is 12kg; what is the amount of fluid requirement?
A. 1000ml C. 860ml
B. 960ml D. 320ml
48. One of the following is not principle of TB management
A. Chemotherapy like INH, rifampin, ethambutol, streptomycin
B. Nutritional rehabilitation
C. Screening for HIV
D. Admission of a patient at least for intiation phase
49. Which one of the following is correct?
A. Streptomycin is an IV drug for TB
B. Ethambutol = ototoxicity
C. BCG vaccine is contraindicated for HIV exposed infant
D. Pyrazinamide= hepatotoxicity
50. One of the following is not a feature of edematous malnutrition :
A. Generalized edema
B. Dermatosis
C. Ascites
D. Significant loss of subcutaneous tissue

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Answer the following three questions (51- 53) based on the information given below:
A study was conducted in one of the government hospital to determine whether chronic
alcoholism was associated with coronary heart disease. Of 156 study participants with coronary
heart disease (CHD), 23 were determined to be alcoholic at the time of their hospital admission.
Of the 3120 participants without coronary heart disease (CHD), 304 were found to be alcoholic
during their incidence.
51. What type of epidemiological study design is this?
A. Cohort C. Cross sectional
B. Case control D. Ecological
52. What is its appropriate measure of association?
A. Relative risk C. Attributable risk
B. Odds ratio D. Population attributable risk
53. Calculate its measure of association
A. 0.6 C. 2.6
B. 1.6 D. 3.6
54. Which of the following study designs is the most persuasive in establishing causality?
A. Ecological study C. Case control study
B. Cohort study D. Randomized controlled trial

55. Which of the following is generally considered to be the strongest or most

important guideline in causality?

A. Specificity C. Consistency
B. Temporality D. Coherence

E. Plausibility

56. Interpret the meaning of one study’s reported relative risk of 0.5 (95% CI 0.2, 0.9) for the
association between high level of Vitamin D consumption and breast cancer incidence.
A. There is no association between high Vitamin D consumption and breast cancer
rates.
B. High Vitamin D consumption is associated with an increased breast cancer rate.

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C. Those who consume a high level of Vitamin D are statistically significantly less
likely than those who consume low or no Vitamin D, to have a high rate of
breast cancer incidence.
D. Those who consume a high level of Vitamin D are less likely than those who
consume little or Vitamin D, to have a high rate of breast cancer incidence, but
it is not statistically significant
57. Which of the following conclusions is not true to explain the hypothetical statement that
“Air pollution is higher in Addis Ababa City than in Hawassa Town, but mortality from
lung disease is lower in Addis Ababa City than in Hawassa Town.” would be an example
of ecologic fallacy?
A. Addis Ababa City may provide better treatment for lung disease than Hawassa Town
B. People in Addis Ababa City may have better health insurance than people in Hawassa
Town.
C. Air pollution protects against lung disease deaths
D. Persons dying of lung disease in Hawassa Town may have moved from high air
pollution cities
58. A disease can be considered as epidemic if
A. It covers wide geographical area
B. It stays a long period of time
C. Excess occurrence of cases than expected
D. All
59. One of the disease is not under the list of surveillance priority diseases in Ethiopia
A. Tuberculosis B. Leprosy C. Meningitis D. Breast ca
60. One of the following statements is incorrect about disease surveillance challenges in
Ethiopia.

A. Late reporting of notifiable diseases

B. Low turnover of technical staff.
C. Inadequate data analysis

D. Lack of resource

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61. What type of data is formed by the figures the health professional has generated regarding
the number of cigarettes her patients smoke?

A. Nominal D. Ratio
B. Ordinal
C. Interval
62. Hypothesis testing can be made using the following methods, except:
A. Comparing the calculated and tabulated value of the test statistics
B. Using confidence interval
C. Using p-value
D. Summary statistics

63. The Characteristics of the Chi-Square Distributions are , but one is not
A. It is a symmetric distribution.
B. The shape of the chi-square distribution depends on the degrees of freedom.
C. As the number of degrees of freedom increases, the chi-square distribution
becomes more nearly symmetric.
D. The values of c2 are nonnegative.
64. In which of the following non random sampling techniques does the researcher ask the
research participants to identify other potential research participants?

