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103+ Free Albania State Medical Exam (Provimi i Shtetit - Mjekësi) Practice Questions

Prepare for the Provimi i Shtetit për Profesionin e Rregulluar të Mjekut (Albanian Physician State Licensing Examination) exam with instant access — no signup required.

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Key Facts: Albania State Medical Exam (Provimi i Shtetit - Mjekësi) Exam

Law No. 10171

Governing Law

Kuvendi i Shqipërisë - Law on Regulated Professions

QSHA & UMSH

Administering Body

Qendra e Shërbimeve Arsimore (Educational Services Center)

Not published (60 min)

Official Exam Length

QSHA Rregullore, Urdher nr. 365, date 28.12.2020

50% of points (grade 5)

Pass Threshold

QSHA - Informacion Lidhur me Provimin e Shtetit ne Profesionet e Rregulluara

10,000 ALL

First-Attempt Fee

Ministry of Education and Sports Tariffs

QSHA Center, Tirana

Testing Location

QSHA Official Testing Center Facility

UMSH Registration

Licensing Authority

Urdhri i Mjekëve të Shqipërisë (UMSH)

Mandatory national licensing exam for Albanian medical graduates, delivered by computer at QSHA in Tirana in one 60-minute round and passed with at least 50% of the paper's points, after which the graduate registers with UMSH. This English-language prep bank offers 103 clinical practice questions across the areas of the official orientation programme; it is a study adaptation, not an official translation or a format simulation.

Sample Albania State Medical Exam (Provimi i Shtetit - Mjekësi) Practice Questions

Try these sample questions to test your Albania State Medical Exam (Provimi i Shtetit - Mjekësi) exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 103+ question experience with AI tutoring.

