HARAR HEALTH SCIENCE COLLEGE

Department of public health

Internal exam FOR 4th year
STUDENTS

NAME

ID NO

TIME ALLOWED 3 HOUR

2020

GOOD LUCK

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 MULTIPLE CHOICE QUESTIONS
CHOOSE THE BEST ANSWER
1. Which one of the following is incorrect about CPD ?
A. it is often due to fetal malposition rather than a true disparity between fetal and
maternal pelvic dimensions
B. If timely intervention (CS) is not undertaken, obstructed labor leads to CPD.
C. Diabetes, post term pregnancy, or hydrocephalus are among the causes
D. None
2. Which one of the following is not risk factor for malposition
A. placenta previa
B. multiple gestation
C. prematurity
D. grand multiparity
E. none
3. Which one of the following is not risk factor for post posrpartum hemmorage
A. Uterine atony
B. Lower genital tract lacerations
C. Retained products of conception
D. None
4. All are major goal of focused antenatal care except
A. Health promotion and disease prevention
B. Early detection and treatment of complications and existing diseases
C. There is no need of goal
D. Birth preparedness and complication readiness planning
5. A 14 yr girl has history of wheezing,chest tightness and coughing at night.she notices these
symptoms occur when she goes out in the cold and breath cold air. what is the most likely
diagnosis?
A. Croup
B. Asthma
C. Pneumonia
D. All
6. which of the following is not component of DUKEs criteria for infective endocarditis
A. osler node
B.splinter hemorrhage
C.erythema marginatum
D.splenomegaly

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 7. which of th following is complication of tetanus except?
A. Seizure
B. Thrombosis
C. aspiration pneumonia
D. gastric ulcer
E. none
8. what is the earliest sign of vit A deficency?
A. corneal xerosis
B. conjectival xerosis
C. C.xerophtalmia
D. corneal ulcer
9. A 3 year old boy has a two day history of cough, coryza and fever. The rash started on his
face and now covers his whole body. what is the most likely diagnosis?
A. rubella
B. pertusis
C. measles
D. diphteria
10. What is the complication anticipated for the above Q.9 child?
A. acute otitis media
B. diarrea
C. malnutrition
D. All
11. A 4 y old girl with unknown vaccination status, presented to our OPD with gross
subconjuctival hemorrhages in both eyes of 2 days duration. She was having for 3 weeks an
irritant cough that, in the last week, worsened and it came paroxysmic with suffocation and
congestion of face.what is the most likely dx?
A. pertussis
B. croup
C. epiglottitis
D. none
12. A 3yr old boy come to emergency due to sore throat,dysphagia,fever,hoarse voice.his neck
is extended and leaning forward.what is the most likely dx?
A. Croup
B. Tonsilopharyngitis
C. Epiglottitis
D. Peritonsillar absess
13. What is the feared complication of epiglotiitis?
A. Airway obstruction
B. Seizure
C. absecess
D. all

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14. The best description of the 1st minute Apgar score is that it:
A. Accurately predicts who will develop cerebral palsy
B. Assesses neonates in need of resuscitation
C. Accurately predicts a low umbilical cord Ph
D. Is unaffected by maternal opiate pain relief
E. Accurately predicts neonates who will die in the neonatal period
15. Breast milk may have sufficient amounts of all of the following nutrients except:
A. Protein
B. Calcium
C. Vit c
D. Vitamin D
16. Which one of the following is not a feature of rickets ?
A. rachitic rosary
B. craniotabes
C. hypocalcemic tetany
D. bow leg
E. none
17. In 6-month-old girl, which of the following conditions would be a contraindication to a
diagnostic lumbar puncture?
A. Uncorrected bleeding diathesis
B. Bulging fontanelle
C. Lumbar puncture 2 days before
D. Seizure
18. Which of the following is a feature of mild croup:
A. Irritability
B. Barking cough
C. Stridor at rest
D. Tachypnoea
E. Hypoxaemia
19. A 2 year old girl with Downs syndrome is attending the cardiologists for follow up. Her
cardiac lesion is most likely to be:
A. VSD
B. AVSD
C. Coarctation of the aorta
D. Tetralogy of Fallot
20. A 4 year old boy presents with 2 day history of generalised body swelling. It started
around the eyes and has spread down his body. It is worst first thing in the morning. He
has no other symptoms He had a similar episode last year that responded to steroid
therapy. The most likely diagnosis is
A. Nephrotic syndrome
B. Oedematous malnutrition
C. Congestive heart failure
D. Chronic liver disease

