100+ Free Test TOM — Ordre des Médecins Practice Questions

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Key Facts: Test TOM — Ordre des Médecins Exam

5 disciplines

The Test TOM assesses surgery, gynecology-obstetrics, internal medicine, neuropsychiatry and pediatrics at general-practitioner level

Provincial CNOM president, opening of the first session, Goma, 7 December 2021

17 faculties

Medical faculties accredited by the CNOM whose graduates are exempt from the Test TOM until further notice

CNOM communiqué of 16 August 2025

Dec 2021

The first Test TOM session ran from 7 to 11 December 2021 in Kinshasa, Lubumbashi and Goma

Radio Okapi, 5 December 2021

OL 68-070

Ordonnance-loi n° 68-070 du 1er mars 1968 created the Ordre des Médecins; its Article 7 bars practice without registration

Journal Officiel de la RDC

Not published

The CNOM publishes no syllabus, item count, exam duration, fee or pass mark for the Test TOM

Review of CNOM communiqués and Congolese press coverage, August 2026

Free 100-question English MCQ study bank for the DR Congo Test Préalable à l'Inscription au Tableau de l'Ordre des Médecins (Test TOM / Test CNOM). The official test is conducted in French before hospital juries in five clinical disciplines, and the CNOM publishes no syllabus, item count, fee or pass mark. This bank is an independent English-language study adaptation of that clinical scope, not an official paper or translation.

Sample Test TOM — Ordre des Médecins Practice Questions

Try these sample questions to test your Test TOM — Ordre des Médecins exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 28-year-old man presents to the emergency ward in Kinshasa with high fever (39.8°C), chills, severe headache, and vomiting. A rapid diagnostic test (RDT) and thick blood smear confirm Plasmodium falciparum infection with 8% parasitemia. He is conscious but prostrated and unable to retain oral medications. According to the DRC National Malaria Control Programme (PNLP) guidelines, what is the first-line treatment of choice?

A.Oral Artemether-Lumefantrine (AL) crushed in water with an antiemetic

B.Intravenous Artesunate at 2.4 mg/kg at 0, 12, and 24 hours, then once daily until oral therapy can be tolerated

C.Intravenous Quinine infusion at a loading dose of 20 mg/kg in 5% Dextrose over 4 hours, without monitoring blood glucose

D.Intramuscular Chloroquine at 10 mg/kg every 12 hours for 3 days

Explanation: Prostration is itself a WHO criterion for severe malaria, and a patient who cannot retain oral medication needs parenteral therapy whatever the parasite density. DRC PNLP and WHO guidance make intravenous artesunate the first-line antimalarial for severe falciparum malaria in adults, given at 2.4 mg/kg at 0, 12 and 24 hours and then once daily. Once the patient has improved and has tolerated oral medication for at least 24 hours, treatment is completed with a full 3-day course of an oral artemisinin-based combination therapy (ACT).

2A 34-year-old HIV-positive patient on antiretroviral therapy presents with a 3-week history of productive cough, evening fever, drenching night sweats, and a 5 kg weight loss. Sputum GeneXpert MTB/RIF reveals Mycobacterium tuberculosis detected with no rifampicin resistance. What is the standard first-line antituberculosis treatment regimen recommended by the DRC National Tuberculosis Programme (PNLT) for this newly diagnosed drug-susceptible pulmonary tuberculosis case?

A.2 months of Isoniazid, Rifampicin, Pyrazinamide, and Ethambutol (2RHZE) followed by 4 months of Isoniazid and Rifampicin (4RH)

B.2 months of Streptomycin, Isoniazid, Rifampicin, and Pyrazinamide (2SHRZ) followed by 6 months of Isoniazid and Ethambutol (6HE)

C.6 months of daily Levofloxacin, Bedaquiline, Linezolid, and Clofazimine

D.9 months of Isoniazid and Rifampicin monotherapy (9RH) with pyridoxine

Explanation: Under the DRC PNLT guidelines, newly diagnosed drug-susceptible pulmonary tuberculosis is treated with the standard 6-month regimen: an intensive phase of 2 months with four fixed-dose combination drugs (Rifampicin, Isoniazid, Pyrazinamide, Ethambutol: 2RHZE) followed by a continuation phase of 4 months with two drugs (Rifampicin and Isoniazid: 4RH). Pyridoxine (vitamin B6) is co-administered to prevent isoniazid-induced peripheral neuropathy.