A. Snowball C. Purposive
B. Convenience D. Quota

65. In a test of Ho: p = 0.4 against HA: p ≠ 0 .4, a sample of size 100 produces Z cal =1.28 for the
value of the test statistic. Thus, the p- value (or observed level of significance) of the test is
approximately equal to: 0.90; which one is true
A. Reject the null hypothesis at 5% significance level.
B. Do not reject the null hypothesis at 5% significance level
C. Reject the alternative hypothesis at 5% significance level
D. We cannot concluded at 5% significance level
66. One of the following are useful when determines sample size of study population, except?
A. Desired level of accuracy or maximum tolerable error

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B. Amount of variability in the population

C. Level of confidence required
D. Size of study populations
E. none of the above

67. The Essential features of a census data except,

A. Individual enumerations D. Taken sample at regular

B. Universality intervals
C. Defined periodicity E. Simultaneity
68. In order to calculate the t- test statistic for a hypothesis test, you do not need to
A. Calculate sample mean C. State a null hypothesis
B. Know a sample size D. Standard error
69. Which one of true statement about central limit theorem regarding sampling distributions.
A. The Sampling distribution of means of size n is equal to population mean.
B. The sampling distribution of any statistic will be normal or nearly normal.
C. The standard deviation of sample mean is given by σ/√n.
D. All are correct sentence.
70. Which one of the following shows distinctions between a population parameter and a
sample statistic?
A. A population parameter is only based on conceptual measurements, but a sample
statistic is based on a combination of real and conceptual measurements
B. A sample statistic changes each time you try to measure it, but a population parameter
remains fixed
C. A population parameter changes each time you try to measure it, but a sample statistic
remains fixed across samples.
D. The true value of a sample statistic can never be known but the true value of a
population parameter can be known.

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71. Scaling up of the different health programs is advocated by FMOH. Scaling up means the
following except

a. Expansion of programs d. Increasing the scope the

b. Increasing accessibility programs
c. Minimizing programs e. None of the above.

72. Health Sector Transformation Plan/HSTP is/are

a. One plan, one budget, one report d. Planned for 20 years

b. Revised every 5 years e. All of the above
c. Is the general plan of the FMOH

73. The latest referral system of the FMOH has

a. 6 tiers system d. 3 tiers system

b. 5 tiers system e. 1 tier system
c. 4 tiers system

74. The process of arranging and allocating work, authority and resources among organization
members to achieve goals is more related to

A. Planning D. Organizing
B. Controlling E. None of the above.
C. Influencing
75. The type of budget that may have the possibility of by passing the fiscal year is

A. Line-item budget C. Capital budget

B. Recurrent budget D. All of the above

76. The basic activities in the human resource management include the following except

A. Job analysis D. Selection of new staff

B. HR Planning E. All are true
C. Performance evaluation

77. Strategic plan of an institute characterized by the following except

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A. Long range plan D.Has mission, vision of the institution

B. Detail activities
E. All are true.
C. Developed by the top level
management

78. Community diagnosis is/are

A. Identifying health and health related problems of the community
B. Performed by going house to house
C. Interviewing the inhabitants
D. Make an intervention
E. All are true.
79. Where are we now? This basic planning question indicates.
A. Situational analysis D. Strategies or methods
B. Defining goals and objectives
C. Monitoring and evaluation
80. The lowest health institution in the Ethiopian structure is

A. Health center C. Community health service

B. Health Post D. Hospital

81. One of the following is not adopted by WHO as basic principles of health full housing
criteria.

A. Fundamental physiological needs

B. Protection against disease
C. Fundamental psychological needs
D. All
E. None

82. About 75% registered OPD cases are associated to lack of basic sanitation: dysentery,
diarrhea, skin and eye infections, helminthiasis, protozoal infections
A. False B. True
83. The role of environmental health sciences to prevent the spread of communicable disease
by breakdown the chain of transmission through

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A. Attacking the agent C. Protection of the host

B. Protecting the environment D. All
84. Which one of the following environmental hazard control principles can control hazards
while persons are close proximity/exposed to the hazard.
A. Isolation C. Shielding
B. Substitution D. Restriction
85. One of the following sanitize process can provide 100% free from pathogenic
microorganism if it is properly made
A. Sterilization C. Antisepsis
B. Disinfection D. Disinfestations
86. A piece of bread with 2 gram of fat, 15 grams of carbohydrate, and 1 grams of protein
contains how mach kilo calori [hint:1 gram of carbohydrates=4 kcal]:
A. 72kcal B. 82Kcal C. 102Kcal D. 147kcal

87. During pregnancy the woman who is a vegan may not obtain adequate amounts of which of
the following nutrients?
A. vitamin B3 B. vitamin B6 C. vitamin B9 D. vitamin B12
88. A 33-year-old Gravida II Para I woman gives birth at term at her home in Sebeta town.
The newborn is initially doing well, but at 3 days of life there is bleeding from the
umbilical cord stump, blood vomiting and ecchymoses are observed over the buttocks.
Which of the following vitamin deficiencies is most likely to be present in this infant?
A. A B. B1 C. B2 D. D E. K
89. True about Childhood undernutrition in Ethiopia from higher to lower prevalence?
A. Stunting--->wasting------>underweight
B. Wasting------>stunting----->underweight
C. Stunting----->underweight ---->wasting
D. Underweight------>wasting------->stunting
90. A mother brings her 3 year-old daughter to the health center. She is worried because the child has
a poor appetite, Open skin lesions, and excessive diarrhea. On examination she shows dependent
edema of the lower extremities as well as her hair is thinner and lighter. Which of the following
nutritional problems is most likely present in this child?

