NMCLE Question 2066 Chaitra

Some  collected questions of NMCLE (nepal medical council licencing Examination)2066 Chaitra/ 2009 march 28 . most of the questions were case type, and 180 questions should be done in 150 minutes.
1. most efficient steroid? belcomethasone, fluticasone
2. best fluid in head injury? dextrose, RL, NS, Mannitol
3. best anesthesia drug used in 66 yr old Hernia patient? bupivacaine, lidocaine, heavy bupivacaine.
4. best anesthesia used in closed reduction ofshafthumerus fracture? .5% lidocaine, .5% bupivacaine, 1% lidocaine, 1% bupivacaine.

5. contraindicated in fits? ketamine, thiopentone, propofol
6. kerosene smell from mouth , bradycardia, lacrimation, salivation, which poisoning? kerosene, organophosphorus, paracetamol
7. obturator nerve supplies? adductor magnus, sartorius, rectus femoris
8. unilateral nasal block in a child with rhinorrea and foul smell? foreign body, polyp, rhinitis
9. 4 year child with fever, high fever, chest pain, b/l wheeze, with previous history ? pneumonia, PTB, acute bronchiolitis

)rita 22 yrs old….with h/o…….flight of ideas, thinks superior to her collegue…what is the diagnosis?? Ans: mania
2)what is true regarding hallucination?
a:false belief b:false perception with stimuli c:false perception without stimuli
3)a boy comes with shaft humerus fracture and for closed reduction, which iv regional anesthesia ..drug of choice??
A: lidocaine b:bupivacaine c: ropivacaine
4)Which is contraindicated for person with fits?
.. a:etomidate b: propofol c: ketamine
5)60 yr old patient with Femoral Hernia..spinal anaesthesia of choice..
a:0.5% lidocaine b:0.5% bupivacaine c:0.5% bupivacaine heavy
6)which stain is used for treponoma pallidum??
a:gram stain b:giemsa stain c: dark field stain d: ziehl nelson
7)regarding treatment of syphilis which is true??
a: penicillin drug of choice in primary syphilis b: penicillin DOC in secondary c: in primary and secondary not in tertiary d:in all stages
8)which match the best??
A:chlamydia:discharge with clump b:gonorrhea:whitish discharge c:trichomonas:Profuse discharge
9)60 yr patient with secondary UV prolapse and decubitus ulcer..what would you do?? a:lefort operation b:girl thingyl hysterectomy with PFR c:abdominal sling operation d:manchester operation
10)32 yr female with completed family size with cervical lengthening??what is the treatment of choice??
A:manchester operation b:lefort operation c: abdominal sling operation d: VH with PFR
11)15 year girl presented with h/o prolonged 4 days of p/v bleeding..what is ur diagnosis?? a:dysmenorrhea b:menorrhagia c:dysfunctional uterine bleeding
12)30 yr old female with intermenstrual bleed..what is the most likely diagnosis?? a:cervicitis b: endometritis c: copper T insertion d: endometrial Ca
13)A pt is intubated..what is the reliable sign u would like to check?? A: capnography b: chest auscultation c: pulse oximetry
14)target value for TB control and case detection rate in nepal??..a.80% &30%, b. 30% & 80%
15)measles vaccine is given?? A: intradermally b:subcutaneously c:Orally d: intramuscularly
16)which is not combined vaccine?? A olio c:measles d: BCG
17)what is true regarding BCG?? A: live vaccine b:killed c:toxoid d:inactive
18)In pelvic inflammatory disease a combination of metronidazole and which drug is given?? A:doxycycline b:ciprofloxacin c:Penicillin
19)a 5 yr child with fever stridor…has glottic edema..sitting with both his hand forward..what is the most likely diagnosis?? A:bronchiolits b:adenoids c: acute epiglottitis d: croup
20)A 4 year child present with fever ,RR 52/min B/L wheeze..he had similar past history..what is your diagnosis?? A: acute bronchiolitis b: bronchitis c: bronchopneumonia d:asthma
21)A 30 yr female presented with h/o …….impending eclampsia….which is the DOC for this???a: nifedipine b: methyl dopa c:hydralazine d: MgSO4
