1
PUBLIC HEALTH COC EXAM
SPECIFIC TO ACTUAL 2025 EXAM
Part One
Direction: Each of the following questions is followed by four possible alternative answers. Read each
question carefully and blacken the letter of your best choice on the separate answer sheet provided.
1. A 21 yrs old male pt. came with compliant of productive cough of one-month duration. He also
has law grade fever, night sweet, weight loss & loss of appetite. On examination he is chronically
sick looking with vital signs in the normal rang. He has no remarkable syndromes. Laboratory
investigation of Sputum microscopy showed mycobacterium bacilli. What is the best next step of
the management of the pt?
A) Rifampicin and isoniazid for two months.
B) . Rifampicin and isoniazid for four months.
C) . Rifampicin and isoniazid, Ethambutol and pyrazinamide for four months.
D) Rifampicin and isoniazid, Ethambutol and pyrazinamide for two months.
2. A 40yr old known RVI pt. who has been on ART for the last three yrs came with a compliant of
whitish loading over his tongue with difficulty & pain during swallowing of two wks duration. His
Vital signs are in a normal range. On examination there is cheese coating over the tongue,
extending to the pharynx, which bleeds while scraped using a spatula.
What is the WHO clinical stage of the pt?
A) Stage I B) Stage II C) Stage III D) Stage IV
3. A 20 yr old male came with complaints of on and off type high grade fever of five days duration.
He also has history of headache and arthralgia. He is acutely seek looking & his cloth is infested
with body lice. His PR is 116/min, RR are 20/min, Temp. is 40.5 O C and BP is 100/70 mmHg. Blood
film shows multiple spirochetes.What is the drug of choice for the management of this pt.
A) Doxycycline C) Erythromycine
B) Ciprofloxaccine D) P.Pencillin
4. A 30 yr old male pt. came to a clinic after he sustained a nail prick injury at his leg while workin at
contruction site a day back. Upon evaluation the wound is deep & clean. What is the most
appropriate next step in the management of this pt?
A) PO antibiotics C) Wound debridement
B) Tetanus anti-toxin D) Tetanus immunoglobulin
5. A 34 yrs. old male pt came with a compliant of burning of epigastric pain of two wks. duration. He
was repeatedly treated with anti-acid & omeprazole for the last three yrs. He is chronically sick
looking with vital sign in the normal range. On examination he has pale conjunctiva & non icteric
and there is mild epigastric tenderness. Laboratory investigation results shows hemoglobin level of
8.4mg/dl and negative H. Pylori test. What is the most likely anticipated complication in this pt?
,2
A) Gastric outlet obstruction C) Perforated peptic ulcer
B) Gastrointestinal bleeding D) Gastric lymphoma
6. A 26 yrs. old male presented with complaints of bloody diarrhea & fever of 12 hrs. duration. He
reported that a day back he had eaten raw vegetables at a local restaurant. His PR is 116/min, Temp
38oC, BP 90/60mmHg and RR 20/min. He has no remarkable systemic findings on examination.
What is the most likely Dx of this pt?
A) Shigellosis C) Taeniasis
B) Giardiasis D) Choler
7. A 54 yr old male came with a complained of abdominal distention of one-month duration. His PR
is 100/min, RR 20/min, BP 100/70 mmHg and temp is 36.8oC. On examination he has greatly
distended abdomen with positive signs of fluid collection, gynaccomatus & erythematous palms.
On investigation HBSAg is Reactive. What is the most likely Dx of this pt?
A) Chronic liver disease 2o to Autoimmune hepatitis
B) Chronic liver disease 2o to Chronic Viral hepatitis
C) Chronic liver disease 2o to drug induced hepatitis
D) Chronic liver disease 2o to alcoholic hepatitis.
8. A 24 yr old male came with a compliant of cough of seven days’ duration. He also has high grade
fever, chest pain & fast breathing. Otherwise, he has no history of hospital admission of Rx for
similar condition. His PR is 108/min, RR 26/min and temp. 38.1oc. On examination there is dullness
and bronchial breath breath sound over over the left middle 1/3 rd of the posterior chest. Chest X-
Ray shows that there is a homogeneous opacity over the middle third of the right chest. What is
the next best step to the management of this pt?