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A. None edematous malnutrition B. Edematous malnutrition C. Niacin deficiency

D. Scurvy
91. Which of one of the following is appropriate for old health problems (problems known to
the people for long period of time)
A. Health education
B. Health information
C. Health literacy
D. Health intervention
92. A health professional is presenting a health education class to a group of senior citizens
regarding exercises to promote cognitive health. As part of the program, the health professional
presents a slide presentation and handouts. Which of the learning domains is the health
professional working through?
A. Perceptual domain B. Cognitive domain
C. Psychomotor domain D. Affective domain

93. A health professional for an Orthodox church provides a free blood pressure screening the
first Sunday of every month. This is what level of prevention?
A. Tertiary prevention D. Quaternary prevention
B. Primary prevention
C. Secondary prevention
94. Nathanael grew up in a family where he was always given positive feedback for his
motivation, no matter how difficult the task. This is an example of a(n)
A. Reinforcing factor. C. Confirming factor.
B. Predisposing factor. D. Enabling factor.
95. Among the basic determinants of health which one is not changed by the plan of the
individuals?
A. Human biology C. Environment
B. Lifestyle D. Health systems
96. Among the following which one is not bacterial causative agent for STIs?

A. Neisseria gonorrhoeae C. Treponema pallidum

B. Chlamydia trachomatis D. Candidia albicans

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97. Which one is not the reason why STIs prevalence is more common in females than males?
A. Increased virus in semen Vs vaginal secretions
B. Increased surface area of cervix and vagina Vs male urethra
C. STIs in women often asymptomatic
D. STIs in male often asymptomatic
98. The risk of HIV infection through sexual intercourse increases if:
A. Women’s partner is uncircumcised
B. Partner has more advanced HIV disease During anal intercourse
C. there are other genital infections
D. During anal intercourse
E. All
99. Adolescent period lies in which age group?

A. 10 - 19 years C. 10 – 24 years
B. 15 – 24 years D. 15 – 29 years

100. Which is not the driving force for an early and increased sexual activity among
adolescents?
A. Late sexual maturation
B. Decline in religious and cultural influences
C. Changing trends for marriage values
D. Urbanization and mass media influence
101. Air under the right dome of the diaphragm on a CXR can be due to each of the following
except:
A. Penetrating abdominal injury C. Perforated PUD
B. Hepatic abscess D. Post operative
102. CXR of a 45 yr old woman treated for pulmonary TB a yr back has showed fibrotic bands
on the right upper lobe region with volume reduction suggestive of right upper lobe
collapse. Based on this information the mechanism of collapse is:
A. cicatrization collapse C. adhesive collapse
B. passive collapse D. resorption collapse
103. One of the following is not a future of rheumatoid arthritis:

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A. periarthicular osteoporosis
B. marginal erosion
C. osteophyte formation
D. diffuse joint space narrowing
104. Which one of the following is true about CXR feature of pleural effusion?
A. Seen as a homogenous opacity with air bronchogram
B. Fluid tracking in to chest wall is called as encysted fluid
C. Large amount causes mediastinal shift towards the side of effusion
D. Encysted fluid may mimic mass lesion on PA radiograph
105. Which one of the following is false about pneumothorax?
A. Radiographically appear as increased lucency with absent bronchovascular
marking
B. Radiographically appears as opaque with absent bronchovascular marking
C. Expiratory film may has benefit
D. Mediastinal shift to the opposite side may be seen
106. A 10year old boy presented with a circumscribed area of skin color change
without elevation or depression over his face. What is the description of the lesion?

A. Papule C. Macule
B. Pustule D. Plaque

107. Which of the following is false about cutaneous tuberculosis?

A. Relatively a common form of extra pulmonary TB
B. It can arise as a complication of BCG vaccine
C. HIV testing is recommended for all patients
D. Treatment is like other extra pulmonary TB
108. A 13year old teenager presented with honey colored crusted plaque lesion on the
lower leg. He was given topical medication and advice on personal hygiene. After
three weeks he came back with a punched out ulcer with erythematous and
indurated border on the previous site. Which of the following is true about the
disease?

