GMDC MOCK 3 /80 26 Quiz 1 / 80 In an acute abdomen a history of frequent copious vomiting, the vomitus being clear initially, then bile-stained and finally brown in colour, is most suggestive of Gastro-enteritis Acute pancreatitis Acute gastritis Acute high intestinal obstruction 2 / 80 A 20 year old man has a tense, fluctuant, non-tender, ovoid, swelling without a cough impulse in the left groin which moves with traction on the testis. What is the most likely diagnosis? Sebaceous cyst of the scrotum Encysted hydrocele of the cord Irreducible incomplete inguinal hernia, probably containing omentum Cyst of the epididymis 3 / 80 Which one of the drugs or measures do not worsen uraemia? Hypotension Paracetamol Gentamycin Diarrhoea 4 / 80 In a vertex presentation, the position is determined by the relationship of what fetal part to the Mother's pelvis: Sacrum. Mentum. Sinciput. Occiput. Acromian. 5 / 80 Features found in nephrotic syndrome include the following EXCEPT: Hypertriglyceridemia Oedema Hypoalbuminsemia Normal renal function 6 / 80 The following are associated with oral candidiasis except; Malignancy Glucose 6 Phosphate Dehydrogenase Lymphoma Retroviral infection 7 / 80 Which of the following is not part of the criteria considered for CURB 65 used to determine the severity of community pneumonia. Respiratory rate> 30 per minute Heart rate >100 Confusion Diastolic pressure <60 mm Hg. 8 / 80 A 40 year old woman complains of difficulty in swallowing for 3 months. During the interview, it was observed that she has difficulty in speaking after a few sentences. She also has drooping of the eyelids. She is most likely suffering from: Bulbar paralysis Diffuse spasm of the oesophageal muscles Myasthenia gravis Scleroderma 9 / 80 For adequate and stable haemostasis the following should obtain: A minimum platelet count of 90,000 per mm3 Retraction of the injured vessel Endothelial cell secretion of factor VIII Increased pressure within the injured vessel 10 / 80 All these conditions cause hypokalemia in children except pyloric stenosis frusemide renal tubular acidosis type 1 gastroenteritis acute tubular necrosis 11 / 80 The prime cause of a venous leg ulcer is: Varicosity of the long (greater) saphenous vein Stasis in the deep veins High venous pressure in the leg veins generally Failure of valves of the perforating and deep veins 12 / 80 Twenty-four hours after partial gastrectomy, a 50 year old man has passed only 200mls of urine; catherization yield a further 100m of urine. Your provisional diagnosis is: Pre-renal renal failure Acute tubular necrosis Acute renal failure Post-renal renal failure 13 / 80 In burns: The rate of fluid exudation from the capillaries is highest in the first 4 hours and falls in 48 hours. There is initial vasodilatation followed by vasoconstriction in the burnt tissue. The increased capillary permeability is restricted to the burnt area. The maximum oedema fluid obtainable is about 10% of the body weight or 50% of total E.C.F. 14 / 80 The following are contraindications for lumbar puncture except Coagulopathy Cervical spondylosis Acute spinal cord injury skin infection at or near the site of the lumbar puncture Raised intracranial pressure 15 / 80 The following are causes of spastic paraparesis except; Guillain Barre syndrome Potts disease Disc prolapse Transverse myelitis 16 / 80 Which of the following patients should you prescribe aspirin if there is no contraindication. Select the MOST appropriate Any patient with severe hypertension and 50 years and cardiovascular disease Any patient with hypertension and aged over 50 years Anyone with hypertension, over 50 years and has cardiovascular risk of <20% over 20 years. All the answers below 17 / 80 In normal pregnancy, the value of ß-hCG doubles every: 10 days. 4 days. 8 days. 2 days. 14 days. 18 / 80 Neuro hormones which are activated in cardiac failure include all EXCEPT: Nordrenaline Thyroxine Brain naturetic protein Aldosterone 19 / 80 Molding of the fetal head: Does NOT have time to occur in breech delivery. Usually cause brain damage. Becomes progressively easier as gestational age increase. Increase the difficulty of delivery. Does not happen when maternal pelvis is adequate. 20 / 80 The thyroid gland in thyrotoxicosis: In over 95 percent has a thrill and a bruit over it If primary is uniformly enlarged and rather soft or firm Is enlarged in all patients so affected If secondary is firm and multinodular in all patients 21 / 80 Which of the of the following is a LEAST likely presentations of myocardial infarction ? Shock . No chest pain in an elderly female diabetic Sharp piercing pain in the left which worsens with breathing Severe crushing pain in the precordium 22 / 80 Which of the following anti diabetic drugs increases insulin sensitivity? Metformin Pioglitazone Glibenclamide DPP4 inhibitors 23 / 80 All these conditions cause conjugated hyperbilirubinemia in newborns except torch infections galactosemia breast milk jaundice biliary atresia sepsis 24 / 80 A 25 year old man who falls on the outstretched right arm complains of pain around the elbow and it is found that the olecranon is unusually prominent. The line from the midial epicondyle through the tip of the