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100+ Free Afghanistan Medical Exit Exam Practice Questions
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2026 Statistics
Key Facts: Afghanistan Medical Exit Exam Exam
160
Four-option multiple-choice questions
Afghanistan Medical Council examination reference
360
Total marks available on the paper
Afghanistan Medical Council examination reference
216
Marks required to pass (60%)
Afghanistan Medical Council examination reference
500 AFN
Exam registration fee
Afghanistan Medical Council registration notice
70 / 30
Clinical vs basic-science item split
Afghanistan Medical Council examination reference
The Afghanistan Medical Exit Exam — officially renamed the practice-licence examination (امتحان جواز فعالیت) — is the national medical licensing examination run by the Afghanistan Medical Council with NExA: 160 four-option MCQs marked out of 360, a 216-mark (60%) pass threshold and a 500 AFN registration fee. The official exam is administered in Dari and Pashto; this bank is an English-language MCQ study adaptation for topic and clinical-judgment preparation, not an official translation.
Sample Afghanistan Medical Exit Exam Practice Questions
Try these sample questions to test your Afghanistan Medical Exit Exam exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.
1A 58-year-old male presents to the emergency department with severe, crushing substernal chest pain radiating to the left arm and jaw that started 90 minutes ago. ECG reveals 3 mm ST-segment elevation in leads V1 through V4. His blood pressure is 135/85 mmHg and pulse is 88 bpm. What is the immediate, most appropriate reperfusion strategy?
A.Primary percutaneous coronary intervention (PCI) if achievable within 120 minutes, or immediate fibrinolytic therapy if PCI is unavailable
B.Immediate intravenous unfractionated heparin bolus followed by elective coronary angiography within 72 hours
C.Oral administration of high-dose beta-blockers and nitroglycerin infusion with repeat ECG in 6 hours
D.Transesophageal echocardiography to rule out aortic dissection prior to administering any antiplatelet therapy
Explanation: This patient has an acute anterior ST-elevation myocardial infarction (STEMI). The primary goal of management is immediate myocardial reperfusion. Guideline-directed care mandates primary percutaneous coronary intervention (PCI) within 120 minutes of first medical contact; if primary PCI cannot be performed within this timeframe, intravenous fibrinolysis should be administered within 30 minutes of arrival in the absence of contraindications.
2A 65-year-old female with a history of hypertension and chronic heart failure presents with worsening dyspnea on exertion, orthopnea, and bilateral lower extremity edema. On examination, jugular venous pressure is elevated and bilateral lung basilar crackles are heard. Echocardiography shows a left ventricular ejection fraction (LVEF) of 32%. Which combination of disease-modifying pharmacotherapies has been demonstrated to reduce mortality in heart failure with reduced ejection fraction (HFrEF)?
A.ARNI (or ACE inhibitor/ARB), beta-blocker (e.g., carvedilol), mineralocorticoid receptor antagonist (spironolactone), and SGLT2 inhibitor
B.Loop diuretic (furosemide), digoxin, and calcium channel blocker (amlodipine)
C.Hydralazine monotherapy, thiazide diuretic (hydrochlorothiazide), and oral potassium chloride supplements
D.Aspirin, clopidogrel, warfarin, and high-dose verapamil
Explanation: Guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF) consists of the 'four pillars' proven to reduce all-cause and cardiovascular mortality: an ARNI/ACEi/ARB, an evidence-based beta-blocker (carvedilol, metoprolol succinate, or bisoprolol), an MRA (spironolactone or eplerenone), and an SGLT2 inhibitor (dapagliflozin or empagliflozin).
3A 72-year-old male with long-standing poorly controlled hypertension presents with acute onset of severe, tearing interscapular back pain. On physical examination, blood pressure is 185/110 mmHg in the right arm and 140/85 mmHg in the left arm. A grade II/VI early diastolic murmur is heard along the right sternal border. What is the most definitive diagnostic imaging test of choice in a hemodynamically stable patient?
