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Sample Romania Residency Admission — Medicine Practice Questions

Try these sample questions to review concepts for the Romania Residency Admission — Medicine exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 58-year-old man presents to the emergency department with severe retrosternal chest pressure lasting 45 minutes that radiates to his left jaw and arm. An electrocardiogram reveals 3 mm ST-segment elevation in leads V1 through V4. What is the most appropriate immediate reperfusion strategy according to clinical cardiology guidelines if primary percutaneous coronary intervention (PCI) can be performed within 90 minutes of first medical contact?
A.Immediate primary percutaneous coronary intervention
B.Intravenous fibrinolysis with tenecteplase followed by elective discharge
C.Intravenous unfractionated heparin infusion alone for 48 hours
D.Urgent coronary artery bypass grafting within 24 hours without angiography
Explanation: Timely primary PCI is preferred for this early STEMI presentation. The ESC's 2023 strategy uses an anticipated diagnosis-to-PCI reperfusion delay of no more than 120 minutes when choosing PCI over fibrinolysis. The stated availability permits prompt PCI; timing definitions should not be interchanged with first-medical-contact metrics.
2A 67-year-old woman has symptomatic heart failure and an ejection fraction of 32%. Which combination represents the four foundational disease-modifying drug classes for HFrEF, subject to contraindications and tolerability?
A.Furosemide, digoxin, and amlodipine
B.Angiotensin receptor-neprilysin inhibitor (ARNI), beta-blocker, mineralocorticoid receptor antagonist (MRA), and SGLT2 inhibitor
C.Isosorbide mononitrate, verapamil, and warfarin
D.Diltiazem, spironolactone, and hydrochlorothiazide
Explanation: The four foundational HFrEF drug classes are an ARNI (or ACE inhibitor/ARB when appropriate), an evidence-based beta-blocker, an MRA, and an SGLT2 inhibitor. Together they improve important outcomes, including cardiovascular death and heart-failure hospitalization. The precise mortality endpoints demonstrated differ between individual trials and agents.
3A 72-year-old man presents with two episodes of exertional syncope over the past month. On auscultation, there is a harsh, late-peaking systolic ejection murmur at the right second intercostal space that radiates to the carotid arteries, accompanied by a delayed and diminished carotid pulse (pulsus parvus et tardus) and a soft second heart sound. What is the most likely diagnosis?
A.Severe aortic valve stenosis
B.Hypertrophic obstructive cardiomyopathy
C.Severe mitral regurgitation
D.Patent ductus arteriosus
Explanation: The classic triad of severe aortic stenosis is angina, syncope, and heart failure dyspnea. Physical findings include a late-peaking crescendo-decrescendo systolic murmur at the right upper sternal border radiating to both carotids, a diminished and delayed carotid upstroke (pulsus parvus et tardus), and an absent or markedly reduced aortic component of S2.
4A 45-year-old male with a prosthetic mechanical mitral valve implanted three years ago presents with persistent fevers, fatigue, and night sweats for three weeks. Blood cultures grow Enterococcus faecalis in three separate sets drawn 12 hours apart. A transesophageal echocardiogram demonstrates a 12 mm mobile vegetation on the prosthetic ring with mild paravalvular regurgitation. According to the modified Duke criteria, which category does this patient meet?
A.Definite infective endocarditis by clinical criteria
B.Possible infective endocarditis only
C.Rejected infective endocarditis
D.Non-bacterial thrombotic endocarditis
Explanation: Positive separate blood-culture sets with E. faecalis and an echocardiographic vegetation provide microbiological and imaging major criteria. Two major criteria support definite infective endocarditis by clinical criteria. This conclusion does not depend on calling a stated twelve-hour interval greater than twelve hours or assuming the regurgitation is new.
5A 64-year-old woman with atrial fibrillation has hypertension, diabetes, and a previous ischemic stroke. She has no mechanical valve, moderate-to-severe mitral stenosis, or contraindication to anticoagulation. Using the CHA2DS2-VA score recommended in the 2024 ESC guideline, what is her score and stroke-prevention strategy?
A.Score of 3; aspirin monotherapy 81 mg daily
B.Score of 4; oral anticoagulation with a direct oral anticoagulant (DOAC)
C.Score of 2; dual antiplatelet therapy with aspirin and clopidogrel
D.Score of 1; observation without antithrombotic therapy
Explanation: CHA2DS2-VA assigns one point each for hypertension and diabetes and two for prior stroke: 1 + 1 + 2 = 4. Age below 65 adds none, and this score omits sex category. The 2024 ESC guideline recommends anticoagulation at a score of at least two, with a DOAC preferred in an eligible patient such as this one.
6A 52-year-old man presents to the clinic for evaluation of elevated blood pressure. Out-of-office 24-hour ambulatory blood pressure monitoring confirms sustained hypertension with an average daytime reading of 152/96 mmHg. His serum creatinine is 1.0 mg/dL, potassium is 4.3 mEq/L, and he has microalbuminuria (urinary albumin-to-creatinine ratio 120 mg/g). What is the first-line antihypertensive regimen according to ESC/ESH guidelines?