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21. An 8 year old girl presents with a 24 hour history of fever, headache, neck stiffness and
photophobia. The most useful investigation to confirm the diagnosis is
A. Blood cultures
B. Lumbar puncture / CSF analysis
C. Urine culture
D. CBC
E. CT brain
22. A 6-year-old black boy has brown urine and healing impetigo lesions. He presents with
hypertension, dyspnea, periorbital edema, and hepatomegaly. The most likely cause of
his problem is
A. IgA nephropathy
B. Poststreptococcal glomerulonephritis
C. Idiopathic hypercalciuria
D. Pyelonephritis
E. E.none
23. Which one of the following lists is cyanotic congenital heart disease?
A. VSD
B. TGA & COA
C. ASD
D. All
E. None
24. A 48hrs old female neonate born from a 20 yrs old primi para leady at term assisted by
vacuum brought to you for swelling on the scalp on P/E PR=180, RR=62 T= 36 grossly
pale, diffuse swelling of the scalp crossing the suture lines on palpation it is cystic.
Hematocrite is 23%. The most likely diagnosis for this infant is
A. caput
B. molding
C. encephalocele
D. cephalhematoma
E. subgalial hemorrhage
25. which one of the following evidences support for febrile seizure for a child who
presented with abnormal body movement?
A. common age between 9mo -5yr
B. simple febrile sz lasts 15min
C. there is genetic predisposition
D. none
E. All

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26. For a child present to emergency with status epilepticus ,which of the following
investigation is inappropriate?
A. serum glucose level
B. serum Calcium
C. serum Sodium
D. none
27. Which one of the following is not true about meningitis
A. viruses are the most common cause in under 5
B. enteroviruses are the most common cause of viral meningitis
C. is similar with encephalitis
D. viral meningitis has lymphocyte count predominant
E. none
28. which of the following is the complication of meconium aspiration syndrome?
A. air leak
B. persistent pulmonary hypertension of newborn
C. hyperinflation of lung
D. deficiency of surfactant
E. all
29. TRUE about RH-issoimunization of newborn
A. occur in fetus who is RH-ve &mother who is RH+ve
B. usually its mild hemolysis
C. rarely affect first pregnancy
D. all
30. Rising intracranial pressure in a patient with head injury is diagnosed by
A. rising GCS level
B. decrease in the pulse rate and increase in the blood pressure
C. increase in the pulse rate and decrease in the blood pressure
D. PA and lateral view of skull X-ray
E. none of the above
31. Which of the following is not a chronic complication of PUD?
A. Stenosis
B. Perforation
C. Gastric Outlet Obstruction
D. Gastric Ca
32. The most common type of hernias in female is/are;
A. Direct inguinal hernia
B. Femoral hernia
C. indirect inguinal hernia
D. All
33. One of the following is/are risk factors for osteomyelitis
A. Malnutrition
B. Trauma
C. Iv drug users
D. Diabetes mellitus
E. All

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34. The most common cause of upper airway obstruction in unconscious patient is?
A. Secretion
B. tongue roll back
C. Airway edema
D. All
35. A 25 year old male patient sustained stone injury to his anterior chest and started to
experience dyspnoea immediately. On P/E he has distended neck vein, tachypnoea,
hypotension, dullness on affected side of the chest . What is the most likely diagnosis?
A. Open pneumothorax
B. Tension pneumothorax
C. massive heamothorax
D. spontaneous pneumothorax
36. One of the following is /are the indication for surgery in patient with benign prostatic
enlargement
A. Renal insufficiency
B. Acute urinary retention
C. Hydronephrosis
D. All
37. Which one of the following is/are signs of basal skull bone fracture?
A. Mastoid ecchymosis
B. Bulgedtympanic membrane
C. Bilateral Periorbital ecchymosis
D. All
38. Which one of the following is/are primary Traumatic brain injury?

