🩺 NMCLE Top 10 Important Past-Style Questions (with Explanations)

NMCLE past questions


1. 🫀 Acute Myocardial Infarction (MI)

Q: A 55-year-old man presents with chest pain radiating to the left arm. ECG shows ST elevation in leads II, III, aVF. Which artery is most likely blocked?

Answer: Right Coronary Artery (RCA)

✔ Explanation:

  • Inferior wall MI = II, III, aVF
  • Usually due to RCA occlusion

🔥 High-yield points:

  • Anterior MI → LAD (V1–V4)
  • Lateral MI → Circumflex (I, aVL, V5–V6)
  • Inferior MI → RCA

2. 🧫 Tuberculosis Diagnosis

Q: What is the most specific test for pulmonary tuberculosis?

Answer: GeneXpert MTB/RIF

✔ Explanation:

  • Detects TB DNA + rifampicin resistance in 2 hours

🔥 High-yield:

  • Ziehl-Neelsen stain → quick but less sensitive
  • Culture (Lowenstein-Jensen) → gold standard but slow
  • GeneXpert = best for rapid diagnosis

3. 💊 Drug of choice in Anaphylaxis

Q: First-line drug in anaphylactic shock?

Answer: IM Adrenaline (Epinephrine)

✔ Explanation:

  • Acts on α1 (vasoconstriction), β1, β2 (bronchodilation)

🔥 High-yield:

  • Give in mid-thigh IM
  • Repeat every 5–15 min if needed
  • Antihistamines are NOT first-line

4. 🧠 Stroke Localization

Q: Right-sided hemiplegia with aphasia indicates lesion in?

Answer: Left middle cerebral artery (MCA)

✔ Explanation:

  • Left hemisphere = language center (Broca/Wernicke)

🔥 High-yield:

  • MCA → face & arm > leg weakness + aphasia
  • ACA → leg > arm weakness
  • PCA → visual disturbances

5. 🤰 Eclampsia Management

Q: Best drug to prevent seizures in eclampsia?

Answer: Magnesium sulfate

✔ Explanation:

  • CNS depressant stabilizes neurons

🔥 High-yield (SIPS):

  • Loading: 4g IV + 10g IM
  • Maintenance: 5g IM 4-hourly
  • Antidote: Calcium gluconate

6. 🧬 Iron Deficiency Anemia

Q: Most common cause of microcytic hypochromic anemia worldwide?

Answer: Iron deficiency anemia

✔ Explanation:

  • Due to poor intake, blood loss, malabsorption

🔥 High-yield:

  • Low ferritin = earliest marker
  • High TIBC
  • Treatment: oral ferrous sulfate

7. 🦠 HIV Diagnosis

Q: Screening test for HIV?

Answer: ELISA (or rapid antibody test)

✔ Explanation:

  • Detects antibodies to HIV

🔥 High-yield:

  • ELISA → screening
  • Western blot → confirmation (less used now)
  • PCR → early infant diagnosis

8. 👶 Neonatal Jaundice

Q: Physiological jaundice appears after how many hours?

Answer: After 24 hours of birth

✔ Explanation:

  • Due to immature liver enzymes (UGT deficiency)

🔥 High-yield:

  • Physiological:
    • Appears after 24h
    • Peaks day 3–5
  • Pathological: within 24h (always abnormal)

9. 🧪 Diabetes Mellitus Diagnosis

Q: Diagnostic fasting blood glucose for diabetes?

Answer: ≥126 mg/dL (7.0 mmol/L)

✔ Explanation:

  • Confirms impaired glucose metabolism

🔥 High-yield:

  • FBS ≥126 mg/dL
  • RBS ≥200 mg/dL + symptoms
  • HbA1c ≥6.5%

10. ⚕️ Most common site of peptic ulcer

Q: Most common site of duodenal ulcer?

Answer: First part of duodenum (bulb)

✔ Explanation:

  • Acid exposure highest here

🔥 High-yield:

  • Duodenal ulcer → pain relieved by food
  • Gastric ulcer → pain worsens with food

📌 Ultra High-Yield Revision Summary (Exam Favorites)

🚨 Must-remember lists:

  • MI leads & arteries
  • TB diagnosis hierarchy (GeneXpert > culture > smear)
  • Anaphylaxis = adrenaline
  • Eclampsia = magnesium sulfate
  • HIV = ELISA screening
  • Diabetes cutoff values
  • Neonatal jaundice timing rules

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