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Exam of 29 pages for the course EXM 1 STUDY GUID at EXM 1 STUDY GUID (CoC Exam)

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Choose the correct answer from the given alternatives

1. A 26 year old male patient presented with headache, fever and neck pain. On physical
examination he has a temperature of 39.2 degree celcius and all meningeal signs are
positive. All of the following findings of CSF analysis suggest pyogenic meningitis
EXCEPT:
A. A CSF WBC count of 10,000 per microliter
B. A CSF glucose concentration of 28mg/dl
C. A CSF protein concentration of 20mg/dl
D. An intracellular gram negative diplococcic on gram stain
2. A 33 years old female patient from Chencha is admitted to E ward after presenting with a
compliant of reddish discoloration of urine of 2 days duration. In addition to this she has
also a Blood pressure record of 150/100mmHg and bilateral pitting leg edema. Urinalysis
showed many dysmorphic RBs and proteinuria of +3. Her creatinine level is 5.4mg/dl. 4
months back she had a creatinine measurement of 1.1mg/dl. What is the most likely
diagnosis?
A. Nephrotic Syndrome
B. Acute glomeluronephritis
C. Acute pyelonephritis
D. CKD
3. Which one of the following laboratory investigation is important to make a definitive
diagnosis of UTI?
A. >5 WBC/HPF on urine microscope
B. Bacteria on gram stain of clean catch urine
C. Culture
D. Leukocytosis
4. Which one the following is not common complication of malaria on pregnancy
A. High-level parasitemia with anemia
B. Hypoglycemia
C. Acute pulmonary edema.
D. Convulsions


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, 5. One the following is not part of management of cerebral malaria
A. Give artesunate as protocol
B. Put on intra nasal oxygen
C. Insertion of NG tube for feeding and catheterization
D. None
6. In chronic hepatitis B virus infection, presence of hepatitis B e antigen signifies which of
the following?
A. Development of liver fibrosis
B. Increased likelihood of an acute fare in the next 1–2 weeks
C. Ongoing viral replication
D. Resolving infection
7. One of the following management in tetanus used for eradication of c. Tetani
A. Human tetanus immune globulin (tig
B. Tetanus anti toxin-
C. Metronidazole
D. Diazepam
8. Which one the following true about rabies
A. There is not definitive or curative treatment for rabid patients
B. The classic presentation of encephalitic rabies includes fever, hydrophobia,
pharyngeal spasms
C. Post exposure rabies prophylaxis, in previously unimmunized persons, should
always include both passive and active immunization.
D. All
9. 57 years old known hypertensive patient presented with exertional dyspnea of 2 weeks
duration. On examination there is dullness on the Right lower 1/3 of posterior chest with
decreased tactile fremitus and PMI shifted to lateral of left MCL. Which one is true
regarding this patient?
A. No need for pleural fluid analysis
B. Normal CXR is expected in this patient
C. ACE inhibitors do not have benefit for this patient
D. The precordial examination findings are normal

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, 10. Abeba is known asthmatic for the past 06 years, presented with compliant of shortness of
breath which doesn’t respond for Salbutamol. She has history of repeated hospital
admission. On examination RR=54, SO2 =81%. She uses her accessory muscles and she
cannot able to speak. Chest is hyper-resonant on auscultation. Which one of the following
is not true regarding management of this patient?
A. Oxygen, 2–4 L/min nasal cannula or 40–60% by mask
B. Salbutamol 6 puff every 20 min for 01 hr
C. IV Hydrocortisone 100mg QID
D. Ceftriaxon 01 grm IV BID with Azythromycin 500 mg PO daily
11. Which one of the following combination of drugs is appropriate for secondary prevention
after acute myocardial infarction?
A. Aspirin, Simvastatin, Morphine & Nitrates
B. Enalapril, Simvastatin, Digoxin &Aspirin
C. Aspirin, Enalapril, Metoprolol& Simvastatin
D. Amlodipine, Aspirin, Morphine &Simvastatin
12. Tamirat is a known cardiac patient, develops dyspnea and PND. On P/E PMI is shifted to
lateral of MCL & CXR shows cardiomegaly. His echocardiography report is consistent
with dilated cardiomyopathy. Which one of the following causes of DCMP has grave
prognosis?
A. HIV related CMP
B. Peripartum CMP
C. Alcoholic CMP
D. Idiopathic CMP
13. What is the leading cause of MS?
A. Rheumatoid arthritis
B. Rheumatic fever
C. Infective endocarditis
D. Dilated CMP




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