1A 58-year-old male with a history of hypertension and hyperlipidemia presents to the emergency department with 90 minutes of severe, crushing substernal chest pain radiating to his left jaw and diaphoresis. An immediate 12-lead ECG demonstrates 3 mm ST-segment elevation in leads V1 through V4. The nearest percutaneous coronary intervention (PCI)-capable hospital is 25 minutes away. What is the most appropriate initial reperfusion strategy for this patient?
A.Administer intravenous unfractionated heparin and monitor cardiac troponins every 3 hours
B.Transfer immediately for primary percutaneous coronary intervention within a door-to-balloon time under 90 minutes
C.Administer immediate intravenous fibrinolytic therapy followed by transfer within 24 hours
D.Perform urgent computed tomography coronary angiography prior to initiating antiplatelet therapy
Explanation: This patient presents with an acute anterior ST-elevation myocardial infarction (STEMI). Primary percutaneous coronary intervention (PCI) is the gold standard reperfusion therapy when it can be performed within 120 minutes of STEMI diagnosis (door-to-balloon time < 90 minutes at a PCI-capable facility). Because the PCI facility is only 25 minutes away, immediate transfer for primary PCI is indicated.
2A 64-year-old female with ischemic cardiomyopathy presents for routine follow-up. Transthoracic echocardiography reveals a left ventricular ejection fraction (LVEF) of 32%. Her current medications are lisinopril 20 mg daily, carvedilol 25 mg twice daily, and furosemide 40 mg daily. She remains in NYHA Class II functional status. Which medication addition represents the fourth pillar of guideline-directed medical therapy (GDMT) to reduce cardiovascular mortality in heart failure with reduced ejection fraction?
A.Digoxin 0.125 mg daily
B.Amlodipine 5 mg daily
C.Empagliflozin 10 mg daily (or Dapagliflozin 10 mg daily)
D.Isosorbide mononitrate 30 mg daily
Explanation: Modern guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF) consists of four foundational drug classes: ARNI/ACEi/ARB, evidence-based beta-blockers, mineralocorticoid receptor antagonists (MRAs), and sodium-glucose cotransporter-2 (SGLT2) inhibitors such as empagliflozin or dapagliflozin. SGLT2 inhibitors significantly reduce cardiovascular death and heart failure hospitalizations regardless of diabetes status.
3A 72-year-old male with hypertension, type 2 diabetes mellitus, and a prior ischemic stroke is diagnosed with non-valvular atrial fibrillation. Physical examination reveals an irregularly irregular pulse at 88 beats/min. What is the most appropriate long-term management strategy to prevent thromboembolic stroke in this patient?
A.Initiate a Direct Oral Anticoagulant (DOAC) such as Apixaban or Rivaroxaban
B.Prescribe dual antiplatelet therapy with Aspirin and Clopidogrel
C.Prescribe Aspirin 100 mg daily as monotherapy
D.Recommend rhythm control with amiodarone without systemic anticoagulation
Explanation: This patient has a CHA2DS2-VASc score of 5 (Age 65-74 = 1, Hypertension = 1, Diabetes = 1, Prior Stroke = 2), indicating a very high risk of thromboembolic stroke (> 6% annual risk). According to international cardiology guidelines, non-vitamin K antagonist oral anticoagulants (DOACs like apixaban, rivaroxaban, dabigatran, or edoxaban) are first-line for stroke prevention in non-valvular atrial fibrillation, superior to antiplatelet therapy in both efficacy and safety.
4A 45-year-old male with a history of intravenous drug use presents with high fever, night sweats, dyspnea, and painful erythematous nodules on the pads of his fingers (Osler nodes). A new holosystolic murmur is auscultated at the lower left sternal border that increases with inspiration. Which diagnostic finding fulfills a Major Duke Criterion for the diagnosis of infective endocarditis?
A.Erythrocyte sedimentation rate (ESR) greater than 100 mm/h
B.Presence of Osler nodes and subungual splinter hemorrhages
C.Fever with core body temperature greater than 38.0°C
D.Transthoracic echocardiogram demonstrating an oscillating tricuspid intracardiac mass
Explanation: According to the modified Duke criteria for infective endocarditis, Major Criteria include: (1) positive blood cultures with typical microorganisms from at least 2 separate blood cultures, and (2) evidence of endocardial involvement on echocardiography (oscillating intracardiac mass/vegetation, abscess, new partial dehiscence of prosthetic valve, or new valvular regurgitation). An oscillating tricuspid mass on echocardiogram fulfills a Major Duke Criterion.
5A 68-year-old male presents to the clinic with fever, productive cough with rust-colored sputum, and pleuritic right-sided chest pain. Vital signs show BP 125/80 mmHg, HR 92 bpm, RR 22 breaths/min, and oxygen saturation 96% on room air. He is fully alert and oriented (Glasgow Coma Scale 15). Blood urea nitrogen (BUN) is 14 mg/dL (5.0 mmol/L). Chest X-ray reveals right lower lobe consolidation. Based on the CURB-65 score, what is the most appropriate management setting for this patient?
A.Immediate admission to the Intensive Care Unit (ICU)
B.Outpatient treatment with oral antibiotic therapy and close follow-up
C.Inpatient admission to the general medical ward for intravenous antibiotics
D.Emergency bronchoscopy with bronchoalveolar lavage
Explanation: The CURB-65 score evaluates: Confusion (0), Urea > 7 mmol/L / BUN > 19 mg/dL (0), Respiratory rate >= 30/min (0), Blood pressure < 90/60 mmHg (0), and Age >= 65 years (1). This patient's score is 1 (due to age >= 65 only), corresponding to low mortality risk (< 1.5%), which is safely and effectively managed in the outpatient setting with oral antibiotics (e.g., amoxicillin or a macrolide/doxycycline).
6A 66-year-old male with severe chronic obstructive pulmonary disease (COPD) presents to the emergency department with increased dyspnea, increased sputum volume, and sputum purulence (Anthonisen Type 1 exacerbation). Arterial blood gas on room air shows: pH 7.31, PaCO2 56 mmHg, PaO2 54 mmHg, and HCO3- 28 mEq/L. What is the most appropriate initial oxygenation and ventilatory management?
A.Controlled oxygen delivery targeting SpO2 88-92% and non-invasive positive pressure ventilation (NIV)
B.100% high-flow oxygen via non-rebreather mask targeting SpO2 99-100%
C.Immediate endotracheal intubation and invasive mechanical ventilation
D.Sedation with intravenous midazolam to reduce the work of breathing
Explanation: In acute hypercapnic COPD exacerbations, oxygen must be titrated carefully to a target oxygen saturation of 88-92% to avoid worsening hypercapnia via ventilation-perfusion mismatch and blunted hypoxic respiratory drive. Non-invasive positive pressure ventilation (NIV/BiPAP) is the first-line ventilatory support for acute respiratory acidosis (pH < 7.35, PaCO2 > 45 mmHg), significantly reducing intubation rates, hospital stay, and mortality.
7A 24-year-old female with moderate persistent asthma reports using her short-acting beta-2 agonist (SABA) inhaler 4 to 5 times per week and waking up with wheezing twice a month. She is currently taking low-dose inhaled budesonide daily. According to GINA guidelines, what is the most appropriate next step in her pharmacotherapy?
A.Discontinue inhaled budesonide and switch to oral theophylline monotherapy
B.Add a daily oral corticosteroid (prednisone 20 mg daily)
C.Step up to a combination of low-dose Inhaled Corticosteroid (ICS) and Long-Acting Beta-2 Agonist (LABA)
D.Prescribe subcutaneous omalizumab therapy immediately
Explanation: Under international asthma guidelines (GINA), when asthma remains uncontrolled on low-dose ICS monotherapy (frequent SABA use and nocturnal awakenings), the recommended step-up therapy is adding a Long-Acting Beta-2 Agonist (LABA) to the low-dose ICS (e.g., Budesonide-Formoterol or Fluticasone-Salmeterol). Formoterol-containing combinations can also serve as Maintenance and Reliever Therapy (MART).
8A 48-year-old woman who underwent total knee arthroplasty 10 days ago presents with sudden-onset pleuritic chest pain, dyspnea, and tachycardia (HR 115 bpm). Her blood pressure is 120/75 mmHg and RR is 24/min. Her modified Wells score for pulmonary embolism is calculated as 6.0 (high probability). What is the definitive diagnostic imaging modality of choice?
A.Quantitative D-dimer enzyme-linked immunosorbent assay (ELISA)
B.Standard posterior-anterior and lateral chest radiography
C.Transthoracic echocardiography to assess tricuspid regurgitation
D.Computed Tomography Pulmonary Angiography (CTPA)
Explanation: In hemodynamically stable patients with high clinical probability (Wells score > 4) of acute pulmonary embolism, Computed Tomography Pulmonary Angiography (CTPA) is the primary diagnostic imaging standard. It directly visualizes filling defects within the pulmonary arterial tree with high sensitivity and specificity.
9A 42-year-old male is diagnosed with a duodenal ulcer, and a gastric mucosal biopsy is positive for Helicobacter pylori on rapid urease testing. He has no known drug allergies. What is the recommended first-line quadruple eradication therapy in regions with high clarithromycin resistance?
A.Proton Pump Inhibitor (PPI) + Amoxicillin for 7 days
B.Proton Pump Inhibitor (PPI) + Bismuth subsalicylate + Metronidazole + Tetracycline for 14 days
C.Amoxicillin + Clarithromycin + Ciprofloxacin for 5 days
D.Proton Pump Inhibitor (PPI) monotherapy for 8 weeks
Explanation: Bismuth-based quadruple therapy (PPI, Bismuth subsalicylate, Metronidazole, and Tetracycline administered for 14 days) is the recommended first-line eradication regimen for Helicobacter pylori, especially in regions with high (> 15%) clarithromycin resistance. It achieves high eradication rates and overcomes macrolide resistance.
10A 40-year-old female presents with severe epigastric pain radiating to her back, nausea, and persistent vomiting following a heavy meal. Serum lipase is 1,450 U/L (reference < 60 U/L). Abdominal ultrasound demonstrates cholelithiasis without common bile duct dilation. What is the cornerstone of initial medical management during the first 24 hours of acute pancreatitis?
A.Goal-directed intravenous fluid resuscitation with isotonic crystalloids (e.g., Ringer's lactate)
B.Immediate prophylactic broad-spectrum intravenous antibiotic administration (imipenem)
C.Total parenteral nutrition (TPN) via central venous catheter
D.Emergency exploratory laparotomy with pancreatic necrosectomy
Explanation: Early, goal-directed fluid resuscitation with isotonic crystalloid solutions (specifically Ringer's lactate, 200-500 mL/h or 20 mL/kg bolus followed by 3 mL/kg/h) during the first 12 to 24 hours is the cornerstone of acute pancreatitis management. Adequate hydration maintains microvascular pancreatic perfusion and prevents ischemic pancreatic necrosis.

