NLE 27 March 2022 by Medicall

NLE Step 1 Solved Past Paper – 27 March 2022

The National Registration Examination (NRE), previously known as NLE (National Licensing Examination), is a mandatory licensing exam for medical graduates in Pakistan, conducted by the Pakistan Medical and Dental Council (PMDC). This exam ensures that candidates possess the necessary medical knowledge and clinical skills required to practice medicine safely in Pakistan.

The NRE Step 1 exam on 27 March 2022 (Morning Shift) included recalled MCQs from students , collected by Medicall App, covering clinical scenarios, pathology, pharmacology, internal medicine, pediatrics, and surgery. Below is a detailed breakdown of the key topics, solved MCQs, and explanations from the exam.

Why Are Past Papers Important?

Studying past papers helps candidates:

✅ Identify frequently repeated questions and high-yield topics.

✅ Understand the structure and pattern of the exam.

✅ Improve time management skills by practicing under real exam conditions.

✅ Enhance clinical decision-making skills.

✅ Gain confidence by solving real exam questions.

Exam Breakdown 27 March 2022

The exam consisted of multiple-choice questions covering the all major and minor disciplines , here are few examples:

📌 1. Internal Medicine & Infectious Diseases

Management of SVT: First-line treatment is IV adenosine, which slows AV nodal conduction.
Polycystic Kidney Disease & Sudden Death: Most likely due to ruptured berry aneurysm.
Pericarditis with Effusion – Nerve Involvement: Phrenic nerve mediates referred pain.
Most Sensitive Test for SLE: ANA (Antinuclear Antibody) has 99% sensitivity.

📌 2. Pharmacology & Drug Mechanisms

Spironolactone Side Effect: Gynecomastia due to increased peripheral estrogen conversion.
Treatment for Status Asthmaticus: IV steroids (e.g., Hydrocortisone) for inflammation reduction.
Anticoagulation for DVT Prevention: Low Molecular Weight Heparin (LMWH) is preferred.
Hypertension in Pregnancy: Methyldopa is the safest choice.

📌 3. Surgery & Trauma Cases

Best Fluid for Hypovolemia Post-Trauma: Ringer’s Lactate.
Postoperative SOB & Hypoxia: Pulmonary Embolism due to immobilization.
Thyroidectomy & Hoarseness of Voice: Recurrent Laryngeal Nerve Injury.

📌 4. Pediatrics & Neonatology

Neonatal Cyanosis Within 24 Hours: Transposition of Great Arteries (TGA).
Failure to Thrive & Hepatosplenomegaly: Thalassemia Major.
Common Cause of Nephrotic Syndrome in Children: Minimal Change Disease.

📌 5. Obstetrics & Gynecology

Indication for C-section: Placenta Previa.
PCOS Treatment: Metformin for insulin resistance.
Diagnosis of Thalassemia in Pregnancy: Hb Electrophoresis shows ↑ HbA2 & HbF.

📌 6. Cardiovascular & Hematology

STEMI in a Setting Without PCI Facility: Thrombolytic therapy (Alteplase).
Diagnosis of ALL in a Child: High WBC, low platelets, anemia, and neutropenia.
Heart Sound in Ventricular Gallop: S3 heart sound.

📌 7. Neurology & Psychiatry

Stroke Management Within 3 Hours: IV tPA.
Glasgow Coma Scale (GCS) Calculation: Score of 9 in confused, pain-responsive patients.
GBS After Viral Infection: Ascending paralysis, absent reflexes, and increased CSF protein.

Clinical Cases from 27 March 2022 Exam (Few)

📌 Case 1: A 55-Year-Old Male with Chest Pain A male patient presents with crushing chest pain radiating to the left arm. ECG shows ST elevation in leads II, III, and aVF. Immediate management includes oxygen, aspirin, and PCI or thrombolysis.

📌 Case 2: A Neonate with Cyanosis and Weak Pulses A newborn presents with severe cyanosis and poor peripheral pulses within 24 hours of birth. Echocardiography confirms Transposition of the Great Arteries (TGA). Prostaglandin infusion is started to maintain ductal patency.

📌 Case 3: A 45-Year-Old Male with Difficulty Swallowing A smoker complains of progressive dysphagia and weight loss. Barium swallow shows bird’s beak appearance, suggestive of achalasia cardia. Endoscopy with biopsy confirms the diagnosis.

Most Repeated MCQs – 27 March 2022

✅ Best Diagnostic Test for Diabetic Nephropathy? Microalbuminuria.

✅ Commonest Site for Bone Marrow Aspiration? Iliac Crest.

✅ Most Common Cause of Painless Hematuria in Elderly? Bladder Cancer.

✅ Diagnosis of Vitamin B12 Deficiency? Methylmalonic Acid Levels.

✅ Management of Epiglottitis in Children? Endotracheal Intubation.

How to Use Past Papers Effectively?

🔹 Step 1: Practice Under Exam Conditions

Set a timer and attempt full-length past papers.
Develop time management skills.

🔹 Step 2: Identify Weak Areas

Focus on subjects where you score below 60%.
Revise missed concepts from standard medical textbooks.

🔹 Step 3: Take Notes & Create Flashcards

Summarize high-yield topics.
Use mnemonics and recall techniques.

🔹 Step 4: Join Online Study Groups

Discuss difficult concepts with peers.
Solve practice MCQs daily.

Final Study Tips for NRE Exam Success

📍 Solve past papers thoroughly – Questions repeat often.

📍 Time yourself – Practice completing 200 MCQs before 3 hours.

📍 Focus on high-yield topics – Medicine, Surgery, OB/GYN, Pediatrics , ENT & Ophthalmology

📍 Use standard textbooks – Davidson’s, Bailey & Love, First Aid USMLE, Goljan Pathology etc

📍 Stay updated with PMDC guidelines – Ensure latest protocols are followed.

Why Choose MedsCrack for NRE Preparation?

✔️ Updated Past Papers – Recalled questions .

✔️ High-Yield Summaries – Concise notes for quick revision.

✔️ Completely Free Access – Helping students without financial burden.

🚀 Ready to Pass the NRE? Start Preparing with MedsCrack Today! 🚀

Hold On

اے ہمارے رب! ہمیں دنیا میں بھی بھلائی دے اور آخرت میں بھی بھلائی عطا فرما اور ہمیں آگ کے عذاب سے بچا۔
Our Lord!give us in this world [that which is] good and in the Hereafter [that which is] good and protect us from the punishment of the Fire. 02:201

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