3A 42-year-old male with newly diagnosed advanced HIV infection (CD4 count 45 cells/uL) presents with subacute headache, fever, neck stiffness, and photophobia. Lumbar puncture reveals clear cerebrospinal fluid (CSF) with elevated opening pressure (280 mm H2O), lymphocytic pleocytosis, low glucose, and India ink preparation showing encapsulated budding yeasts. Cryptococcal antigen (CrAg) lateral flow assay is positive. What is the optimal induction management and timing of Antiretroviral Therapy (ART) initiation?

A.Immediate initiation of TDF + 3TC + DTG on day 1 alongside oral fluconazole 200 mg daily

B.Induction with IV Amphotericin B deoxycholate plus oral Flucytosine (or high-dose Fluconazole 1200 mg/day), therapeutic lumbar punctures for intracranial hypertension, and deferring ART by 4 to 6 weeks from the start of antifungal treatment

C.Immediate high-dose intravenous Dexamethasone for 4 weeks combined with immediate ART initiation to prevent neurological deficit

D.Single-dose intrathecal Methotrexate followed by maintenance Co-trimoxazole prophylaxis

Explanation: WHO guidelines for cryptococcal meningitis recommend antifungal induction with amphotericin B plus flucytosine, or a single high dose of liposomal amphotericin B combined with flucytosine and fluconazole, followed by fluconazole consolidation. Controlling raised intracranial pressure by serial therapeutic lumbar punctures is essential. WHO makes a strong recommendation against immediate ART: it should be deferred by 4 to 6 weeks from the start of antifungal treatment (about four weeks after an amphotericin B-based induction) because early initiation increases mortality through cryptococcal immune reconstitution inflammatory syndrome.

4A 38-year-old HIV-infected woman (CD4 count 85 cells/uL) presents with a 2-week history of worsening dry non-productive cough, progressive exertional dyspnea, and low-grade fever. Arterial blood gas on room air shows PaO2 of 58 mmHg (pulse oximetry 88%). Chest radiograph reveals bilateral symmetrical perihilar interstitial ground-glass infiltrates. What is the most appropriate definitive therapeutic regimen?

A.Intravenous Ciprofloxacin 400 mg twice daily alone for 7 days

B.High-dose oral or intravenous Trimethoprim-Sulfamethoxazole (TMP-SMX, 15–20 mg/kg/day of TMP) for 21 days PLUS adjunctive systemic Prednisone tapered over 21 days

C.Inhaled Pentamidine 300 mg once monthly as primary monotherapy without oral steroids

D.Amoxicillin-Clavulanate 1g three times daily plus Clarithromycin for 10 days

Explanation: The clinical picture is classic for Pneumocystis jirovecii pneumonia (PJP/PCP) in an immunocompromised host. First-line therapy is high-dose Trimethoprim-Sulfamethoxazole (15-20 mg/kg/day of the TMP component divided q6-8h) for 21 days. In moderate-to-severe PJP (defined as PaO2 < 70 mmHg on room air or alveolar-arterial gradient >= 35 mmHg), adjunctive corticosteroids (oral prednisone 40 mg BID tapered over 21 days) significantly reduce mortality and respiratory failure when started before or within 72 hours of antimicrobial therapy.

5During a cholera outbreak along Lake Tanganyika in eastern DRC, an adult woman arrives at the Cholera Treatment Center (CTC) with profuse watery 'rice-water' diarrhea, undetectable radial pulses, sunken eyes, skin pinch retracting very slowly (> 2 seconds), and profound lethargy. According to WHO/DRC cholera treatment protocols (Plan C), how should intravenous rehydration be initiated?