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A. The most likely diagnosis is impetigo

B. The lesion affects only the epidermal layer
C. Pseudomonas aeruginosa can be the causative agent
D. The disease always arises from pre existing lesion
109. A 7 year old girl developed a skin rash after taking antibiotics for abdominal
complain. What is the most common drug eruption you expect in this patient?
A. Exanthematous eruption C. Urticaria
B. Fixed drug eruption D. Angioedema
110. Which of the following is false about diffuse cutaneous leishmaniasis (DCL)
A. Leishmania ethiopica can be the etiologic agent.
B. It needs systemic treatment
C. It affects nerves like lepromatous leprosy
D. It is rare in countries where Leishmaniasis is endemic

111.A person who presented with the hoarseness’ of voice or shortness of breath can best
evaluated by
A. Indirect laryngoscope C. CT-scan of the neck
B. DIRECT laryngoscope D. Bronchoscopy

112. The best treatment for relapsing polychondritis

A. Antibiotic D. Cauterization
B. Steroid
C. Excision
113. which of the following is not true about acute otitis media
A. S. pneumoniae is most common etiology
B. Otoscopic appearance is Hyperemic, bulging TM ,loss of landmarks
C. Pts can have ear pain,ear discharge
D. To diagnosis otitis media the complaints must persists > 2weeks
114. True about acute epiglottitis
A. Mostly caused by respiratory syncytial virus/RSV/

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B. First secure IV line and then do thorough P/E and take neck lateral X-ray
C. Nontypable H. influenza is the most common cause
D. Rapidly progressive high grade fever, cyanosis, odynophagia, drooling of saliva, slow
breathing, inspiratory stridor and lungs are clear with decreased air entry.
115. A women presented with a 3 year old child who has foul smelling unilateral nasal
discharge With no other signs of URTI ,what could the most likely diagnosis
A. Acute sinusitis C. Foreign body
B. Epistaxis D. Polyp

116. The average antero-posterior diameter of the adult human eye is:

A. 24mm C. >30mm
B. 16.5mm D. 10mm

117. The most sensitive sign of vitamin A deficiency in children is:

A. Bitot’s spot D. Corneal xerosis

B. Night blindness
C. Conjunctival xerosis
118. According to the 2005-6 national survey of blindness and low vision, the major
causes of blindness in Ethiopia in ascending order are:
A. Trachomatous corneal opacity, Refractive error, cataract
B. Cataract, Refractive error, trachomatous corneal opacity
C. Trachomatous corneal opacity , glaucoma,Refractive error
D. Cataract,trachomatous corneal opacity, Refractive error
119. The end stage of xerophthalmia is:

A. Corneal xerosis C. Night blindness

B. Bitot’s spot D. Keratomalecia

120. Among the following anti glaucoma drugs, which one is different with respect to
its route of administration?

A. Timolol C. Acetazolamide
B. Pilocarpine D. Betaxolol

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121. Which of the following is not a risk factor(s) for suicide?

A. Presence of schizophrenia B. being single
C. presence of diabetics Mellitus D. None
122. A 34 years old Female patient present with Hearing of voice which says “kill your
baby”After 2 weeks of delivery at home. She has also insomnia and poor appetite
physical examination shows negative. What is the most likely diagnosis?
A. Brief psychotic disorder
B. Post traumatic disorder
C. Post partum psychosis
D. Post partum blue
123. A middle-aged man is chronically preoccupied with his health. For many years he
feared that his irregular bowel functions meant he had cancer. Now he is very
worried about having a serious heart disease, despite his physician’s assurance that
the occasional “extra beats” he detects when he checks his pulse are completely
benign. Which of the following is the most likely diagnosis?
A. Somatization disorder D. Pain disorder
B. Hypochondriasis E. Conversion disorder
C. Delusional disorder
124. The central fear is that they will act in such away as to humiliate or embarrass
themselves in front of the others refers
A. Panic attack B. social phobia C. Acrophobia D. phleno phobia
125. The Management of patient with delirium is/are not
A. Treating the primary illness
B. Symptomatic treatment of specific target symptoms like agitation, insomnia, etc.
C. Provide physical and sensory support, avoiding over or under stimulation
D. Immediate initiations of anti depressants
126. A 20-year-old male patient came with chief complain ‘my tooth aches” and said
he has sharp and severe pain on thermal stimulation which is continues after stimulus
removal. Which of The following is the possible diagnosis?

A.Reversible pulpitis B. periapical cyst

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C.Irreversible pulpitis D.None

127. One of the following is not the characteristic of gingivitis

A. Inflammation of gum
B. There is attachement and alveolar bone loss
C.There may be formation of pseudo pocket
D.is non responsive for the usual anti pains
128. A patient complains of “numb sensation in the left half of his tongue, after removal of his
left lower wisdom tooth”. Which of the following nerve is most likely to have been injured
during removal of this tooth?
A. Facial nerve
B. Gloss pharyngeal nerve
C. Inferior alveolar nerve
D. Lingual nerve
E. Mandibular nerve

129. A bacterial infectious disease that results in localized dissolution & destruction of the
calcified tissues of the tooth is __

A.Erosion C.Abrasion
B. Dental caries D.Attrition

130. One of the following is not contraindication for tooth extraction in adult patients
A. Uncontrolled diabetic patient
B. A patient with myocardial infarction
C. Pregnancy at any trimester
D. Bleeding disorders like hemophilia
131. A 27 years old man in excellent health has present with sever headache , vomiting and
painful redness of the eye and sudden onset of visual impairment . Which of the following
is the most likely diagnosis?
A .conjunctivitis B. pterigium
C. acute angle closed glaucoma D .Scleritis