A) Clarithromycine C) Ceftriaxone
B) Augumentin D) Cefalexine
9. A 28 yr old male presented with complaints of shortness of breath & dry cough of two wks
duration. He also has low grade fever & decrease appetite. He is chronically sick looking with vital
signs in the normal range. On respiratory examination, there is dullness and abscess air entry over
the posterior lower 1/3 rd of the left chest. What is the most likely explanation for this finding?
A) Consolidation C) Bronchieotasis
B) Lung abscess D) Pleural effusion
10. A 29 yr old female who is known asthmatic pt. on intermittent Salbutamol puff for the last two
yrs came for routine follow up. She states that she has been using her Salbutamol puff more than
three times a day to get relieved to the last one month. What is most appropriate step to the
management of this pt?
A) Oral corticosteroid C) Low dose inhaled corticosteroid
B) Long acting B-agonist (LABA). D) High dose inhaled corticosteroid
, 3
11. A 27 yr old female came with a compliant of fever of five days’ duration. She has history of IV drug
use for the last one year. Her BP is 120/78mmHg, PR is 120/min,RR 24/min & temp. is 39.2 oc . On
cardiovascular examination, there is systemic murmur at the apex. Laboratory investigation result
shows Hgb level of 9.5 mg/dl & positive blood culture for staphylococcus aureus. What is the most
likely Dx of this Pt.?
A) Infective endocarditis C) Acute Pericarditis
B) Acute rheumatic fever D) Myocarditis
12. A 66 yr old male came to a clinic for BP checkup. Two months back his BP was 144/92 mmHg &
he was advised to have salt free diet & to start follow up. Now his BP is 158/99 mmHg, PR 74/min,
RR 14/min & temp. is 36.7oc. There is no remarkable systemic finding on examination. His serum
creatinine is 0.9 mg/dl (NR Serum Cr.= 0.6-1.2 mg/dl). What is the next step in management of this
Pt.?
A) Start single PO anti-hypertensive drug C) Appoint her after two days for repeat
measurement
B) Start combined PO anti-hypertensive drug D) Advise on life style modification & send
him home
13. A 28 yr male came to an Em OPD with a compliant of shortness of breath of six days’ duration. He
also had pleuritic type of chest pain which improves with leaning forward & worst with supine
position, high grade fever & dry cough of four days’ duration. He is mostly sick looking with BP of
70/50 mmHg, PR of 112/min, RR of 32/min, temp. of 38.7oc . Distended neck veins & distal heart
are the findings on cardiovascular examination. What is the most likely Dx of the Pt.?
A) Severe Pneumonia C) Pulmonary embolism
B) Carotide temponade D) Spontaneous pneumothorax
14. A 36 yr old male came with compliant of watery diarrhea & vomiting of two days duration. He
was being treated with oral antibiotic & ORS but has no improvement. Three days back he treated
to complain of decreased urine outpot & headache. He is lethargic with BP of 140/97 mmHg, PR
122/min, RR of 24/min & temp. of 36.8oc. On investigation serum creatinine level is 5.4 mg/dl &
stool examination shows trophozoite of Giardiasis (NR Serum Cr, = 0.6-1.2 mg/dl). What is the most
likely cause of the pts. Current condition?
A) Oral antibiotics C) Sepsis of GI focus
B) GI fluid loss D) Obstructive uropathy
15. A 35 yr old woman came with compliant of right side flank pain of one-day duration. She also has
high grade fever & repeated vomiting. She is acutely sick looking with BP 90/60 mmHg, PR 124/min,
RR of 22/min & temp. of 39.2oc. On examination there is right side costovertebral angle tenderness.
Laboratory investigation result shows WBC count 19,000/mm3 & 12 WBC/HPF on urinalysis. What
is the next best step in the management of this pt?