A.Initial dual combination of an ACE inhibitor or ARB with a dihydropyridine calcium channel blocker or thiazide/thiazide-like diuretic
B.Beta-blocker monotherapy with atenolol
C.Centrally acting alpha-2 agonist monotherapy with clonidine
D.Loop diuretic monotherapy with furosemide
Explanation: For most adults with confirmed hypertension requiring medication, European guidance favors an initial low-dose two-drug combination, often in one pill. A renin-angiotensin system inhibitor plus a dihydropyridine calcium channel blocker or thiazide-type diuretic is a standard choice. Albuminuria supports including an ACE inhibitor or ARB, with renal function and potassium monitoring.
7A 34-year-old woman presents with sudden onset of rapid palpitations, lightheadedness, and shortness of breath. An ECG demonstrates a regular narrow-complex tachycardia at a rate of 185 beats per minute with no visible P waves. Her blood pressure is 118/74 mmHg and oxygen saturation is 98% on ambient air. Vagal maneuvers with a modified Valsalva maneuver fail to terminate the arrhythmia. What is the next most appropriate pharmacologic intervention?
A.Intravenous adenosine as a rapid bolus
B.Intravenous amiodarone infusion over 60 minutes
C.Oral digoxin loading dose
D.Immediate synchronized direct-current cardioversion at 200 J
Explanation: In a hemodynamically stable patient with regular narrow-QRS paroxysmal supraventricular tachycardia (most commonly AV nodal reentrant tachycardia), IV adenosine given as a rapid flush (initial dose 6 mg, followed if needed by 12 mg) is the drug of choice after vagal maneuvers. Adenosine transiently blocks AV node conduction, terminating the reentry circuit with high efficacy.
8A 28-year-old tall man with arachnodactyly, pectus excavatum, and joint hypermobility presents with acute tearing chest pain radiating to his interscapular region. Blood pressure in the right arm is 165/90 mmHg, while in the left arm it is 115/65 mmHg. A high-pitched early diastolic decrescendo murmur is heard at the right sternal border. Contrast-enhanced chest CT reveals an intimal flap originating 1.5 cm above the aortic valve and extending into the aortic arch. According to the Stanford classification, what is the diagnosis and urgent management?
A.Stanford type A aortic dissection; emergent surgical repair
B.Stanford type B aortic dissection; medical management with IV labetalol alone
C.Stanford type A aortic dissection; outpatient follow-up with oral beta-blockers
D.Thoracic aortic aneurysm without dissection; elective endovascular stenting
Explanation: Ascending aortic involvement defines Stanford type A dissection regardless of distal extension. Rupture, tamponade, severe aortic regurgitation, and coronary malperfusion make it a surgical emergency. Urgent surgical assessment and repair proceed alongside controlled hemodynamic management.
9A 48-year-old man presents with sharp precordial chest pain that worsens with deep inspiration and coughing, and is relieved by sitting upright and leaning forward. On examination, a scratchy three-component friction rub is audible over the left lower sternal border. An ECG demonstrates diffuse, concave upward ST-segment elevation across leads I, II, aVF, and V2-V6, along with PR-segment depression in lead II and PR-segment elevation in lead aVR. What is the first-line medical therapy for this condition?
A.High-dose oral NSAID (such as ibuprofen or aspirin) combined with colchicine
B.High-dose systemic corticosteroids (prednisone 1 mg/kg/day) alone
C.Low-molecular-weight heparin anticoagulation
D.Urgent needle pericardiocentesis
Explanation: Acute pericarditis is diagnosed clinically by characteristic positional pleuritic chest pain, pericardial friction rub, and classic widespread concave ST elevation with PR depression. First-line therapy consists of an anti-inflammatory regimen: high-dose NSAID (e.g., ibuprofen 600 mg every 8 hours or aspirin 750-1000 mg every 8 hours) plus weight-adjusted colchicine (0.5 mg once or twice daily) for 3 months to reduce recurrence rates.
10A 62-year-old woman is admitted to the coronary care unit with an acute inferior wall STEMI. Two hours after admission, her telemetry monitor shows a regular ventricular rate of 38 beats per minute with normal P waves occurring at a rate of 82 beats per minute. The PR intervals vary completely, and there is no relationship between P waves and QRS complexes. The QRS complexes are narrow. What conduction abnormality is present and what is its most likely anatomical vascular culprit?
A.Third-degree (complete) atrioventricular block; right coronary artery ischemia
B.First-degree atrioventricular block; left anterior descending artery occlusion
C.Mobitz type I second-degree AV block; left circumflex artery occlusion
D.Sinus arrest with junctional escape; left main coronary artery disease
Explanation: Independent atrial and ventricular rhythms indicate complete AV block. With inferior infarction, AV nodal ischemia is commonly associated with right coronary artery disease, because the AV nodal artery usually arises from the RCA in right-dominant circulation. Coronary anatomy varies; the narrow escape rhythm supports a relatively proximal block.