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132 . An 8-year-old boy has severe pain with ear movement. He has no fever, nausea, vomiting,
or other symptoms. He has been in good health and ear examination reveals a somewhat red
pinna that is extremely tender with movement, a very red and swollen ear canal, but an
essentially normal tympanic membrane. Which of the following is the most appropriate next
course of therapy?
A. Administration of topical corticosteroids
B. High-dose oral amoxicillin
C. Intramuscular ceftriaxone
D. Intravenous vancomycin
133. An otherwise normal 2-year-old boy, with a family history of seizure in his father, has a
brief, generalized, self-limited seizure associated with an elevated temperature. His examination
is non focal. He has completely recovered within 1 to 2 hours of the seizure. What is your
possible diagnosis
A. Simple febril seizure
B. Complex febril seizure
C. Hypoglycemia
D. Absence seizure

134. A 3-yr-old boy presents to your office with sudden onset of cola colored urine, progressive
facial swelling over the past 3 days, and decreased urine volume over the past day. His
examination is notable for blood pressure 130/80 mm Hg, periorbital edema, bibasilar rales, and
ankle swelling. His urinalysis is remarkable for 3+ hematuria, 1+ proteinuria, 100 red blood cells
per high-power field, and red blood cell casts. His serum electrolytes are normal and the serum
albumin is 3.2 g/liter. This clinical presentation is most consistent with____?
A. Acute kidney injury
B. Nephrotic syndrome
C. Acute glomerulonephritis
D. Chronic kidney disease
135. A 6 -yr-old grade one student presents with signs of tonsilopharyngitis. His throat culture is
positive for group A streptococci. The recommended management is:
A. Oral Amoxacillin for 7 days
B. Oral Amoxacillin for 10 days
C. Oral erythromycin for 5 days
D. Intramuscular ceftriaxone for 3 days
136. A 33 year old Gravida II Para I mother at her 25 weeks of gestational age present with
increased in body weight about 12 kg thus far this pregnancy. With her last pregnancy she gained
18 kg and was diagnosed gestational diabetes mellitus and delivered 4300 gm male neonate by
cesarean section .She wants to know whether she is diabetic or not in this pregnancy and which
screening test is administered for her?
A. Random Blood Sugar/RBS
B. Fasting Blood Sugar/FBS
C. Oral Glucose Tolerance Test/OGTT
D. Hemoglobin A1C

137. Identical twins are arising from one zygote and the chorionicity and amniocity depend of
the time of cleavage after fertilization. If the cleavage takes place after 13 th day of fertilization

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the possible outcome is ?

A. Monoamniotic and Monozygotic
B. Dizygotic and Diamniotic
C. Monozygotic and Diamniotic
D. Monoamniotic and Dizygotic
E. Conjoined twins

138. Obstructed labour is the result of multi level deficiencies in health care delivery system so
particular attention should be given to
A. Increase community awareness and education on obstructed labor and improve the socio-
economic environment
B. Proper ANC visits to ensure fetal and maternal well being and to assess for any risk
factors of obstructed labour
C. Preventing and managing prolonged labor
D. All

139. Which one of the following is not the proper definition of Post Partum Hemorrhage/PPH/?
A. Traditionally blood loss of >500 ml after vaginal birth or >1000ml after cesarean
delivery
B. Clinically as excessive bleeding that makes the patient symptomatic and/or results in
signs of hypovolaemia
C. is a 10 % decline in postpartum hemoglobin concentration from antepartum levels
D. any form of bleeding from female genitalia after 28 weeks of gestation

140. According to Food and Drug Administration/FDA/ there are five categories of drug and
drugs in which adequate studies show no any risk for the fetus at any pregnancy trimester like
folic acid are under
A. Category A B. Category B C. Category C D. category D E. Category X

141. A 24 year old multigravida mother at 32 weeks of gestation comes to emergency obstetrics
OPD stating she woke up in the middle of the night in a pool of blood . She denials any pain or
uterine contractions. Examination of the uterus shows fetus to be in transverse lie and FHB is
regular and 140bpm.On inspection the perineum is grossly bloody .What could be your possible
diagnosis ?
A. APH secondary to abruption placenta
B. APH secondary to placenta previa
C. APH secondary to uterine rupture
D. APH secondary to vasa previa

142. A 64-year-old man presents with symptoms of malaise, shortness of breath, edema, and
no urine output for 24 hours. His past medical history is not significant, and his only medication
is daily aspirin. On examination his JVP is 4 cm, heart sounds are normal, lungs are clear, and