22)which is least likely in eclampsia??a: headache b:epigastric pain c BP>120mmhg d:blurring of vision
23)A 19 yr patient presented with h/o mass on left side of floor of mouth..there is pain when he takes sour food which goes off spontaneously..on palpation there is 3*3 cm2 mass firm mass on left side on submandibular region..what is your diagnosis?? A:lymphadenitis b:ranula c:submandibular calculi
24)one case from fibroadenoma ..i couldn’t remember question
25)A couple presented with h/o infertility for past 14 months..what is the first thing you would like to do?? A: semen analysis b: serum gonadotrophin c:Progesterone level d:tubal patency test
26)a27 yr patient has h/o fall from tree..he present withpain on wrist..there is mild swelling…..on examination he has tenderness on anatomical snuff box..what is the diagnosis??a:monteggia b:greenstick fracture c:scaphoid fracture
27)a 25yr patient presentd with 3 days h/o fe ver throat pain..on examination there is inflammed tonsils congestion…with uvula shifted to left side ..what is the diagnosis?? A:acute tonsillitis b:Parapharyngeal abscess c:Peritonsillar abscess d:Pharyngitis
28)one question from acute leukemia( blast cell >21% in PBS)
29)one question from CLL
30)a 45 yr patient presented with h/o…..his blood pictures were MCV>90,all peripheral counts decreased and hypersegmented neutrophils…what is your diagnosis?? A: acute leucopenia B:AML c:megaloblastic anemia
31)A patient presented with h/o gum bleeding for last 2 days ,there is no cyanosis normal skin pinch..he had joint pain 1 day back..which would be true regarding this?? A: APTT decreased b:PT decreased c:low platelets
32)Regarding AB+VE blood group which is true??a: no agglutinin b:no agluttinogen c:
33)which structure is supplied by obturator nerve???a: sartorius b: adductor magnus c:hamstring
34)while doing cystic artery ligation in cholecystectomy which ligament has to be cut?? A: falciform ligament b:hepatoduodenal c:gastroduodenal d:gastrocolic
35)a 49 yr old female presented with h/o acute retention of urine..on examination…there is firm and cysticmass protruding toward pouch of Douglas..what would you do?? A:transurethral catheterization b:USG c:suprapubic catheterization
36)A 10 yr old boy presented with h/o ballooning of prepuce and acute retention of urine..what is the diagnosis??a: posterior urethral valve b:Pinhole meatus
37)In mitral stenosis which is most unlikely??a: left atrial dilatation b: LVH c:Pulmonary HTN d:right ventricular hypertrophy
38)mid diastolic murmur heard in??a: MS b:MR c:TR
39)You are posted in PHC…a 50yr pt. presented with h/o chest pain….SOB….on ECG there is ST elevation in lead V2-V5 , aVL..what will you do immediately ???a:refer to tertiary centre b:administer high dose aspirin c:02 2litre/min D:give morphine
40)how does buscopan(hyoscine butyl bromide) act??a:m2 receptor antagonist b:m1 receptor antagonist c:m3 receptor antagonist d:m receptor agonist
41)cause of jaundice in pregnancy??ans:acute fatty liver
42)A tourist From England went to thamel …..took fried rice..vanilla sausage…after 4 hours he developed vomiting…diarrhea…..which organism is responsible for this???a:staph aureus b:clostridium perfringes c:E. toxigenic E.coli d:bacillus cereus
43)Regarding rheumatic heart disease what is the sequence of valve involvement??ans:mitral,aortic,tricuspid,pulmonary
44)which poisoning result in optic atrophy??ans:methyl poisoning
45)a 45 yr female presented with flat topped pinkish lesion ….on volar aspect of hand??what is ur diagnosis.??ans:lichen planus
46)In macconkey’s agar medium which causes lactose fermentation?ans :enterobacter
47)one question was from throttling..idon’t remember the question
48)cornea is supplied by which nerve?ans:maxillary others were nasocilaiary , lacrimal nerve
49)xerophthalia treatment question
50)InNepal vitamin A supplementation programme done for which group??ans: 6months-5 years age group