A.CT angiography (CTA) of the chest and abdomen
B.Transthoracic echocardiography (TTE)
C.Standard posterior-anterior and lateral chest radiography
D.Abdominal ultrasound examination
Explanation: The clinical presentation of acute tearing chest/back pain, pulse/blood pressure asymmetry between limbs, and a new aortic regurgitation murmur is highly characteristic of acute aortic dissection (Stanford Type A). In hemodynamically stable patients, computed tomography angiography (CTA) of the chest and abdomen is the gold-standard imaging modality due to its high sensitivity and specificity (>95%) and rapid availability.
4A 62-year-old female presents with palpitations and lightheadedness. An ECG demonstrates irregularly irregular narrow-complex tachycardia with no identifiable P waves and a ventricular rate of 145 bpm. Her blood pressure is 125/80 mmHg. She has a history of type 2 diabetes and hypertension. What is her CHA2DS2-VASc score, and what long-term stroke prevention is indicated?
A.CHA2DS2-VASc score of 3; oral anticoagulation with a direct oral anticoagulant (DOAC) or warfarin is indicated
B.CHA2DS2-VASc score of 1; aspirin 81 mg daily monotherapy is sufficient
C.CHA2DS2-VASc score of 2; dual antiplatelet therapy with aspirin and clopidogrel is recommended
D.CHA2DS2-VASc score of 0; no antithrombotic therapy is needed
Explanation: Scoring this patient: Congestive heart failure 0, Hypertension 1, Age >= 75 gives 2 and age 65-74 gives 1 (she is 62, so 0), Diabetes mellitus 1, prior Stroke/TIA 0, Vascular disease 0, and female Sex category 1 — a total CHA2DS2-VASc score of 3. Guidelines recommend oral anticoagulation with a DOAC (apixaban, rivaroxaban, edoxaban or dabigatran) or dose-adjusted warfarin for women scoring >= 3 (equivalent to >= 2 counting non-sex risk factors), because antiplatelet therapy does not provide comparable protection against cardioembolic stroke.
5A 48-year-old male with a history of IV drug use presents with high fever, chills, night sweats, and progressive fatigue for 3 weeks. On physical examination, temperature is 39.1°C, and a new 3/6 holosystolic murmur is heard at the lower left sternal border that increases in intensity with inspiration (Carvallo sign). Transthoracic echocardiography reveals a 12 mm mobile vegetation on the tricuspid valve. What is the most common causative organism?
A.Staphylococcus aureus
B.Streptococcus viridans
C.Enterococcus faecalis
D.Pseudomonas aeruginosa
Explanation: In patients with a history of intravenous drug use, the tricuspid valve is the most commonly affected cardiac valve in infective endocarditis (right-sided endocarditis). Staphylococcus aureus is the causative pathogen in over 60–70% of right-sided infective endocarditis cases in this population, often manifesting acutely with high fevers and septic pulmonary emboli.
6A 68-year-old male is brought to the clinic with fever, productive cough with rust-colored sputum, and right-sided pleuritic chest pain for 3 days. On physical examination, he is confused (disoriented to time and place), respiratory rate is 32 breaths/min, blood pressure is 88/56 mmHg, pulse is 112 bpm, and blood urea nitrogen is 28 mg/dL (10 mmol/L). Chest X-ray reveals right lower lobe consolidation. Based on the CURB-65 criteria, what is his score and appropriate level of care?
A.CURB-65 score of 5; requires urgent hospital admission with consideration for intensive care unit (ICU) management
B.CURB-65 score of 1; suitable for outpatient treatment with oral amoxicillin
C.CURB-65 score of 0; home management with symptomatic therapy only
D.CURB-65 score of 2; short-stay observation unit for 12 hours followed by discharge
Explanation: CURB-65 awards one point each for Confusion, Urea > 7 mmol/L (BUN > 19 mg/dL), Respiratory rate >= 30/min, Blood pressure < 90 mmHg systolic or <= 60 mmHg diastolic, and Age >= 65 years. This patient meets all five criteria — he is disoriented, his urea is 10 mmol/L, his respiratory rate is 32/min, his systolic pressure is 88 mmHg and he is 68 years old — giving the maximum score of 5. Scores of 3 to 5 carry high 30-day mortality and mandate inpatient admission with assessment for intensive care.