A. DAI C. Hypotension
B. Concussion D.A & B

39. Which one of the following is/are the most important secondary TBI?

A. Hypoxia C. Hypotension
B. Hypoglycemia D. A & C

40. Which one of the following is true?

A. Lucid interval is a must in a patient with Epidural hematoma
B. The major source of bleeding in EDH is venous source
C. Mortality is high in ASDH b/c of underlying associated primary brain injury
D. Mortality is high in EDH than ASDH
41. What is the major source of bleeding in ASDH?
A. Bridging veins
B. Meningeal artery
C. Jugular veins
D. None

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42. Which of the following signs & symptoms are associated with risk of inhalational injury?
A. Burn in a closed house.
B. Burn around the face.
C. Stridor & shortness of breath.
D. All
43. XN - in WHO classification of vit a deficency is
A. bitot’s spot
B. keratomalacia
C. night blindness
D. corneal scar
44. vit a causes
A. cellular differentiation
B. reproduction
C. growth
D. all of the above
45. signs and symptom in ophthalmology include
A. blurring of visions
B. eye pain
C. diplopia
D. floater
E. all of the above
46. intra-ocular pressure is measured by
A. slit lamp microscopy
B. pin-hole
C. tonometry
D. ophthalmoscope
47. This is a 30yrs old female patient who presented with eye swelling, edema, fever,
proptosis, reddening of eye and difficulty to eye movement. what is the likely dx
A. blindness
B. orbital cellulitis
C. hyperthyroidism
D. none
48. opacification of the lens is
A. refractory error
B. catract
C. glaucoma
D. none

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49. causes of catract
A. congenital
B. age related
C. trauma
D. all of the above
E. none of the above
50. glaucoma is an eye disease characterized by
A. elevated intra-ocular pressure
B. optic atrophy
C. visual defect
D. all of the above
51. This is a 3 yrs old boy who presensented with white unilateral pupillary reflex. what is
the likely dx
A. vit a deficiency
B. refractive error
C. retinoblastoma
D. none of the above
52. treatment of epistaxis include
A. anterior packing
B. anteroposterior packing
C. cauterization
D. all of the above
53. substance that produce allery is called
A. allergen
B. sinus
C. antibody
D. bleeding
54. causes of epistaxis include
A. nasal trauma
B. bleedng tumours
C. hypertension
D. bleeding disorder
E. all of the above
55. inflammation of middle ear is called
A. acute otitis externa
B. acute otitis media
C. acute otitis interna
D. perichondral bleeding

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56. symptoms of acute otitis media include
A. fever
B. discharge
C. pain
D. all of the above
57. complication of acute otitis media if not treated include
A. intracranial complication
B. facial nerve paralysis
C. acute mastoiditis
D. lateral sinus thrombosis
E. all of the above
58. the special sense of smell in the nose is by
A. red blood cell
B. auditory cell
C. eosinophil
D. olfactory cell
59. signs of allergic rhinitis include
A. nasal congestion
B. running nose
C. itching or watery eyes
D. all of the above
E. none of the above
60. aids associated disease of oral mucosa
A. candidasis of oralmucosa
B. leukoplakia
C. karposi sarcoma
D. all of the above
61. Sign and symptom of facial nerve palsy include
A. droping of lower eyelid
B. missing of nasolabial fold
C. tilted mouth
D. droping of the corner of the mouth
E. all of the above
62. The client with one of the following is an appropriate candidate of vaginal birth after
cesarean delivery.
A. Client with one-low transverse previous cesarean delivery
B. Client with breech presentation in current pregnancy
C. Client with history of previous classical cesarean scar
D. Client with previous inverted ``T`` cesarean car

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63. Risk of uterine rupture is lowest with one of the following previous uterine scar.
A. Previous classical cesarean scar
B. Previous fundal uterine rupture
C. Previous low vertical cesarean scar
D. Previous inverted ``T`` cesarean scar
64. Most common cause of first trimester abortion is?
A. Fetal chromosomal abnormality
B. Parental chromosomal abnormality
C. Uterine structural abnormality
D. Endocrine abnormality
65. The least risk factor for ectopic pregnancy is?
A. Failed tubal sterilization
B. Previous PID
C. Previous cervicitis
D. Multiple sexual partner
66. One of the following is not an etiology of second trimester recurrent abortion?
A. Uterine congenital abnormality
B. Cervical incompetence
C. Chromosomal abnormality
D. Hypothyroidism
67. The earliest sign of chorioamnionitis is:
A. Maternal fever
B. Maternal tachycardia
C. Maternal foul smelling discharge
D. Fetal tachycardia
68. The gold standard test for diagnosis of premature rupture of membrane is:
A. Ultrasound
B. Aminsure test
C. Dye-test (amniocentensis)
D. Nitrizine paper
69. Serious complication of combined oral contraceptive is:
A. Deep vein thrombosis
B. Severe anemia
C. Dysmenorrhea
D. All

