Medical Doctor’s COC Exam
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Medical Doctor’s COC Exam
Medical Doctor’s COC Exam In Ethiopia
33. A 46 year-old man is brought to the Emergency Department because he was puking fresh blood. 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?
A. Esophageal cancer B. Esophageal varices C. Mallory Weiss D. Reflux esophagitis
34. A 47 year-old man comes to a Hospital complaining of epigastric pain that's exacerbated by eating. Antigenic test for Helicobacter pylori is positive. Endoscopic examination reveals a duodenal ulcer. Which of the following is the most applicable therapy?
A. Amoxicillin, clarithromycin and omeprazole
B. Amoxicillin, metronidazole andanti-acid
C. Omeprazole andanti-acid
D. Ranitidine, amoxicillin and metronidazole .
35. A 29 year-old man with HIV infection presents with habitual 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 um oocytes. Which of the following is the most likely cause?
A. Cryptosporidium parvum B. Microsporidia
C. Mycobacterium avium complex D. Pneumocystis jiroveci
36. Which of the following is the stylish early indicator for diabetic nephropathy?
A. Rising blood urea nitrogen B. Alburainuria
C. Hypertension D. Rising creatinine level
37. A 35 year-old man presents with generalized body swelling of two months. Physical examination reveals BP- 120/ 70mmHg, ascites and 3 pretibial edema. Protein = 4.5 g/ 24hour urine collection. Which of the following is the most likely diagnosis?
A. Chronic liver disease B. Heart failure C. Nephrotic syndrome D. Glomerulonephritis
38. A 55 year-old man comes to the Emergency OPD because of excruciating pain in his right big toe. He was diagnosed to have gouty arthritis. Which of the following is the most applicable pharmacotherapy?
A. Allopurinol B. Ceftriaxone C. Indomethacin D. Morphine
39. A 28 year-old lactating woman presented to the emergency OPD with a complaint of right breast pain of five days duration. On examination body T- 38 °C with right breast tenderness but no fluctuation. What's the most likely diagnosis?
A. Breast Abscess B. Breast Cancer C. Fibroadenoma D. Fibrocystic Change
40. A 32 year-old man presented to the surgical OPD with complaint of neck mass of one year duration. On examination he l as a coarse voice and a solitary 2 cm x 2 cm thyroid mass on the right side which has firm consistency and fixed to underlying structures.There was no lymphadenopathy. What's th utmost likely diagnosis?
A. Thyroid adenoma B. Thyroid cancer
C. Thyroiditis D. Toxic Nodule
Medical Doctor’s COC Exam In Ethiopia
41. A 35 year-old man with a habitual peptic ulcer disease presented with features of acute abdomen and chestx-ray revealed pneumo- peritoneum. 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 coming step in the managenent of this case?
A. Barium meal study B. Endoscopy C. Triple therapy D. Laparotomy
42. A 50 year-old woman brought an ultrasound imaging result which showed Gall Bladder Stone.
She has no abdominal pa n and no given medical illness. Which of the following is the recommended management?
A. Cholecystectomy B. Extracorporal Shockwave Lithotripsy (ESWL)
C. Reassurance D. 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 deficient sense of defecation and had lost weight. What's the most likely diagnosis? Amebic dysentery
B) Colorectal cancer Sigmoid Volvulus 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's the investigation of choice?
A. Abdominal CT- Scan B. Barium Enema C. Colonoscopy D. Upper GI Endoscopy
45. A 30 yeur-old man was seen at the Emergency surgical OPD with perianal pain of two days duration. He has fever and chills. He has left perianal induration with tenderness but no fluctuation. What's the most likely diagnosis?
A. Anal fissure B. Perianal Abscess
C. Perianal fistula D. Thrombosed Hemorrhoids
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 BP80/50 mmHg and PR- 120/ min. He has tire marks on the abdomen and it was tender. The patient is started on 1V fluids. What's the coming step in the management?
A. Abdominal CT- scan B. Exploratory laparotomy C. Observation D. Plain abdominalx-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's the gold standard individual modality?
A. Abdominal Ultra sound B. CUpper GI Endoscopy
C. Plain abdominal film D. CT scan of the abdomen
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 original measure before referral?