7A 34-year-old male from rural Afghanistan presents with a 2-month history of productive cough, hemoptysis, low-grade evening fever, drenching night sweats, and a 7 kg weight loss. A chest radiograph demonstrates bilateral upper lobe cavitary infiltrates. Sputum GeneXpert MTB/RIF confirms Mycobacterium tuberculosis without rifampicin resistance. According to the National Tuberculosis Control Program and WHO guidelines, what is the standard first-line treatment regimen for drug-susceptible pulmonary tuberculosis?
A.2 months of Isoniazid, Rifampicin, Pyrazinamide, and Ethambutol (2HRZE), followed by 4 months of Isoniazid and Rifampicin (4HR)
B.6 months of Isoniazid, Rifampicin, and Streptomycin daily
C.9 months of Rifampicin and Ethambutol monotherapy
D.2 months of Ciprofloxacin, Isoniazid, and Kanamycin, followed by 10 months of Ethambutol
Explanation: The WHO-standardized first-line treatment regimen for new cases of drug-susceptible pulmonary tuberculosis consists of an intensive phase of 4 drugs (Isoniazid [H], Rifampicin [R], Pyrazinamide [Z], and Ethambutol [E]) daily for 2 months (2HRZE), followed by a continuation phase of 2 drugs (Isoniazid and Rifampicin) daily for 4 months (4HR), total 6 months.
8A 60-year-old male with a 40 pack-year smoking history presents with worsening dyspnea and chronic productive cough. Spirometry demonstrates a post-bronchodilator FEV1/FVC ratio of 0.58 and an FEV1 of 45% of predicted value. He experiences frequent exacerbations despite regular use of a short-acting beta-agonist. According to GOLD guidelines, which maintenance inhaler therapy is most appropriate?
A.Long-acting muscarinic antagonist (LAMA) combined with a long-acting beta2-agonist (LABA)
B.Oral theophylline twice daily combined with systemic prednisone
C.Short-acting muscarinic antagonist (ipratropium) as sole monotherapy
D.Inhaled corticosteroid (ICS) monotherapy without bronchodilators
Explanation: A post-bronchodilator FEV1/FVC < 0.70 confirms chronic obstructive pulmonary disease (COPD). An FEV1 of 45% corresponds to GOLD Stage 3 (Severe). For patients with high symptom burden and frequent exacerbations, GOLD guidelines recommend dual long-acting bronchodilator therapy (LAMA + LABA) as initial maintenance therapy. Inhaled corticosteroids (ICS) are added to LAMA/LABA if blood eosinophils are >= 300 cells/uL or in persistent exacerbators.
9A 24-year-old female presents with acute shortness of breath and wheezing. She is using her accessory muscles of respiration, speech is limited to single words, respiratory rate is 36 breaths/min, heart rate is 130 bpm, and oxygen saturation on room air is 89%. Auscultation reveals widespread expiratory wheezing with quiet breath sounds at the bases. What is the immediate first-line emergency management?
A.High-flow supplemental oxygen, inhaled short-acting beta-agonist (salbutamol) combined with ipratropium via nebulizer, and systemic corticosteroids (IV hydrocortisone or oral prednisolone)
B.Immediate intravenous aminophylline bolus and subcutaneous epinephrine
C.Endotracheal intubation and mechanical ventilation prior to medical therapy
D.Inhaled fluticasone propionate high dose and oral montelukast
Explanation: This patient has a severe acute exacerbation of bronchial asthma. Immediate management consists of oxygen to maintain SpO2 93–95%, repeated or continuous nebulized SABA (salbutamol 5 mg) combined with SAMA (ipratropium bromide 0.5 mg), and early administration of systemic corticosteroids (oral prednisolone 40–50 mg or IV hydrocortisone 100–200 mg). IV magnesium sulfate is added in refractory severe cases.