olecranon to the latual epicandgle is angulated. The most likely clinical diagnosis is Fracture of the olecranon process Monteggia fracture dislocation Supracondylar fracture Dislocation of the elbow 25 / 80 A 31 year old drug addict who uses intravenous drugs presents to your clinic with a 4 day history fever with temperatures in tween 38.5 and 40 degree Celsius, chills,sweats. headaches progressive weakness, dypsnoea and cough.Examination confirms high fever, pulse rate of 116 beats per minute, newly diagnosed pansystolic murmur. Fine crepitations were heard at the lung bases. The eyes had a lemon yellow tinge and there were macular rash in the palms. What is the MOST likely diagnosis? Acute rheumatic carditis. Acute bacterial endocarditis Sub acute bacterial endocarditis Viral hepatitis 26 / 80 A71 year old man present with rapidly developing fever, cough productive of rust-clouded sputum which grew gram positive diplococci. His chest X-ray show lobar consolidation. He responds to treatment with amoxicillin . Which is the MOST likely organism for her infection? Staphylococcus aureus Klebsiella pneumoniae Mycoplasma pneumonia Streptococcus pneumoniae 27 / 80 Which of these discriptions adequately describe malena stools? Black stools Black tarry or sticky stools Dark stools Loose very shining black stools 28 / 80 The main tissues which provide support to the uterus include: Perineal body and the Broad ligaments Cardinal ligaments and the Uterosacral ligaments Broad ligaments and the Uterosacral ligaments Uterosacral ligaments and the Broad ligaments Round ligament and the Broad ligaments 29 / 80 The management of retroexposed babies include PCR at 6 weeks of age zidovudine for six months mixed feeding at 1 month cotrimoxazole at birth lamivudine and zidovudine for 6 weeks for high risk babies 30 / 80 Cause of ptosis include the following except horner syndrome botulism tick paralysis 4th nerve palsy myasthenia gravis 31 / 80 The relationship of the long axis of the fetus to the long axis of the mother is called: None of the above. Presentation. Attitude. Position. Lie. 32 / 80 A man of 40 complains of epigastric discomfort, progressive weight loss, anorexia malaise and intermittent pyrexia of 6 weeks duration. He looks ill, anaemic but not jaundiced and has a tender palpable liver; free fluid is detectable in the abdomen. The most likely clinical diagnosis is Carcinoma of the body of the pancreas Carcinoma of the stomach Primary liver cell carcinoma Amoebic liver abscess 33 / 80 On assessment of Semen Fluid Analysis: Azoospermia indicates a sperm count more than 5 million/ml Abstinence should be maintained for 3 days prior to production of the sample Asthenozoospermia indicates abnormal forms Teratozoospermia indicates abnormal motility Abstinence should be maintained for 10 days prior to "production" of the sample 34 / 80 Facial features of fetal alcohol syndrome include the following except microcephaly smooth philtrum ptosis short palpebral tissue thick upper lip 35 / 80 A bloody nipple discharge in a 35 year old West African is most likely to be caused by: Chronic breast abscess Scirrhous breast carcinoma Duct ectasia Intraductal comedo-carcinoma 36 / 80 Regarding missed abortion, all of the following are CORRECT, EXCEPT: Patient may present with loss of the symptoms of pregnancy Ultrasound should be done to confirm the diagnosis Disseminated intra-vascular coagulation may occur as a sequele of missed abortion Per vaginal bleeding may be one of the presenting symptom Immediate evacuation should be done once the diagnosis is made 37 / 80 The most common route of primary infection with Mycobacterium Tuberculosis is: Via the payer's patches to the mesenteric lymph nodes. The genitourinary mucosa-urethra and bladder. Directly to the lung tissue establishing a Primary Complex (Gohn focus) Through the tonsils to the cervical lymph nodes. 38 / 80 These are chronic complications associated with sickle cell disease except priapism congestive heart failure chronic lung disease leg ulcers aseptic necrosis of the hip or shoulder 39 / 80 Stroke due involving the right middle cerebral artery pathology in most people usually causes the symptoms and signs below EXCEPT No effect on the muscles in the upper part of the face. Paralysis of lower facial muscles on the left. Motor aphasia May cause incontinence of urine 40 / 80 Which of these pairs does not match with regards to neurocutaneous disorders. port wine stain and sturge weber syndrome shagreen patch and tuberous sclerosis cortical tuber in neurofibromatosis adenoma sebaceum and tuberous sclerosis café - au-lait spots and neurofibromatosis 41 / 80 An ectopic pregnancy: Can only be treated surgically Usually presents with pain before bleeding Occurs only in the fallopian tubes Gives an increased risk of Hyperemisis Gravidarium Pain always presents before the bleeding 42 / 80 Antenatal booking investigations include all of the following, EXCEPT: Stool routine examination Urine routine examination Complete blood count Hepatitis screening Thyroid function 43 / 80 Which of the following is NOT a characteristic of normal labour: Increasing intensity of contractions. Progressive cervical dilation. Moderate bleeding. Moderate pain. Uterine relaxation between contractions. 