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the abdomen is soft. A Foley catheter is inserted into his bladder for 200 cc of urine, which is
sent for urinalysis. His urine output still remain slow. Which of the following is the most
appropriate initial diagnostic test?
A. renal ultrasound
B. blood cultures
C. urine cultures
D. Blood urea nitrogen (BUN)/creatinine ratio
143. The gold standard for diagnosis of UTI is______.
A. Urine analysis
B. Blood culture
C. Urine culture
D. Intravenous pyelography
144. A 44-year-old woman complains of 6 months of epigastric pain that is worst between meals.
She also reports symptoms of heartburn. The pain is typically relieved by over-the-counter
antacid medications. She comes to clinic after noting her stools darkening. She has no
significant past medical history and takes no medications. Her physical examination is
normal except for diffuse midepigastric pain. Her stools are blood positive. She undergoes
endoscopy , which demonstrates a wellcircumscribed, 2-cm duodenal ulcer that is positive
for H pylori. Which of the following is the recommended initial therapy given these
findings?
A. Omeprazol , clarithromycin, and amoxicillin for 14 days
B. Pantoprazole and amoxicillin for 21 days
C. Pantoprazole and clarithromycin for 14 days
D. Omeprazole, metronidazole, and clarithromycin for 7 days
145. A 40-year-old flight attendant presents to your office for evaluation of abdominal pain. It is
worse after eating, especially if she has a meal that is spicy or high in fat. She has tried over-the-
counter antacids, but they have not helped the pain. After examining her abdomen, you strongly
suspect cholecystitis. Which sign on examination increases your suspicion for this diagnosis?
A. Psoas sign C. Murphy’s sign
B. Rovsing’s sign D. Grey Turner’s sign

146.Which one of the following is false statement about Hepatitis A infection?

A. Mainly affects children between 6-14 years
B. Its complication increases as the age increases
C. Main way of transmission is feco-oral
D. Results severe complication around 99% of the cases

147. How much maintenance fluid is required for 50 kg person over 24 hrs ?
A. 2100
B.3200
C.2500
D.3100
148. A 74-year-old woman develops acute sepsis from pneumonia and is admitted to the
intensive care unit because of hypotension. She is started on antibiotics, and her blood pressure is
with intravenous normal saline. Despite this she remains oliguric Her urinalysis has muddy

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brown granular casts and the urine sodium is 56 mEq/L. Which of the following is the most
likely cause of her ARF(AKI)
A. Nephrotoxic antibiotics
B. acute infectious GN
C. acute tubular necrosis (ATN)
D. contrast nephropathy
149. A 68-year-old man with acute renal insufficiency presents with weakness, parenthesis, and
progressively worsening shortness of breath. He has been experiencing these symptoms for 4
days. Laboratory findings show a potassium level of 7.2 it is very high; an electrocardiogram
reveals peaked T waves and widening of the QRS complex. Which of the following is NOT
indicated in the initial treatment of this patient?
A.Intravenouscalcium
B.Intravenousglucoseandinsulin
C.Dialysis
D. Beta blockers
150. The general management of the patient with chronic renal disease involves the following
issues, except?
A. Treatment of reversible causes of renal dysfunction
B. Preventing or slowing the progression of renal disease
C. Treatment of the complications of renal dysfunction
D. Frequent replacement of a fluid

151. Which of the following patients has the greatest risk of progression to chronic kidney
disease?
A. A 30-year-old man with an estimated glomerular filtration rate (GFR) of 50 mL/min/1.73 m2
B. A 45-year-old man with an estimated GFR of 90 mL/min/1.73 m2
C. A 55-year-old man with an estimated GFR of 70 mL/min/1.73 m2
D. A 65-year-old woman with an estimated GFR of 65 mL/min/1.73 m2
151. A 3-year-old boy is brought to the emergency room after spilling bleach onto his lower
extremities. He is diagnosed with a chemical burn and all involved clothing are removed. In
addition to resuscitation, which of the following is the most appropriate initial management of
this patient?
A. Treatment of the burn wound with antimicrobial agents.
B. Neutralize the burn wound with weak acids.
C. Lavage of the burn wound with large volumes of water.
D. Wound debridement in the operating room..
152. . A 45-year-old woman with history of heavy nonsteroidal anti-inflammatory drug ingestion
presents with acute abdominal pain. She undergoes exploratory laparotomy 30 hours after onset
of symptoms and is found to have a perforated duodenal ulcer. Which of the following is the
procedure of choice to treat her perforation?
A . Simple closure with omental patch
B. Truncal vagotomy and pyloroplasty
C. Truncal vagotomy and antrectomy
D. Highly selective vagotomy with omental patch
153. Stroke should be considered as medical emergency, as it affects vital functions of an
individual. Initial Assessment and maintenance of vital functions/stabilizing the patient includes

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all of the following ,except?