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70. Placenta previa is defined as:-
A. Presence of placental tissue found before the fetus
B. Presence of the fetus found before the placental tissue
C. Presence of placental tissue over or adjacent to the cervical os
D. Presence of placental tissue in the vaginal cannel which is attached to the wall of
the vaginal epithelial lining in front of the cervical canal
71. Leopold’s maneuver number 3 is used to determine
A. Fundal palpation
B. Lateral palpation
C. Pelvic palpation
D. Pawlik grip
72. Normal menstruation include all except
A. Every 21-35 days
B. Average flow of 3-5days
C. Non clotted fluid blood
D. none
73. Complication of PROM include
A. Chorioamnionitis
B. Placental abruption
C. Oligohydramnios
D. Cord prolapse
E. All
74. Post term pregnancy is pregnancy beyond
A. 40 week
B. 41 week
C. 42 week
D. 43 week
75. Placenta abruption
A. Separation of the placenta from its site of implantation before delivery of fetus
B. It can be concealed or external hemorrhage
C. Concealed abruption carries greater hazard to the mother
D. All
E. None
76. Commonest causes of APH
A. Placenta previa
B. Placenta abruption
C. Uterine rupture
D. All
77. ------------- is the most common cause of portal hypertension?
A. Cirrhosis
B. Schistosomiasis
C. Constrictive pericarditis
D. Splenic vein thrombosis

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78. _______is the most common and severe complication of ascitis?
A. Respiratory complication
B. Umbilical hernia
C. Pleural effusion
D. Spontaneous bacterial peritonitis
79. Which of the following is the most common clinical feature of Acute rheumatic fever?
A. Carditis
B. Migratory polyarthritis
C. Sydenham’s chorea
D. Subcutaneous nodules
80. Which of the following is NOT microvascular complication of Diabetes mellitus?
A. Retinopathy
B. Nephropathy
C. Neuropathy
D. stroke
81. Is involves identification, analysis and evaluations of literatures
related to the problem under investigation
A. Statement of the problem
B. Literature review
C. Work plan
D. All
82. The main objective of the study come / driven from
A. Back ground information
B. Methods
C. Statement of the problem
D. Significance of the study

83. The type of study design chosen depend on

A. The type of problem
B. The knowledge already available about the problem
C. The resource available for the study
D. All
84. Is the characteristic of a person, object or phenomenon that can take on
different values in research study
A. Study design
B. Variable
C. Measurement
D. None

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 85. In the study to predict the level of obesity based on different factors that will determine
the level of obesity like physical activity, dietary habit , age, sex, family history and type
of oil use. The dependent variable will be:-
A. Physical activity
B. Dietary habit
C. Obesity
D. Age
86. The following table shows the results of population-based Cohort Study on association
between lung Cancer and cigarette smoking
Lung cancer

Yes No Total

Cigarette smoking Yes 400 200 600

No 100 700 800

Total 500 900 1400

The relative risk (RR) of this study is?

A. 14.0 C. 66.7
B. 8.0 D. 5.3
The following table is the result of new screening program for breast cancer among high risk
women population

New Screening Breast cancer status by Gold standard test

Test Result Present Absent Total

Positive 380 50 430

Negative 20 550 570
Total 400 600 1000
Based on this, determine the

87. What is the Specificity of the new Screening test

A. 88.37% C. 95%
B. 91.67% D. 96.49%

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88. What is the Sensitivityof the new Screeningtest
A. 88.37%
B. 91.67%
C. 95%
D. 96.49%
89. What is the Positive predictive valuesof the new Screeningtest
A. 88.37%
B. 91.67%
C. 95%
D. 96.49%
90. What is the Negative predictive valuesof the new Screeningtest
A. 88.37%
B. 91.67%
C. 95%
D. 96.49%
91. Which of the following interventions is carried out in tertiary prevention
A. Early detection and treatment of breast cancer
B. Proper excreta disposal
C. Provision housing and clothing
D. Treatment to prevent further disability or death
92. An epidemiologist wants to assess the effect of Khat chewing on college students’
performance. He identified 200 first year students who chewed Khat regularly and 400
students never chew Khat. Then he followed both groups until their graduation to
determine the effect.
What type of study design is best for this research?
A. Cross-sectional study
B. Cohort study
C. Case-control study
D. Experimental study

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 93. Ministry of health of Ethiopia communicates to public through ETV that “any person
with fever, cough and sore throat can be covid-19 and therefore, should visit the nearby
health institution”.
What type of case definition is this?

