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Choice the correct answer from the given alternatives. 1. A4 years old child presented to the hospital with bilateral pitting edema, Weight for height lt -3Z score and no clinical sign of anemia Finally you diagnose severe acute malnutrition . What will be the next management? B. Treat as an outpatient treatment program and give Iron , amoxicillin and F-75 C. Admit to inpatient and give Vitamin A , Iron, amoxicillin and F-75 D. Admit to inpatient give amoxicillin and F-75 E. Admit to inpatient and give Vitamin A , amoxicillin and F-100 2. Bekele is a 3 years old male child from rural area who came to the Pediatric ER with a complaint of cough and SOB more prominent at night of 2 days duration . He was treated for a similar complaint and improved after treatment with salbutamole puff. His father is an asthmatic and Bekele has history of egg allergy. P/E - diffuse wheeze all over the lung fields. What is the most likely Diagnosis of the case? A. Bronchial asthma C. Tonsilitis D. pharyngitis 3. Baby of Almaz is 13 weeks of life This baby has an appointment at 14 weeks . He has been taking vaccination according to a routine schedule of immunization . What vaccines should be given to him? A. Measles 1 and Vitamin A B. Penta -1 , PCV-1, Rota -1 and OPV - 1 C. Per ita -2,PCV-2, Rota -2 and OPV -2 Penta -3,PCV-3,IPV and OPV-3 4. Which childhood vaccine provides some protection against bacterial meningitis & bacterial pneumonia? A. Hib vaccine B. Hepatitis B vaccine C. Varicella vaccine D Influenza vaccine 5. A 4-year-old child complains of ear pain for 3 days duration. He has a temperature of 38.9^circ C and has had a cold for several days but he has been eating well and his activity has been essentially normal. On examination with otoscopy, the ear drum was red, inflamed , bulging and opaque . What is the most likely diagnosis? A. Acute otitis media C. Chronic otitis media B. Mastoditis D. Diphtheria 6. One of the following is Not Major Modified Framingham clinical criteria for diagnosis of heart failure. A. Crepitations C. Acute pulmonary edema B. Hepatomegaly D. S3 gallop 7. Encephalopathy , convulsion, permanent brain damage is most likely the side effects of: A.BCG B. DPT C. Measles D.OPV 8. The most common cause of bacterial sore throat is: A. Group B streptococci C. Staph. aureus B. Group A streptococci D. Moraxella catarrhalis

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48. A 48-year-old diabetic patient diagnosed as first degree uterine prolapsed, was admitted for an elective surgery. She has complaints of urinary frequency , urgency and incontinence . Physical examinatior result shows that she has skin rash at the area of perineum and upper part of her thigh. What is the priority intervention for the woman? A. Catheterization B. Kegel exercises C. Restriction of fluid intake D. Use skin protection product 49. You see a 20-year-old G1PO with a diagnosis of genital herpes in pregnancy . What is the gestational age at which a primary infection occurs that the risk of transmission to the baby is greatest? A. First trimester (8-13) weeks) B. Second trimester (14 -22 weeks) C.Third trimester (29-34 weeks) D.Third trimester (34-40 weeks) 50. You admit a woman at 40 weeks of gestation in labour with confirmed genital herpes. This is thought to be a primary infection . She is offered an emergency CS that she refuses. How will you manage this patient? A. Administer herpes immunoglobulin to the mother and baby after birth B. Administer herpes immunoglobulin to the baby after birth C. Allow vaginal delivery and offer baby prophylactic aciclovir D. Commence her on intravenous aciclovir and also offer the neonate intravenous aciclovir 51. An elective caesarean section is being performed on a 30-year-old Rhesus D negative pregnant woman at 37 weeks of gestation for placenta praevia (major). Arrangements were made and she is receiving intraoperative cell salvage (ICS) transfusion. What would be the plan with regard to Rhesus D prophylaxis in this woman assuming the baby's blood group is unknown? A. Administer 500 IU anti-D Ig and then take a sample of maternal blood 30-45 min after (ICC) infusion

52.What is the recommended regimen for anti-D prophylaxis for a 26-year-olc I Rhesus D negative woman who is not sensitized? A. 500 IU Ig at 28 weeks of gestation B. 500 IU lg anti-D at 34 weeks of gestation C. 1000 IU Ig anti -D at 28 weeks gestation D. 1500 IU Ig anti-D at 28 weeks gestation 53. A 20-year-old RhD negative woman presents with bleeding at 11 weeks of gestation. When will you consider administering anti-D lg prophylaxis to this woman? A. She goes on to have a complete miscarriage B. The bleeding is heavy but is stopping C. The bleeding is repetitive or associatec I with pain D. The bleeding is small and painless

13. A 25-year-old woman delivered her baby at a health center. You attempt to deliver the placenta actively with intramusculal oxytocin but it was not successful. She starts to bleed heavily. It has been 40 minute since the delivery of the baby . Despite your attempt, the placenta neither expels out nor it shows sign of separation. What is your best intervention at this level? ( Hidar 2012/December 2019) A. Put her on IV fluid, give ampicilline 2 g IV refer her B. Change oxytocin with ergometrine and attempt CCT once again C. Wait the placenta for additional 20 minutes, attempt manual removal D. Give sedative agent and prophylactic antibiotics, attempt manual removal