A. Cover the intestine with salinc gauze
B. Refer to a near hospital without intervention
C. Replace the intestine back into the peritoneal Cavity
D. Widen is stab wound under original anesthesia
49. A2 year-old farmer presented to the OPD with abdominal pain and frequent vomiting of one day duration. On examination the abdomen is slightly overinflated and has visible peristalsis. Plain abdominalx-ray showed step ladder pattem air- fluid level. Which of the following is the most likely diagnosis?
A. Caecal Volvulus B. Sigmoid Volvulus
C. Small bowel Volvulus D. Compound Volvulus
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'd two analogous 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 measures is to be avoided?
A. Analgesics B. Antibiotics C. IV fluid D. Rectal tube deflation
Medical Doctor’s COC Exam In Ethiopia
51. A 45 year-old housewife presented with progressive submandibular swelling of two days duration. She visited a dentist and undergone tooth extraction a day previous to the start of her symptoms. Examination showed tense, candescent bilateral submandibular swelling with no area of fluctuation. She also has drooling of the slaver and protruded tongue. What's the diagnosis of this patient?
A. Ludwig’s angina B. Periodontal abscess
C. Submandibular cellulites D. Submental abscess
52. A 20 year-old man presented to the OPD forty minutes after he sustained stab injury to his left posterior chest. He has shortness of breathing. He's acutely sick looking; BP = 110/60 mmHg. PR- 90/ min, RR- 26/ min. He has dropped air entry on the lower left chest with visible air rush through the stab wound. What's the stylish first step in the management of this patient?
A. Apply watertight dressing B. Apply triangular dressing
C. Suture the wound D. Take chestX-ray
53. A 35 year-old manly patient came to emergency OPD 12 hours after he started to have unforeseen onset of epigastric pain. He has long standing history of dyspepsia for which he has been takinganti-acids repeatedly. Examination revealed tachycardia, rigid and tender abdomen. What's the applicable imaging study to reach a definitive opinion?
A. Barium follow through B. Barium meal C. chestX-ray D. Plain abdominalX-ray
54. A 27 year-old patient was involved in a road traffic accident. He was brought to the Hospital by the driver. He's agitated; PR- 140/ min and delicate, BP-80/40 mmHg. He has pale conjunctiva and his chest is clear with good air entry. He has an ecchymosis over his left hand area. Abdominal Ultrasonography showed a significant collection of fluid in his abdomen. What's the most likely diagnosis?
A. Cardiogenic shock B. Hemorrhagic shock
C. Neurogenic shock D. Septic shock
55. A 64 year-old manly patient presented to the Emergency OPD after he failed to pass urine for a day. He'd difficulty of urination for the last one year. The former night he took seven bottles of beer with friends. On examination he's acutely sick looking and in pain. Bladder is palpable 10 cm above the pubic bone and tender. What's the most likely cause for acute urinary retention?
A. Benign Prostatic Hyperplasia B. Bladder cancer
C. Bladder stone D. Urethral Stricture
56. An 18 years old manly 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 isn't thickened. What's the most likely diagnosis?
A. Testicular torsion B. Epididymo- orchitis
C. Infected hydrocele D. Testicular tumor
57. A 36 year-old manly patient came with difficulty of urination for the last two years. He'd former history of whitish urethral discharge for which he was treated with tablets and injections. What's the most likely diagnosis?
A. Benign prostatic hyperplasia B. Prostatic Cancer
C. Sexually transmitted disease D. Urethral Stricture
58. A 43 year-old manly 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 unfit to move his right lower branch. On examination his vital signs are normal, there's right pubic tenderness and blood on the penile meatus. What should be the coming step in management?
A. Decompress with percutanous needle puncture B. Do image- guided catheterization
C. Inset a folley catheter to decompress the bladder D. Perform emergency suprapubic cystostomy
59. A 24 year-old man came to the Emergency OPD with severe pain originating in the hand, radiating inferiorly and anteriorly. He also has nausea and vomiting. His vital signs are within normal limies. Abdominal examination showed pronounced costovertebral angle tenderness. Urinalysis showed bitsy hematuria. What's the most likely diagnosis?
A. Cystitis B. Pyelonephritis C. Pyonephrosis D. Ureteric colic
60. A 60 year-old womanish 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's chronically sick looking with normal vital signs, a bimanually palpable mass on the right flank. What's the most likely diagnosis?
A. Chronic pyelonephritis B. Neuroblastoma C. Renal cell cancer D. Wilm’s tumor