10A 52-year-old male with chronic hepatitis B cirrhosis presents to the emergency department with hematemesis and melena. On arrival, blood pressure is 85/50 mmHg, pulse is 120 bpm, and he appears pale and confused. In addition to securing the airway and initiating IV crystalloid fluid resuscitation, what is the most appropriate initial pharmacological and procedural management?
A.IV octreotide/terlipressin, prophylactic IV ceftriaxone, and urgent upper gastrointestinal endoscopy within 12 hours for variceal band ligation
B.Oral omeprazole 20 mg daily and elective outpatient colonoscopy
C.Immediate placement of a Sengstaken-Blakemore balloon tube before any resuscitation or medical therapy
D.Intravenous tranexamic acid infusion and surgical total gastrectomy
Explanation: In acute variceal hemorrhage secondary to portal hypertension, resuscitation must be accompanied by vasoactive therapy (IV terlipressin, somatostatin, or octreotide) to reduce splanchnic blood flow, short-term prophylactic antibiotics (IV ceftriaxone 1 g/day for 5-7 days) to prevent bacterial infections and rebleeding, and urgent diagnostic and therapeutic endoscopy within 12 hours for endoscopic variceal band ligation (EVL).
About the Afghanistan Medical Exit Exam Exam
The Afghanistan Medical Exit Exam (امتحان دولتی طب معالجوی) is the statutory national licensing examination administered by NExA for the Afghanistan Medical Council. Passing is mandatory for all medical doctors (MD) to obtain a license to practice medicine.
Assessment
160 four-option multiple-choice questions marked out of 360, weighted 70% to clinical disciplines (112 items) and 30% to basic and paraclinical sciences (48 items), sat as a single centralized paper-based OMR examination.
Time Limit
Single centralized sitting; official session length not published
Passing Score
216 of 360 marks (60%)
Exam Fee
500 AFN (Afghanistan Medical Council (AMC) and National Examination Authority (NExA))
Afghanistan Medical Exit Exam Exam Content Outline
112 items (70%)
Clinical Disciplines
Internal medicine, general surgery, pediatrics, obstetrics and gynecology and other bedside specialties — the published clinical stratum of the paper.
48 items (30%)
Basic and Paraclinical Sciences
Anatomy, physiology, biochemistry, pathology, microbiology, pharmacology, public health and medical ethics — the published basic-science stratum.
How to Pass the Afghanistan Medical Exit Exam Exam
What You Need to Know
- Passing score: 216 of 360 marks (60%)
- Assessment: 160 four-option multiple-choice questions marked out of 360, weighted 70% to clinical disciplines (112 items) and 30% to basic and paraclinical sciences (48 items), sat as a single centralized paper-based OMR examination.
- Time limit: Single centralized sitting; official session length not published
- Exam fee: 500 AFN
Keys to Passing
- Work through all 100 available questions
- Review every answer and explanation
- Track weak areas and revisit them
- Use our AI tutor for tough concepts
Afghanistan Medical Exit Exam Study Tips from Top Performers
1Focus heavily on high-yield clinical presentations in internal medicine and emergency surgical management.
2Review national Afghan treatment guidelines and WHO protocols for tuberculosis, malaria, and maternal-child health.
3Practice multi-step clinical vignette questions combining diagnosis, laboratory evaluation, and first-line pharmacotherapy.
Frequently Asked Questions
What is the official structure of the Afghanistan Medical Exit Exam?
The official examination is a 160-item four-option multiple-choice paper marked out of 360, sat on OMR answer sheets in a single centralized session, with 70% clinical questions and 30% basic and paraclinical science questions.
Who is eligible to take the AMC Medical Exit Exam?
Graduates of accredited 7-year medical faculties (Curative Medicine / MD degree) who have completed their mandatory 1-year clinical internship (دوره ستاژ) with MoHE-attested credentials.
What is the passing score and retake policy?
The pass mark is 216 of 360 marks, which is 60%. Candidates who do not reach it may re-register and sit a subsequent round; the examination is normally held about twice a year.
In what language is the official examination conducted?
The official exam is administered in Afghanistan's national languages, Dari and Pashto. Our practice bank provides an English-language MCQ study adaptation to support conceptual learning and clinical decision-making.