A.Infuse 1000 mL of 5% Dextrose over 12 hours with oral rehydration salts

B.Administer Ringer's Lactate at 100 mL/kg total: give 30 mL/kg rapidly within the first 30 minutes, then 70 mL/kg over the next 2.5 hours

C.Administer 0.9% Normal Saline at 10 mL/kg over 6 hours combined with intravenous furosemide

D.Give oral loperamide 4 mg immediately and withhold all intravenous fluids until vomiting ceases

Explanation: In severe dehydration due to cholera (WHO Plan C for adults), Ringer's Lactate is the fluid of choice because it replaces isotonic sodium, chloride, potassium, and bicarbonate lost in massive watery stools. The 100 mL/kg bolus is divided into an immediate resuscitation phase of 30 mL/kg in the first 30 minutes, followed by 70 mL/kg over the subsequent 2.5 hours, accompanied by continuous reassessment and early addition of oral rehydration once the patient is conscious.

6In the Equateur province of DRC, a 24-year-old hunter presents with high fever, malaise, prominent tender bilateral cervical and inguinal lymphadenopathy, and a progressive synchronous rash consisting of deep-seated, umbilicated pustules distributed centrifugally over his face, palms, and soles. Which clinical feature most reliably distinguishes Mpox (Monkeypox, Clade I) from Varicella (chickenpox)?

A.Mpox lesions appear in successive asynchronous waves at different stages of development on the trunk

B.Marked painful lymphadenopathy (cervical, submandibular, inguinal) in Mpox, which is typically absent or minimal in varicella, along with synchronous pustular lesions affecting palms and soles

C.Varicella always causes severe hemorrhagic lesions on the conjunctiva, whereas Mpox never affects mucous membranes

D.Mpox lesions are superficial, pruritic vesicles that resolve without crusting within 48 hours

Explanation: Prominent lymphadenopathy (submandibular, cervical, inguinal) is the key clinical hallmark that differentiates Mpox from chickenpox (varicella) and smallpox during the prodromal phase. Furthermore, Mpox lesions evolve synchronously (all in the same stage: macule to papule to vesicle to umbilicated pustule to crust) with a characteristic centrifugal distribution affecting the face, palms, and soles, unlike varicella where lesions appear in successive 'crops' at multiple stages primarily on the trunk.

7A 22-year-old university student in Lubumbashi presents with a 10-day history of step-ladder fever, dull frontal headache, dry cough, constipation followed by foul-smelling diarrhea, and relative bradycardia (temperature 39.5°C, pulse 72 bpm: Faget's sign). Abdominal examination reveals mild splenomegaly and rose spots on the lower chest. What is the most common serious surgical complication of this disease that typically occurs during the third week of illness?

A.Acute appendiceal carcinoid tumor

B.Terminal ileal perforation at the site of necrotizing Peyer's patches

C.Acute ascending cholangitis due to Clonorchis sinensis

D.Splenic rupture secondary to infectious mononucleosis

Explanation: The clinical presentation is characteristic of typhoid fever (Salmonella enterica serovar Typhi). During the 3rd week of untreated or inadequately treated typhoid, necrosis and ulceration of Peyer's patches in the antimesenteric border of the terminal ileum frequently cause life-threatening intestinal perforation and peritonitis, as well as severe lower gastrointestinal hemorrhage.

8In a rural health zone in Bandundu, an adult farmer presents with daytime somnolence, nocturnal insomnia, progressive behavioral changes, ataxia, and cervical lymphadenopathy (Winterbottom's sign). Microscopic examination of CSF reveals trypanosomes and a white blood cell count of 45 cells/uL. According to WHO guidelines for Trypanosoma brucei gambiense Human African Trypanosomiasis (HAT), what is the current first-line treatment for this second-stage (meningo-encephalitic) sleeping sickness?

