NLE 28 March 2022 by Medicall

NLE Step 1 Solved Past Paper – 28 March 2022

The National Registration Examination (NRE), formerly called NLE (National Licensing Examination), is the essential medical licensing exam in Pakistan under the Pakistan Medical and Dental Council (PMDC). This assessment ensures that medical graduates possess the necessary clinical knowledge and reasoning skills to practice medicine safely and effectively.

The NRE Step 1 exam from 28 March 2022 is a recall-based exam compiled from multiple students' experiences collected by Medicall App. Below, we provide a detailed breakdown of all topics covered, including solved MCQs, explanations, and high-yield discussions to enhance preparation for future candidates.

Why Are Past Papers Important for NRE?

📍 Understand the Exam Pattern: Repeated exposure to past questions helps identify common themes and subject focus areas.

📍 Improve Time Management: Practicing under real exam conditions helps in finishing the paper within the allocated time.

📍 Recognize High-Yield Topics: Certain subjects and diseases are consistently tested, allowing candidates to focus on key areas.

📍 Boost Exam Confidence: Familiarity with question styles helps reduce anxiety on exam day.

Subject-Wise Breakdown of Step 1 (28 March 2022) Exam

Only few are mentioned below:

📌 1. Internal Medicine & Infectious Diseases

Cerebellar Lesion Presentation: Wide-based gait, abnormal posture, dysdiadochokinesia, and past-pointing → Cerebellar lesion.
Acute Management of SVT: First-line treatment → IV adenosine to slow AV nodal conduction.
Hereditary Spherocytosis & Cholelithiasis: Hemolysis leading to pigment gallstones.
Lower Motor Neuron Lesions: Characterized by flaccid paralysis, muscle atrophy, fasciculations.

📌 2. Pharmacology & Drug Mechanisms

Most Common Drug for Anaphylactic Shock: IV Epinephrine.
Spironolactone Side Effect: Gynecomastia due to estrogenic effects.
Diabetes Medication with Best CV Outcomes: GLP-1 receptor agonists (e.g., Liraglutide).
Anticoagulant for DVT Prevention: Low molecular weight heparin (LMWH).

📌 3. Surgery & Trauma

Hoarseness Post-Thyroidectomy: Recurrent Laryngeal Nerve Injury.
Most Common Cause of Postoperative SOB: Pulmonary Embolism due to prolonged immobilization.
Best Fluid for Trauma Resuscitation: Ringer’s lactate over normal saline.

📌 4. Pediatrics & Neonatology

Neonatal Cyanosis Within 24 Hours: Transposition of Great Arteries (TGA).
Failure to Thrive with Hepatosplenomegaly: Suggests Thalassemia Major, confirmed via Hb electrophoresis.
Common Cause of Nephrotic Syndrome in Children: Minimal Change Disease.

📌 5. Obstetrics & Gynecology

Most Common Cause of Amenorrhea in 16-Year-Old with Cyclic Abdominal Pain: Imperforate Hymen.
Painless Vaginal Bleeding at 36 Weeks Pregnancy: Placenta Previa.
First-Line Treatment for Preeclampsia: IV Magnesium Sulfate & Antihypertensives.

📌 6. Cardiology & Hematology

STEMI Without PCI Facility: Thrombolytic therapy (Alteplase).
Heart Sound in CHF with Volume Overload: S3 Gallop.
Leukemia in Children with Gum Bleeding, Auer Rods, & Anemia: Acute Myeloid Leukemia (AML).

📌 7. Neurology & Psychiatry

Parkinson’s Disease Clinical Feature: Pill-rolling tremor, bradykinesia, rigidity.
Stroke Management Within 3 Hours: IV tPA (Tissue Plasminogen Activator).
Post-Viral Neuropathy with Progressive Weakness: Guillain-Barré Syndrome (GBS).

Clinical Case Scenarios from 28 March 2022 Paper (few)

📌 Case 1: A 55-Year-Old Male with Chest Pain A male presents with severe chest pain radiating to his left arm. ECG reveals ST-elevation in leads II, III, and aVF. Emergency thrombolysis or PCI is required.

📌 Case 2: A Neonate with Cyanosis & No Cardiac Murmur A newborn exhibits severe cyanosis within hours after birth. Echocardiography confirms Transposition of the Great Arteries (TGA). Prostaglandin infusion is initiated.

📌 Case 3: A 40-Year-Old Female with Hoarseness Post-Surgery A patient develops hoarseness after thyroidectomy. Laryngoscopy reveals unilateral vocal cord paralysis, suggesting Recurrent Laryngeal Nerve Injury.

Most Frequently Repeated MCQs – 28 March 2022

✅ Best Diagnostic Test for Diabetic Nephropathy? Microalbuminuria Test.

✅ Most Common Cause of Bloody Nipple Discharge? Intraductal Papilloma.

✅ Drug of Choice for Eclampsia? IV Magnesium Sulfate.

✅ Commonest Site for Bone Marrow Aspiration? Iliac Crest.

✅ Causative Organism for Septic Arthritis? Staphylococcus aureus.

Exam Preparation Strategy Using Past Papers

🔹 Step 1: Solve past papers under exam conditions.

🔹 Step 2: Review incorrect answers and reinforce weak areas.

🔹 Step 3: Cross-reference Davidson’s Medicine, Bailey & Love, First Aid USMLE and so on.

🔹 Step 4: Make flashcards for rapid revision.

🔹 Step 5: Join study groups & online discussions.

Why Choose MedsCrack for Past Papers?

✔️ Genuine Recalled Questions – Updated and reviewed

✔️ Exam-Oriented Explanations – High-yield content with clinical relevance.

✔️ Free & Easily Accessible – Open and study anytime.

🚀 Ready to Ace the NRE? Let’s Get Started! 🚀

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اے ہمارے رب! ہم پر وه بوجھ نہ ڈال جس کی ہمیں طاقت نہ ہو اور ہم سے درگزر فرما! اور ہمیں بخش دے اور ہم پر رحم کر
Our Lord! Do not burden us with what we cannot bear. Pardon us, forgive us, and have mercy on us 02:286

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