PUBLIC HEALTH COC EXAM
SPECIFIC TO ACTUAL 2025 EXAM
Part One
Direction: Each of the following questions is followed by four possible alternative answers. Read each
question carefully and blacken the letter of your best choice on the separate answer sheet provided.
1. A 21 yrs old male pt. came with compliant of productive cough of one-month duration. He also
has law grade fever, night sweet, weight loss & loss of appetite. On examination he is chronically
sick looking with vital signs in the normal rang. He has no remarkable syndromes. Laboratory
investigation of Sputum microscopy showed mycobacterium bacilli. What is the best next step of
the management of the pt?
A) Rifampicin and isoniazid for two months.
B) . Rifampicin and isoniazid for four months.
C) . Rifampicin and isoniazid, Ethambutol and pyrazinamide for four months.
D) Rifampicin and isoniazid, Ethambutol and pyrazinamide for two months.
2. A 40yr old known RVI pt. who has been on ART for the last three yrs came with a compliant of
whitish loading over his tongue with difficulty & pain during swallowing of two wks duration. His
Vital signs are in a normal range. On examination there is cheese coating over the tongue,
extending to the pharynx, which bleeds while scraped using a spatula.
What is the WHO clinical stage of the pt?
A) Stage I B) Stage II C) Stage III D) Stage IV
3. A 20 yr old male came with complaints of on and off type high grade fever of five days duration.
He also has history of headache and arthralgia. He is acutely seek looking & his cloth is infested
with body lice. His PR is 116/min, RR are 20/min, Temp. is 40.5 O C and BP is 100/70 mmHg. Blood
film shows multiple spirochetes.What is the drug of choice for the management of this pt.
A) Doxycycline C) Erythromycine
B) Ciprofloxaccine D) P.Pencillin
4. A 30 yr old male pt. came to a clinic after he sustained a nail prick injury at his leg while workin at
contruction site a day back. Upon evaluation the wound is deep & clean. What is the most
appropriate next step in the management of this pt?
A) PO antibiotics C) Wound debridement
B) Tetanus anti-toxin D) Tetanus immunoglobulin
5. A 34 yrs. old male pt came with a compliant of burning of epigastric pain of two wks. duration. He
was repeatedly treated with anti-acid & omeprazole for the last three yrs. He is chronically sick
looking with vital sign in the normal range. On examination he has pale conjunctiva & non icteric
and there is mild epigastric tenderness. Laboratory investigation results shows hemoglobin level of
8.4mg/dl and negative H. Pylori test. What is the most likely anticipated complication in this pt?
,2
A) Gastric outlet obstruction C) Perforated peptic ulcer
B) Gastrointestinal bleeding D) Gastric lymphoma
6. A 26 yrs. old male presented with complaints of bloody diarrhea & fever of 12 hrs. duration. He
reported that a day back he had eaten raw vegetables at a local restaurant. His PR is 116/min, Temp
38oC, BP 90/60mmHg and RR 20/min. He has no remarkable systemic findings on examination.
What is the most likely Dx of this pt?
A) Shigellosis C) Taeniasis
B) Giardiasis D) Choler
7. A 54 yr old male came with a complained of abdominal distention of one-month duration. His PR
is 100/min, RR 20/min, BP 100/70 mmHg and temp is 36.8oC. On examination he has greatly
distended abdomen with positive signs of fluid collection, gynaccomatus & erythematous palms.
On investigation HBSAg is Reactive. What is the most likely Dx of this pt?
A) Chronic liver disease 2o to Autoimmune hepatitis
B) Chronic liver disease 2o to Chronic Viral hepatitis
C) Chronic liver disease 2o to drug induced hepatitis
D) Chronic liver disease 2o to alcoholic hepatitis.
8. A 24 yr old male came with a compliant of cough of seven days’ duration. He also has high grade
fever, chest pain & fast breathing. Otherwise, he has no history of hospital admission of Rx for
similar condition. His PR is 108/min, RR 26/min and temp. 38.1oc. On examination there is dullness
and bronchial breath breath sound over over the left middle 1/3 rd of the posterior chest. Chest X-
Ray shows that there is a homogeneous opacity over the middle third of the right chest. What is
the next best step to the management of this pt?