A. Maintenance of air way and ventilation
B. Aggressive control of blood pressure
C. Control of body temperature
D. Maintenance of euvolumic state
154. A 54 years old woman is hospitalized for pneumonia. On the 10th hospital day she develop
swelling and tenderness of her right leg over the past 48 HRs. Doppler ultra sound
examination shows
femoral vein thrombosis. Which of the following is most likely contributing for the
appearance of these finding?
A. Pregnancy B. Immobilization C. Smoking D. Chronic alcohol abuse

155. A 48-year-old male patient develops fever, night sweats, cough, weight loss, and
malaise. Chest x-ray reveals an infiltrate in the posterior-apical segment of the right upper lobe.
CT scan of the lesion reveals cavitation. Sputum examination reveals acid-fast bacteria. Cultures
are pending. Which of the following treatment options would you institute for this patient at this
time?
A. INH and rifampin
B. INH, rifampin, and ethambutol
C. INH, rifampin, ethambutol, and pyrazinamide
D. INH, rifampin, ethambutol, pyrazinamide, and streptomycin
156. A 27-year-old HIV-seropositive man develops cough, fever, and weight loss. Chest x-ray
reveals acavitary lesion in the left upper lobe. Sputum culture is found to be smear-positive
and, subsequently,Culture positive for Mycobacterium tuberculosis. He is hospitalized and
placed in isolation. Medicationsinclude zidovudine, lamivudine, and nevirapine, as well as
trimethoprim-sulfamethoxazole. Which of the following anti-TB drugs is contraindicated
because of drug -drug interaction in this patient?
A. Rifampicine
B. Ethambutol
C. Isoniazid
D. Streptomycin
157. A 35-year-old woman takes acetylsalicylic acid (aspirin) for arthritis. Although her joint
pain is reduced with this therapy, the inflammatory process continues. The aspirin therapy
alleviates her pain mainly through reduction in the synthesis of which of the following
mediators?
A. Prostaglandins B. Leukotriens C. Histamine D. Nitric oxide

158.All of the following ECG waveforms are matched correctly to the cardiac cycle that they
represent EXCEPT:
A. P wave – atrial repolarization
B. PR interval – atrial repolarization
C. QRS complex – ventricular depolarization
D. T wave – ventricular repolarization

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159. PPH is one of the cause for maternal morbidity and mortality ;all of the following are
prevention modalities except ?
A. By recognizing high risk factors for PPH and applying proven methods to limit bleeding
B. By spontaneous delivery of the placenta at time of cesarean section to reduces blood
loss by 30%
C. By universal application of Active management of third stage of labor (AMTSL)
D. By encouraging mothers home delivery

160. At obstetrics OPD a 24 year old primi gravid mother present at 10 th week of her pregnancy
with minimal vaginal bleeding and lower abdominal cramps and when you did physical
examination you found Closed cervix and uterine size comparable to gestational age and you
told her the pregnancy has the potential to be continued. This type of abortion is called _____
A. Inevitable abortion
B. Complete abortion
C. Incomplete abortion
D. Threatened abortion

161. Antenatal care/ANC/ is one of the essential health sector interventions for Safe Motherhood
and it includes
A. Risk assessment
B. Care provision
C. Health promotion
D. All

162. A 32-year-old woman is evaluated in the emergency department for abdominal pain. She
reports a vague loss of appetite for the past day and has had progressively severe abdominal pain,
initially at her umbilicus, but now localized to her right lower quadrant. The pain is crampy. She
has not moved her bowels or vomited. She reports that she is otherwise healthy and has had no
sick contact. Exam is notable for a temperature of 37.7°C and heart rate of 105 bpm, but
otherwise, vital signs are normal. Her abdomen is tender in the right lower quadrant, and pelvic
examination is normal. Urine pregnancy test is negative. Which of the following imaging
modalities is most likely to confirm her diagnosis?
A. Chest X-ray C. Endoscopy
B. Barium meal D. Ultrasound of the abdomen
163. Which of the following is the most common symptom or sign of liver disease?
A. Fatigue
B. Itching
C. Jaundice
D. Nausea
164. A 54-year-old man is admitted to the ICU with severe pancreatitis. His BMI is ≥30 kg/m2,
and
he has a prior history of diabetes mellitus. A CT of the abdomen is obtained and shows severe
necrotizing pancreatitis. He has no fever. All of the following medications are effective in the
treatment of acute necrotizing pancreatitis, except ?
A. Fluid replacement B. Cimetidine

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C. Anti pain D.Surgicalintervention