51)scleritis associated with which disease???ans:rheumatoid arthritis
52)what is most likely in multivalvular heart disease??ans:constrictive pericarditis
53)A 5 year boy presented with……with subconjunctival haemorrhage..what is your diagnosis??ans:whooping cough
54)A 37 yr female presented with h/o vertigo..no tinnitus..no hearing loss….she has latency of 15 seconds…..what is her diagnosis??ans:BPPH(benign paroxysmal positional vertigo)
55)A 10 yr old child present with h/o impaired hearing since 3-4 days..O/E there is retracted tympanic membrane and conductive hearing loss..what is the diagnosis??a: CSOM b:ASOM c: OME
56)A 50 YR old patient presented with h/o nasal bleeding….his vitals……what would u do??ans:anterior nasal packing
57)one question from seborrhoic dermatitis
58)follwing would be diagnosis of HIV??a:CD4 count<300/mm3 b: 200/mm3 c:400/mm3 d:500/mm3
59)one question was from heat stroke( an army man with h/o heavy exercise……temp>104 degree f ..without sweating…..what is your diagnosis)
60)one question was from waterhouse friedrichson syndrome( a 15 yr boy with h/o fever with vomiting and rashes on …..his bp 70/50..what is your diagnosis??)
61)one question was from conn’s adenoma…pt’s history given..with HTN …serum sodium was high..and K+ low..
62)A 2 year child with h/o chest infection..failure to thrive..O/E RR>50/min,no cyanosis……what is your diagnosis???ans:VSD
63)A pt..with h/o…….on X-ray examination boot shaped heart was seen..what is your diagnosis???ans:tetralogy of fallot
64)a patient presented with h/o winging of scapula…damage to which structure would have cause this???a:axillary nerve b:radial nerve c:long thoracic nerve
65)a pt. presented with h/o fall on outstretched hand….with shoulder dislocated anterior..which is the nerve damage???a: brachial b:radial nerve c:median d:axillary nerve
66)A patient was transfuse 6 units of whole blood…which is false regarding this??a:thrombocytopenia b IC c:hypocalcemia d:hypercalcemia
67)A patient known case of HIV presented with h/o white plaques on oral cavity..on staining pseudohyphae was seen..which organism would have cause this??a:histoplasmosis b:cryptococcus c:candida albicans d:blastomycosis
68)A 55 year pt. presented with h/o DVT..which investigation would you like to send?? A:USG b: venograph C: CT d:doppler
69)A patient present with h/o suggestive of abdominal aortic aneurysm..which test would you like to send for diagnosis?? A:CT abdomen b:USG abdomen c:Aortogram
70)there was one question from epidemics
71)After polio which disease is targeted for eradication from Nepal??ans:measles(not sure..check out yourself)
72)which drug combination would likely responsible for congestive cardiac failure??A:atenolol+nifedipine b:atenolol+verapamil c:atenolol+diltiazem c:atenolol+amlodipine
73)A 32 yr patient with a h/o neck swelling(thyroid) since 20 years….for the last one month the mass has increased rapidly.. O/Emass is hard ……what is most likely diagnosis??A:anaplastic Ca b:Papillary Ca thyroid c: follicular Ca
74)by direct ophthalmoscope image is magnified how many times ??a:10 times b:20 times c:5 times d:15 times
75)a patient with h/o discomfort on eye since 2 days…O/E dendritic ulcer was seen..what is the diagnosis?? A: herpes simlex infection b:fungal ulcer c:bacterial infection
76)An obese patient with recent loss of weight…..his random Blood glucose level is 250 mg%….what would you like to do?? A: advice exercise b: start glitazone c: start insulin d:start metformin
77)A 2 yrchild presented with h/o bleeding per rectum……O/E maroon colored stoll was seen….tenderness on right iliac fossa??what is yourdiagnosis??A:acute appendicitis b:acute intussuception c:meckel’s diverticulum
78)one question was from juvenile rheumatoid arthritis
79)one was from rheumatoid arthritis
80)one question was from breast milk