A.Intravenous Melarsoprol monotherapy for 30 consecutive days

B.Oral Fexinidazole (with food) as first-line for non-severe second stage, or Nifurtimox-Eflornithine Combination Therapy (NECT) for severe disease

C.Intramuscular Pentamidine isethionate 4 mg/kg for 7 days

D.Oral Praziquantel 40 mg/kg in three divided doses

Explanation: For gambiense human African trypanosomiasis, WHO recommends oral fexinidazole over NECT in patients aged 6 years and over weighing at least 20 kg who have stage 1 disease or second-stage disease with a CSF white cell count below 100/uL, which is this patient's situation at 45 cells/uL. NECT (nifurtimox-eflornithine combination therapy) remains recommended once the CSF white cell count reaches 100/uL or more, and for patients who cannot take or have failed fexinidazole. Melarsoprol has been displaced by its risk of fatal post-treatment reactive encephalopathy.

9A 55-year-old known hypertensive and diabetic male presents with crushing retrosternal chest pain radiating to his left jaw and arm lasting for 2 hours, associated with diaphoresis and nausea. ECG shows 3 mm ST-segment elevation in leads V1 through V4 with reciprocal ST depression in leads II, III, and aVF. The nearest cardiac catheterization laboratory is 8 hours away. What is the immediate pharmacologic management in the emergency department?

A.Immediate loading dose of Chewable Aspirin (300 mg) + Clopidogrel (300–600 mg), parenteral anticoagulation, and IV thrombolysis (e.g., Tenecteplase or Streptokinase) within 30 minutes if no contraindications exist

B.Oral Metoprolol 100 mg immediate release plus high-dose intramuscular Diclofenac

C.Immediate sublingual nitroglycerin every 5 minutes while withholding all antiplatelet drugs until cardiac enzymes return

D.Immediate administration of oral Vitamin K and urgent coronary artery bypass surgery within 1 hour

Explanation: In an acute ST-elevation myocardial infarction (STEMI) presenting within 12 hours of symptom onset where primary percutaneous coronary intervention (PCI) cannot be performed within 120 minutes (as is common in resource-limited settings in DRC), intravenous fibrinolytic therapy (e.g., Streptokinase, Tenecteplase) within 30 minutes ('door-to-needle') is the reperfusion strategy of choice. Dual antiplatelet loading (Aspirin 300 mg + Clopidogrel 300-600 mg) and anticoagulation (Unfractionated or Enoxaparin) are administered immediately.

10A 60-year-old woman is brought to the emergency department with a blood pressure of 220/130 mmHg, severe headache, confusion, blurred vision, and bilateral papilledema on fundoscopic examination. Urinalysis shows proteinuria and microscopic hematuria. What is the target rate of blood pressure reduction during the first hour of management for this hypertensive emergency?

A.Rapidly normalize blood pressure to 120/80 mmHg within the first 15 minutes using sublingual nifedipine

B.Reduce the Mean Arterial Pressure (MAP) by no more than 20% to 25% (or to roughly 160/100–110 mmHg) over the first hour using a titratable intravenous agent like Nicardipine or Labetalol

C.Lower systolic blood pressure to below 90 mmHg immediately to relieve cerebral edema

D.Administer oral hydrochlorothiazide 25 mg daily and discharge with outpatient follow-up in 1 week

Explanation: In hypertensive emergencies (acute severe hypertension with target organ damage such as encephalopathy and papilledema), blood pressure must be reduced cautiously with titratable intravenous medications (e.g., nicardipine, labetalol, sodium nitroprusside). The goal is to decrease mean arterial pressure (MAP) by at most 20-25% in the first hour to prevent cerebral, coronary, and renal hypoperfusion and ischemic infarction caused by shifted vascular autoregulation.

About the Test TOM — Ordre des Médecins Exam

The Test Préalable à l'Inscription au Tableau de l'Ordre des Médecins (Test TOM, also called the Test CNOM) is the national pre-registration examination run by the Conseil National de l'Ordre des Médecins (CNOM) in the Democratic Republic of the Congo. The Ordre itself was created by Ordonnance-loi n° 68-070 du 1er mars 1968, whose Article 7 bars anyone from practising medicine unless entered on the tableau de l'Ordre. Since the first session in December 2021 the CNOM has required graduates of medical faculties it has not accredited to sit the test; graduates of the 17 faculties accredited in the CNOM communiqué of 16 August 2025 are exempt until further notice. The test covers the clinical and basic-science knowledge expected of a general practitioner in five disciplines: surgery, gynecology-obstetrics, internal medicine, neuropsychiatry and pediatrics. Candidates who satisfy the juries are registered on the tableau as médecins généralistes.