About the Albania State Medical Exam (Provimi i Shtetit - Mjekësi) Exam

The Albanian State Exam for the Regulated Profession of Physician (Provimi i Shtetit për Profesionin e Rregulluar të Mjekut) is the mandatory national licensing examination required for medical graduates to obtain full clinical practice licensure in the Republic of Albania. Regulated under Law No. 10171 ('Për profesionet e rregulluara në Republikën e Shqipërisë') and Law No. 123/2014 ('Për Urdhrin e Mjekëve në Republikën e Shqipërisë'), the exam is organized by the Educational Services Center (QSHA) in Tirana. QSHA's orientation programme for the physician profession (Programi i Provimit të Formimit për degën Mjekësi e Përgjithshme) lists eight areas without percentage weights: internal diseases (allergology, cardiology, gastro-hepatology, endocrinology, nephrology, pneumology, haematology, neurology, psychiatry, infectious and occupational diseases), surgery (general, urology, cardiac surgery and angiology, orthopaedics and traumatology, paediatric surgery, anaesthesia and intensive care), oncology, obstetrics and gynaecology, paediatrics, forensic medicine, pharmacology and clinical toxicology, and health organisation and management. Note: the official exam is administered in Albanian (Shqip); this practice bank is an English-language multiple-choice study adaptation, not an official translation of the exam and not a simulation of its format.