A) Clarithromycine C) Ceftriaxone
B) Augumentin D) Cefalexine
9. A 28 yr old male presented with complaints of shortness of breath & dry cough of two wks
duration. He also has low grade fever & decrease appetite. He is chronically sick looking with vital
signs in the normal range. On respiratory examination, there is dullness and abscess air entry over
the posterior lower 1/3 rd of the left chest. What is the most likely explanation for this finding?
A) Consolidation C) Bronchieotasis
B) Lung abscess D) Pleural effusion
10. A 29 yr old female who is known asthmatic pt. on intermittent Salbutamol puff for the last two
yrs came for routine follow up. She states that she has been using her Salbutamol puff more than
three times a day to get relieved to the last one month. What is most appropriate step to the
management of this pt?
A) Oral corticosteroid C) Low dose inhaled corticosteroid
B) Long acting B-agonist (LABA). D) High dose inhaled corticosteroid
, 3
11. A 27 yr old female came with a compliant of fever of five days’ duration. She has history of IV drug
use for the last one year. Her BP is 120/78mmHg, PR is 120/min,RR 24/min & temp. is 39.2 oc . On
cardiovascular examination, there is systemic murmur at the apex. Laboratory investigation result
shows Hgb level of 9.5 mg/dl & positive blood culture for staphylococcus aureus. What is the most
likely Dx of this Pt.?
A) Infective endocarditis C) Acute Pericarditis
B) Acute rheumatic fever D) Myocarditis
12. A 66 yr old male came to a clinic for BP checkup. Two months back his BP was 144/92 mmHg &
he was advised to have salt free diet & to start follow up. Now his BP is 158/99 mmHg, PR 74/min,
RR 14/min & temp. is 36.7oc. There is no remarkable systemic finding on examination. His serum
creatinine is 0.9 mg/dl (NR Serum Cr.= 0.6-1.2 mg/dl). What is the next step in management of this
Pt.?
A) Start single PO anti-hypertensive drug C) Appoint her after two days for repeat
measurement
B) Start combined PO anti-hypertensive drug D) Advise on life style modification & send
him home
13. A 28 yr male came to an Em OPD with a compliant of shortness of breath of six days’ duration. He
also had pleuritic type of chest pain which improves with leaning forward & worst with supine
position, high grade fever & dry cough of four days’ duration. He is mostly sick looking with BP of
70/50 mmHg, PR of 112/min, RR of 32/min, temp. of 38.7oc . Distended neck veins & distal heart
are the findings on cardiovascular examination. What is the most likely Dx of the Pt.?
A) Severe Pneumonia C) Pulmonary embolism
B) Carotide temponade D) Spontaneous pneumothorax
14. A 36 yr old male came with compliant of watery diarrhea & vomiting of two days duration. He
was being treated with oral antibiotic & ORS but has no improvement. Three days back he treated
to complain of decreased urine outpot & headache. He is lethargic with BP of 140/97 mmHg, PR
122/min, RR of 24/min & temp. of 36.8oc. On investigation serum creatinine level is 5.4 mg/dl &
stool examination shows trophozoite of Giardiasis (NR Serum Cr, = 0.6-1.2 mg/dl). What is the most
likely cause of the pts. Current condition?
A) Oral antibiotics C) Sepsis of GI focus
B) GI fluid loss D) Obstructive uropathy
15. A 35 yr old woman came with compliant of right side flank pain of one-day duration. She also has
high grade fever & repeated vomiting. She is acutely sick looking with BP 90/60 mmHg, PR 124/min,
RR of 22/min & temp. of 39.2oc. On examination there is right side costovertebral angle tenderness.
Laboratory investigation result shows WBC count 19,000/mm3 & 12 WBC/HPF on urinalysis. What
is the next best step in the management of this pt?