A. Confirmed case definition

B. Probable case definition
C. Possible case definition
D. All of the above
94. Which one is not the Limitations of statistics
A. It deals usually with those subjects of inquiry that are capable of being
quantitatively measured and numerically expressed
B. It deals only with aggregates of facts and no importance of is attached to
individual items
C. Statistical data are only approximately and not mathematically correct
D. all
95. _______Is related to the extent or degree of scatteredness or variability in observations
or statistical data from an average value.

A. Central Tendency C. Dispersion

B. measures of central Tendency D. all

96. A hospital administrator wishes to know what proportion of discharged patients is

unhappy with the care received during hospitalization. There is no previous study on the
same topic in that area or somewhere else. How large a sample should be drawn if we let
the confidence level of 95% and margin of error 5%?

A. 578
B. 250
C. 384
D. Can’t be determined

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97. A research wants to assess the prevalence of latrine utilization in households of Harar
town. He stratified the 1200 households in to 3 woredas and wants to allocate the sample
size of 360 to each woreda proportional to size. There are 540; 260 and 400 households
in Village A, Village B and Village C respectively. How the researcher can distribute
this total sample size in to each village?

A. Village A= 120; Village B= 120 and Village C= 120

B. Village A= 162; Village B= 78 and Village C= 120
C. Village A= 160; Village B= 100 and Village C= 100
D. A and B are correct
98. A survey is being planned to determine the prevalence of family planning utilization
among women in reproductive age living in Harar town. It is observed in previous study
that the proportion of family planning is 35%. How many women should be selected to
estimate the true proportion within margin of error (d) of 5% and 95% confidence level?

A. 178
B. 350
C. 384
D. 538
99. A study of 250 adult patients admitted to a Jugal hospital during the past year revealed
that, on the average, the patients lived 15 miles from the hospital. What is the target
population?
A. All 250 adult patients admitted to Jugal hospital during the past year
B. All adults admitted in Jugal hospital during the past year
C. All adults lived 15 miles from the Jugal hospital
D. All adults living in that Harar town
100. According to the CSA of Ethiopia, there were 44,038,900 men and 44,927 700 women
in Ethiopia. Calculate proportion of female in Ethiopia
A. 102
B. 98
C. 50.5
D. 49.5

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101. The most basic scheme of random sampling that individuals are selected at random
from the sampling frame by lottery methods or using table of random number

A. Simple random sampling

B. Systematic random sampling
C. Stratified random sampling
D. Cluster sampling

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Answer sheet
Name _________________________ ID No_ _______
1. 21. 41. 61. 81.

2.___ _ 22.___ _ 42.____ .___ 62. 82. _

3.___ _ 23.____ 43.____ 63.____ 83.

4.__ _ _ 24.____ 44.____ 64.____ 84.

5.___ _ 25.____ 45.____ 65.____ 85.

6.___ _ 26.____ 46. 66.___ 86._

7.___ _ 27.____ 47. 67.___ 87._

8.___ _ 28.___ 48. 68.__ _ 88. _

9.___ _ 29.___ 49._ 69.____ 89.

10._ 30. 50. 70. 90.

11. 31. 51. 71. 91.

12. 32. 52. 72. 92.

13. 33. 53. 73. 93.

14. 34. 54. 74. 94.

15. 35. 55. 75. 95.

16. 36. 56. 76. 96.

17. 37. 57. 77. 97.

18. 38. 58. 78. 98.

19. 39. 59. 79. 99.

20.____ 40.____ 60. 80. 100.

101.

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Answer sheet

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Answers
1.D 18.B 36.D 54.E 72.D
2.E 19.B 37.D 55.B 73.E
3.D 20.A 38.D 56.D 74.C
4.c 21.B 39.D 57.E 75.D
5.B 22.B 40.C 58.D 76.D
6.C 23.B 41.A 59.D 77.A
7.E 24.E 42.D 60.D 78.D
8.B 25.E 43.C 61.E 79.B
9.C 26.D 44,D 62.A 80.D
10.D 27.C 45.E 63.C
11.A 28.E 46.C 64.A
12.C 29.C 47.B 65.D
13.A 30.B 48.B 66.C
14.B 31.B 49.D 67.D
15.D 32.B 50.D 68.C
16.E 33.E 51.C 69.A
17.A 34.D 52.D 70.C

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35.C 53.A 71.C

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