Assessment

One 60-minute computerised round at the QSHA examination centre in Tirana (Bulevardi Zhan D'Ark, Nr. 23). The system selects the items automatically and they are identical for every candidate in that session; marking is automatic and the result appears on screen at the end. Candidates report 30 minutes early with photo ID, mobile phones are prohibited, and a written appeal may be sent to QSHA within 10 days of the result.

Time Limit

60 minutes

Passing Score

At least 50% of the paper's total points (at least 50 of 100 points). Grades run from 4 (under 50 points) to 10 (95-100 points); grade 5 (50-54 points) is the minimum pass.

Exam Fee

10,000 ALL for the 1st attempt, 12,500 ALL (2nd), 15,000 ALL (3rd), 17,500 ALL (4th), 20,000 ALL (5th) and 25,000 ALL for the 6th or later attempt, per the QSHA payment invoices. The fee is prepaid and non-refundable. (Qendra e Shërbimeve Arsimore (QSHA) & Urdhri i Mjekëve të Shqipërisë (UMSH))

Albania State Medical Exam (Provimi i Shtetit - Mjekësi) Exam Content Outline

Not published

Internal Medicine & Subspecialties

Cardiovascular diseases (CAD, heart failure, arrhythmias, hypertension), respiratory pathology (pneumonia, COPD, asthma, PE), gastroenterology & hepatology (PUD, pancreatitis, cirrhosis, IBD), nephrology (AKI, CKD, glomerulonephritis), endocrinology (diabetes, thyroid disorders, DKA), and infectious diseases.

Not published

General Surgery & Surgical Specialties

Acute abdominal conditions (appendicitis, cholecystitis, bowel obstruction, perforation), ATLS trauma evaluation, abdominal wall hernias, colorectal pathology, urology (renal colic, acute retention, testicular torsion), and vascular emergencies.

Not published

Pediatrics & Neonatology

Neonatal adaptation and resuscitation, neonatal hyperbilirubinemia, respiratory distress syndrome, developmental milestones, pediatric respiratory infections, acute gastroenteritis, childhood exanthems, and pediatric emergency management.

Not published

Obstetrics & Gynecology

Routine antenatal care, hypertensive disorders of pregnancy, gestational diabetes, labor stages, postpartum hemorrhage, obstetric emergencies, gynecologic oncology screening, and reproductive endocrine disorders.

Not published

Psychiatry & Neurology

Acute cerebrovascular accidents (ischemic stroke, SAH), epilepsy and status epilepticus, neurodegenerative disorders, primary headache syndromes, mood disorders, psychotic disorders, and psychopharmacology.

Not published

Public Health, Family Medicine & Medical Deontology

Albanian healthcare legislation (Law No. 10171, Law No. 123/2014), UMSH Code of Medical Ethics, patient autonomy and informed consent, confidentiality, levels of prevention, epidemiology study designs, and diagnostic test metrics.

Not published

Oncology

Listed as its own area (C. Onkologjia) in the QSHA orientation programme: recognition of common solid tumours, principles of staging and treatment intent, and oncological emergencies such as febrile neutropenia.

Not published

Forensic Medicine

Listed as its own area (F. Mjekësia Ligjore) in the QSHA orientation programme: early postmortem changes and estimation of the postmortem interval, examination and documentation of injuries, and the physician's medicolegal duties.

Not published

Pharmacology & Clinical Toxicology

Listed as its own area (G. Farmakologji - Toksikologji Klinike) in the QSHA orientation programme: drug classes and adverse effects, recognition of common poisoning syndromes, and specific antidotes.