Assessment

Candidates are assessed on the clinical and basic-science knowledge expected of a general practitioner across five disciplines: chirurgie, gynécologie-obstétrique, médecine interne, neuropsychiatrie and pédiatrie. Candidates present to the jury in a white coat (blouse blanche). Sessions are held in Kinshasa and the provinces, with the 2021 Kinshasa pool sitting at the Cliniques Universitaires de Kinshasa, the Centre Neuro-Psycho-Pathologique of UNIKIN and the Université Protestante au Congo, the Goma pool sitting at the provincial hospital, and a further pool in Lubumbashi.

Time Limit

Not published. Reported sessions ran over five consecutive days (7-11 December 2021; 27-31 October 2025).

Passing Score

Not published by the CNOM

Exam Fee

Not published by the CNOM (Conseil National de l'Ordre des Médecins (CNOM) de la RDC)

Test TOM — Ordre des Médecins Exam Content Outline

25% of this bank

Internal Medicine & Tropical Infectious Diseases (Médecine Interne & Pathologie Tropicale)

Diagnostic workup and clinical management of severe and uncomplicated malaria (PNLP protocols, IV artesunate vs ACTs), pulmonary tuberculosis (GeneXpert, 2RHZE/4RH regimen, MDR-TB), HIV/AIDS opportunistic infections, outbreak diseases (cholera, mpox, viral hemorrhagic fevers), cardiovascular emergencies (acute coronary syndrome, hypertensive crisis, acute heart failure), diabetic ketoacidosis, and acute kidney injury.

20% of this bank

General Surgery & Emergency Traumatology (Chirurgie Générale & Traumatologie)

Clinical diagnosis and surgical indications for acute abdomen (appendicitis, peritonitis, intestinal obstruction, strangulated hernia), initial trauma stabilization (ATLS primary survey, tension pneumothorax, open fractures, compartment syndrome), hemorrhagic shock resuscitation, wound debridement and tetanus prophylaxis, burn management, and surgical site infection prevention.

20% of this bank

Gynecology & Obstetrics (Gynécologie & Obstétrique)

Antenatal care risk stratification, active management of third stage of labor (AMTSL), emergency management of postpartum hemorrhage (uterotonics, tranexamic acid, balloon tamponade), hypertensive disorders of pregnancy (severe preeclampsia/eclampsia, magnesium sulfate protocol), partograph monitoring, obstructed labor, puerperal infections, and cervical cancer screening.

20% of this bank

Pediatrics & Neonatal Care (Pédiatrie & Santé de l'Enfant)

Neonatal resuscitation (Helping Babies Breathe, golden minute, bag-valve-mask ventilation), neonatal sepsis and jaundice, Integrated Management of Childhood Illness (IMCI / PCIME) danger signs and classification, acute severe malnutrition (Kwashiorkor vs Marasmus, F-75 stabilization, therapeutic refeeding, RUTF), pediatric severe malaria, dehydration protocols (Plan A/B/C), and Expanded Programme on Immunization (PEV).

15% of this bank

Neuropsychiatry, Medical Ethics & Public Health (Neuropsychiatrie, Déontologie Médicale & Santé Publique)

Neurological emergencies (acute stroke, status epilepticus, meningoencephalitis, Glasgow Coma Scale), psychiatric emergency management (acute delirium, psychomotor agitation, suicide risk), medical ethics and legal framework under Ordonnance-loi 68-070, Code de déontologie médicale (professional secrecy, patient consent, disciplinary proceedings), and Health Zone (Zone de Santé) primary care architecture in DRC.