165. A 42-year-old man with cirrhosis related to hepatitis C and alcohol abuse has ascites
requiring frequent large-volume peritoneal fluid drainage . All of the following therapies would
be indicated for this patient EXCEPT:
A. Fluid restriction C. Sodium restriction
B. Furosemide /lasix D. Normal saline replacement
166. A 64-year-old man is admitted to the ICU with a large GI bleed. Endoscopy reveals
esophageal varices. He is confused and unable to provide any history. His physical examination
is notable for palmar erythema,spider angioma and testicular atrophy . Ultrasound demonstrates a
small liver
consistent with cirrhosis. Which of the following is the most likely cause of his cirrhosis?
A. Alcoholism
B. Autoimmune hepatitis
C. Chronic hepatitis C infection
D. Hemochromatosis
167. A 35 year old male patient present at E-OPD after he develops a sudden onset of epigastric
pain which radiate to the back and two episodes of vomiting of ingested matter. He has history
of repeated treatment for the diagnosis of PUD. On physical examination its none revealing
except the derangement on vital signs. What is your possible diagnosis?
A. Gastric outlet obstruction C. Gastric cancer
B. Perforated PUD D. adhesion
168. According to question no.167 what is the best investigation for your possible diagnosis?
A. chest X- ray C. Plain abdominal x ray
B. Abdominal ultra sound D. serum amylase
169.According to question no.167 what are the components of management for your possible
diagnosis?
A. GI-Decompression
B. IV- fluid replacement
C. Analgesia and broad spectrum Antibiotics
D. Simple observation without any interventions
170. A 15-mo-old child who attends a child care center 5 days per week is diagnosed with
meningococcal infection. Which of the following agents should be used for prophylaxis for the
child care classmates of this infant?
A. Chloramphenicol
B. Cefixime
C. Rifampicin
D. Isoniazide
171. An 8-yr-old boy presents with fever of 2 weeks' duration, shortness of breath, ankle edema,
intermittent painful swelling of the wrists, elbows, and knees unrelated to edema, and a new
systolic murmur. One month ago he had a sore throat that lasted for 5 days, which resolved
spontaneously. The most likely diagnosis is:
A. Endocarditis C. Meningococcal sepsis
B. Rheumatoid arthritis D. Rheumatic fever
172. Which one of the following is true about acute osteomyelitis in children?

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A. Is commonly caused by Streptococcus pyogenes infection

B. Usually commences in the epiphysis
C. Blood cultures are always positive
D. Joint fluid aspiration may be necessary to make a diagnosis
173. An 18-mo-old girl has a 2-day history of rhinorrhea, pharyngitis, and low grade fever.
During the night, she wakes with a barky cough, hoarseness, and Inspiratory stridor. Which of
the following is the most likely etiologic agent?
A. Influenza virus type A
B. Respiratory syncytial virus
C. Parainfluenza virus
D. Adenovirus

174. One of your friend calls to ask advice about a 3-yr-old boy with fever and a
cough. He thinks the patient has croup but is also concerned about epiglottitis. Which of
the following physical findings is most helpful in attempting to differentiate croup from
epiglottitis?
A. Fever C. Stridor
B. Barky cough D. Drooling
175. A 2-yr-old boy is presented to the emergency department at 3 A.M. with a
chief complaint of fever and cough. His respiratory rate is 36/min, his temperature is
39oC, and his pulse oximetry reading is 96%. On physical examination he has a barky
cough and stridor only with crying. He is well hydrated, able to drink, and consolable.
What is the appropriate next step in patient management?
A. Nasal washing for influenza virus and respiratory syncytial virus
B. Lateral radiograph of the neck
C. Complete blood count and blood culture
D. Giving dose of dexamethasone
176. which one of the following is not the biochemical effect of vitamin D?
A. Increases intestinal calcium & phosphorus absorption
B. Stimulates osteoclastic activity releasing calcium from bone
C. Regulates level of serum alkaline phosphatase
D. Decreased reabsorption of phosphorus from kidney
177. A 14-month-old child has lower-extremity bowing, a waddling gait and frontal bossing.
Laboratory data include low to normal serum calcium, moderately low serum phosphate, and
elevated serum alkaline phosphatase levels and normal parathyroid levels. Which of the
following is the most
likely diagnosis?
A. Genetic primary hypophosphatemia
B. Vitamin D deficiency
C. Phosphate malabsorption
D. Renal osteodystrophy
178. Which one of the following is not correctly matched abbreviation of the name with its
vitamin A deficiency clinical manifestation ?
A. XN-Night blindness B. X1A-corneal xerosis
C. X1B-Bitot’s spot D.X1A- conjuctival xerosis

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179. An 84-year-old woman who resides in a nursing home presents for evaluation of fever of
unknown origin. Two weeks ago, she was transferred to the nursing home after undergoing 3
months of inpatient treatment for a cerebrovascular accident. After readmission, bacterial
cultures grow Methicilin Resistant Staphylococcus Aureas /MRSA. What is the most appropriate
antibiotic choice for this patient?
A. Ceftriaxone
B. Vancomycin
C. Linezolid
D. Erythromycin
180. Infection with T. pallidum typically progresses through well-described stages if left
untreated.
Which of the following findings would be consistent with the secondary stage of syphilis?
A. Diffuse, painless lymphadenopathy and patchy alopecia
B. A hyperpigmented maculopapular rash involving the trunk, extremities, palms, and
soles
C. Signs and symptoms of meningitis (fever, stiff neck, photophobia)
D. Single non tender ulcer at the site of entry

33