How to Pass the Albania State Medical Exam (Provimi i Shtetit - Mjekësi) Exam

What You Need to Know

  • Passing score: At least 50% of the paper's total points (at least 50 of 100 points). Grades run from 4 (under 50 points) to 10 (95-100 points); grade 5 (50-54 points) is the minimum pass.
  • Assessment: One 60-minute computerised round at the QSHA examination centre in Tirana (Bulevardi Zhan D'Ark, Nr. 23). The system selects the items automatically and they are identical for every candidate in that session; marking is automatic and the result appears on screen at the end. Candidates report 30 minutes early with photo ID, mobile phones are prohibited, and a written appeal may be sent to QSHA within 10 days of the result.
  • Time limit: 60 minutes
  • Exam fee: 10,000 ALL for the 1st attempt, 12,500 ALL (2nd), 15,000 ALL (3rd), 17,500 ALL (4th), 20,000 ALL (5th) and 25,000 ALL for the 6th or later attempt, per the QSHA payment invoices. The fee is prepaid and non-refundable.

Keys to Passing

  • Work through all 103 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

Albania State Medical Exam (Provimi i Shtetit - Mjekësi) Study Tips from Top Performers

1Focus on high-yield clinical presentations and first-line pharmacotherapy across internal medicine (especially cardiovascular, pulmonary, and endocrine protocols).
2Master emergency surgical and trauma algorithms (ATLS primary survey, signs of acute abdomen, and urgent surgical indications).
3Thoroughly review pediatric milestones, common childhood infectious rashes, neonatal jaundice thresholds, and dehydration management.
4Understand obstetric red flags including preeclampsia management with magnesium sulfate, antepartum bleeding differentials, and postpartum hemorrhage protocols.
5Familiarize yourself with Albanian health legislation, specifically Law No. 10171 on regulated professions, UMSH deontological rules, and patient confidentiality.
6Practice working with multiple-choice questions under timed 60-minute conditions to develop rapid elimination strategies for distractor options.

Frequently Asked Questions

What is the Albanian Physician State Exam (Provimi i Shtetit për Mjekun)?

It is the mandatory national licensing examination established under Law No. 10171 for all medical university graduates seeking to obtain their permanent clinical license (Licenca për Ushtrimin e Profesionit) and register with the Order of Physicians of Albania (Urdhri i Mjekëve të Shqipërisë - UMSH).

Who administers the examination and where does it take place?

The examination is administered by the Educational Services Center (Qendra e Shërbimeve Arsimore - QSHA) in coordination with UMSH and the Ministry of Health. It is conducted electronically at the computerized testing facilities of QSHA in Tirana.

What is the format and duration of the official exam?

The exam is delivered on a secure computer terminal at QSHA in Tirana and lasts 60 minutes. QSHA does not publish a fixed item count: the regulation approved by Order No. 365, dated 28.12.2020 requires the official question fund to hold at least 1,500 alternative-response items per profession or profile, requires every item to offer at least four alternatives with only one correct answer, and leaves the structure of each paper to the State Exam Commission. The system selects the items automatically, they are identical for every candidate in that session, they carry different point values, and marking is automatic with the result shown on screen.

What is the passing score and when are results released?

The exam is passed with at least 50% of the total points of the paper, that is at least 50 of 100 points. The published grading scale runs from 4 (under 50 points) through 5 (50-54), 6 (55-64), 7 (65-74), 8 (75-84), 9 (85-94) to 10 (95-100), so grade 5 is the minimum pass. The result appears on screen immediately and a written appeal may be sent to QSHA within 10 days of the result.

What are the eligibility requirements to sit for the exam?

Candidates must hold an integrated Master of Science diploma in General Medicine (6-year program / 360 ECTS) from an accredited university (or an equivalent nostrified foreign degree) and have successfully completed the mandatory post-graduate practical internship (praktika profesionale) certified by UMSH.

What is the examination fee schedule for the Albanian State Exam?

The initial examination fee is 10,000 ALL (Albanian Lek). For retakes, the fee escalates progressively: 12,500 ALL for the 2nd attempt, 15,000 ALL for the 3rd attempt, 17,500 ALL for the 4th attempt, and 20,000 ALL for the 5th attempt and beyond.

In what language is the official QSHA exam administered?

The official QSHA exam is administered exclusively in the Albanian language (Shqip). This OpenExamPrep question bank provides an English-language clinical adaptation designed to help candidates thoroughly master underlying medical concepts, diagnostic algorithms, and pharmacology.

What happens after passing the State Exam?

Upon passing, candidates receive an official State Exam Certificate from QSHA, which they submit to Urdhri i Mjekëve të Shqipërisë (UMSH) along with registration documents to obtain their definitive medical license (Licenca për Ushtrimin Individual të Profesionit).

Can I retake the examination if I do not achieve the passing score?

Yes. Candidates who fail may register for the next scheduled testing season announced by QSHA and UMSH upon paying the corresponding retake fee. There is no legal limit on the number of attempts permitted.