About the Romania Residency Admission — Medicine Exam

Independent practice for Concursul Național de Rezidențiat — Medicină and selected medical subjects. The official Romanian-language admission contest is scheduled for 15 November 2026. This English-language MCQ study adaptation uses four options and one correct answer. It is not an official translation, a full format simulation, or a substitute for the official bibliography, Romanian examination reading, or clinical and practical training.

Exam sponsor: Ministerul Sănătății (Ministry of Health), with six university centers. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Questions

200 questions

Time Limit

240 minutes (4 hours)

Passing Score

60% of the highest national medicine score; ranking and available places/posts determine allocation

Exam / Certification Fees

500 lei (2026 session)

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

15 practice questions

Cardiology

Coronary disease, heart failure, rhythm disorders, and hemodynamics.

10 practice questions

Pulmonology

Respiratory disease and infections.

13 practice questions

Gastroenterology and hepatology

Gastrointestinal disease, liver disease, and complications.

11 practice questions

Nephrology and urology

Renal disease, electrolytes, and urinary stones.

6 practice questions

Endocrinology

Diabetes and thyroid disease.

7 practice questions

Neurology

Coma, stroke, and central nervous system infection.

12 practice questions

General surgery and surgical specialties

Abdominal surgery, vascular emergencies, ENT, orthopedics, and urinary retention.

12 practice questions

Infectious disease and hematology

Sepsis, HIV-related infection, anemia, and hemostasis.

3 practice questions

Rheumatology

Inflammatory joint and systemic disease.

2 practice questions

Pediatrics

Selected pediatric respiratory presentations.

3 practice questions

Gynecology and obstetrics

Ectopic pregnancy, preeclampsia, and cervical screening.

2 practice questions

Psychiatry

Depression risk assessment and delirium.

2 practice questions

Dermatology

Psoriasis and erythema migrans.

2 practice questions

Epidemiology and ethics

Test performance and consent. These are bank counts, not official weights; coverage is selective.

Preparing for the Romania Residency Admission — Medicine Exam

What You Need to Know

  • Passing score: 60% of the highest national medicine score; ranking and available places/posts determine allocation
  • Exam length: 200 questions
  • Time limit: 240 minutes (4 hours)
  • Exam / certification fees: 500 lei (2026 session) Official sources

Using Our Practice Resources

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

Romania Residency Admission — Medicine: Suggested Study Strategy

1Study the specified 2026 pages and exclusions across all three official books.
2Practice Romanian clinical terminology and the official multiple-answer selection rules separately.
3Check why each distractor is less appropriate and which findings limit a diagnostic conclusion.
4Use supervised clinical and performance practice alongside written study; this bank cannot replace it.

Frequently Asked Questions

What is the official assessment format?

A four-hour Romanian-language written contest with 200 five-option items: 50 with one correct answer and 150 with two to four correct answers. The ordinary admission assessment has no separately graded oral examination, practical test, assignment, or case-study submission.

Does reaching 60% guarantee a residency place?

No. The threshold is 60% of the highest achieved national medicine score. Eligible candidates choose within the available places/posts in ranking order.

Does this bank cover every page in the official bibliography?

No. It offers independent practice on selected subjects. Use the exact 2026 page list, exclusions, and clarifications. Clinical guidance can change after textbook publication; explanations discuss clinical limitations rather than claiming to reproduce the official answer key.