How to Pass the Test TOM — Ordre des Médecins Exam

What You Need to Know

Passing score: Not published by the CNOM
Assessment: Candidates are assessed on the clinical and basic-science knowledge expected of a general practitioner across five disciplines: chirurgie, gynécologie-obstétrique, médecine interne, neuropsychiatrie and pédiatrie. Candidates present to the jury in a white coat (blouse blanche). Sessions are held in Kinshasa and the provinces, with the 2021 Kinshasa pool sitting at the Cliniques Universitaires de Kinshasa, the Centre Neuro-Psycho-Pathologique of UNIKIN and the Université Protestante au Congo, the Goma pool sitting at the provincial hospital, and a further pool in Lubumbashi.
Time limit: Not published. Reported sessions ran over five consecutive days (7-11 December 2021; 27-31 October 2025).
Exam fee: Not published by the CNOM

Keys to Passing

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Test TOM — Ordre des Médecins Study Tips from Top Performers

1Master DRC national treatment protocols: IV artesunate for severe malaria, oral ACTs for uncomplicated malaria, 2RHZE/4RH for pulmonary TB, and first-line TDF+3TC+DTG for HIV.

2Review the ATLS primary survey sequence (ABCDE), indications for emergency tube thoracostomy, and immediate fluid resuscitation in hemorrhagic shock.

3Memorize the Pritchard magnesium sulfate protocol for severe preeclampsia and eclampsia (4 g IV loading dose plus 10 g IM, then 5 g IM every 4 hours in alternating buttocks), the Zuspan IV-infusion alternative, and the calcium gluconate antidote for hypermagnesemia.

4Understand the IMAM protocol for severe acute malnutrition (Phase 1 F-75 stabilization, avoiding high sodium, treating hypoglycemia and hypothermia, transitioning to F-100 and RUTF).

Frequently Asked Questions

What is the Test TOM administered by the CNOM in DR Congo?

The Test Préalable à l'Inscription au Tableau de l'Ordre des Médecins (Test TOM, or Test CNOM) is a national pre-registration examination run by the Conseil National de l'Ordre des Médecins (CNOM) of the Democratic Republic of the Congo. The first session was held from 7 to 11 December 2021 in Kinshasa, Lubumbashi and Goma, and sessions have continued since, the most recent one documented in the Congolese press running from 27 to 31 October 2025 across the country. The CNOM does not publish a fixed annual calendar, so confirm session dates with the Ordre rather than assuming a cadence. It assesses medical graduates from faculties not on the CNOM accreditation list before a registration number on the tableau de l'Ordre is issued.

Who is required to sit the Test TOM, and who is exempt?

Medical graduates holding a medical doctorate from universities not accredited by the CNOM are required to pass the test to obtain registration and practice legally in the DRC. Graduates from the 17 accredited medical faculties (such as UNIKIN, UNILU, UNIKIS, UPC, UCB, and others specified in the CNOM August 2025 communiqué) are exempt from the test until further notice.

What is the format and fee of the Test TOM?

Candidates are assessed on the clinical and basic-science knowledge expected of a general practitioner in five disciplines: surgery, gynecology-obstetrics, internal medicine, neuropsychiatry and pediatrics. They present to hospital juries in a white coat (blouse blanche), and the reported sessions of December 2021 and October 2025 each ran over five consecutive days. The CNOM does not publish a syllabus, an item count, per-paper timings, a pass mark or a fee, so treat any figure you see quoted for those online as unverified.

Is the legal basis of the Test TOM settled?

Not entirely. On 20 July 2023 the Conseil d'État suspended CNOM circular n° 001/023 of 1 April 2023, holding that Ordonnance-loi n° 68-070 du 1er mars 1968 did not provide for a pre-registration test, in a case brought by more than 2,000 applicants for a numéro d'ordre. The CNOM has nonetheless continued to organise sessions, and in August 2025 the Ministry of Higher Education publicly contested the CNOM's faculty accreditation list. Confirm the current position with the CNOM before relying on either the test or the exemption list.

Is this practice question bank an official CNOM examination paper?

No. The official assessment is conducted in French before hospital juries. This bank is an independent English-language four-option MCQ study adaptation covering the clinical knowledge, DRC national treatment protocols and medical deontology within the test's scope. It is not an official translation, not a past paper, and it cannot substitute for bedside clinical training or simulate an oral jury.