44 / 80 The features listed below may be associated with migraine headache EXCEPT Photophobia. Neck stiffness may be present Pulsatile or throbbing headache Nausea 45 / 80 The second stage of labour involves: Expulsion of the placenta. Separation of the placenta. Effacement of the cervix. Dilation of the cervix. Expulsion of the fetus. 46 / 80 A 27 year old man who is in good health has a persistently raised blood pressure of between 145/92 mmHg and 149/92 both at the poly clinic and in the home for 6 months. What will be the MOST appropriate management ? Start amlodipine therapy. Refer him to the specialist for investigations. Start him on nifedipine XL 30 mg once a day to observe his blood pressure for a further 10 months before initiating treatment . 47 / 80 The following statement are all TRUE about vomiting in pregnancy, EXCEPT: Is associated with urinary tract infection Is commonest in the third trimester Associated with multiple pregnancy Is associated with trophoblastic disease May be cured by admission to hospital 48 / 80 In bronchiolitis, all these are true except primarily affects children less than 2 years old most commonly caused by respiratory syncytial virus may present with with low grade fever it's usually a self-limiting disease drug of choice is acyclovir 49 / 80 Regarding Hyperemesis gravidarum, which one of the following items is TRUE? Urine for culture and sensitivity is not important Not known to happen in molar pregnancy Is a complication of multiple pregnancy Worsen in missed abortion Liver function test is not required 50 / 80 Neonatal resuscitation most effective action is ventilation of the baby's lungs atropine is administered when heart rate is below 100 bpm chest compression is initiated when heart rate is below 100 bpm clearing airway preceeds keeping baby warm involves administration of iv aminophylline to preterms 51 / 80 Concerning febrile seizures Overall, 30% develop epilepsy They usually have a poor prognosis Overall risk for recurrence is 3-4% Complex features is not a risk factor for recurrence Main risk factor for recurrence is the temperature at time of seizure. 52 / 80 These are causes of acute stridor except acute epiglottitis bacterial tracheitis laryngomalacia diphtheria croup 53 / 80 This is not a cause of hypoglycaemia in newborns prematurity sepsis intrauterine growth retardate hypoinsulinaemia infant of a diabetic mother 54 / 80 The source of progesterone that maintains the pregnancy during early 1st trimester is: Adrenal glands. Endometrium. Corpus albicans. Corpus luteum. Placenta. 55 / 80 In intestinal obstruction at the sigmoid colon due to stenosis, perforation is most likely to occur in the Descending colon Caecum Terminal ileum Transverse colon 56 / 80 The pelvis includes which of the following bones: Trochanter, hip socket, ischium, sacrum and pubis. Ilium, scapula, ischium and pubis. Trochanter, sacrum, coccyx, ilium and pubis Ilium, ischium, pubis, sacrum and coccyx. Sacrum, Tibia, ilium and pubis. 57 / 80 You are called to see a 67 year old man 30 hours after a major abdominal surgery with oligourea. Investigation shows blood urea 15 mold/l, creatinine 122mmol/l serum potassium 5.1 mold/ l and urinary sodium 10mmol/l (normal is 25 to 250 mom/l) What is the most likely diagnosis? Post renal uraemia Injury to sacral nerve plexus Atonic bladder Hypovolaemia 58 / 80 Which of the underlisted factors has been shown by critical analysis to be the most important influence on the genesis of Surgical Site Infection (SSI) Bacterial content of the wound at end of operation Glove puncture in the course of surgery Preoperative showering for the patient Age of the patient 59 / 80 Adverse effects of corticosteroids include all EXCEPT Cataract Euphoria Osteomalacia Avascular necrosis of the hip. 60 / 80 A 16 year old boy from a deprived area of Accra who is undergoing treatment for pulmonary TB reports that his urine has become 'bloody'. Which one of the following is the MOST likely diagnosis? Drug induced Urinary tract infection Renal stone Haemolysis 61 / 80 A 55 year old man undergoes a CT abdominal scan with contrast. Following the scan his renal function has progressively deteriorated. What is the MOSTlikely diagnosis ? Renal artery stenosis Acute tubular necrosis Post renal obstruction Rapidly progressively glomerulonephriitis 62 / 80 The risk of postpartum uterine atony is associated with: Hypotension. Median episiotomy. Labour associated with an active rate of change of 1 cm per hour. Epidural anesthesia. Twin pregnancy. 63 / 80 The heart rate of a normal fetus at term is: There is no baseline heart rate. 100-120 bpm. 160-180 bpm. 120-160 bpm. 80-100 bpm. 64 / 80 This is not true about autism it's characterised by restricted and repetitive behavior there is severe language and speech developmental disorder it is pervasive developmental disorder most cases have normal intelligence commoner in males than in females with a male:female ratio of 3:1 65 / 80 Malignant degeneration of a healing wound is most likely to occur: When a state of chronicity from (e.g) recurrent infection prevails. When wounds are exposed to heat. When iodophor antiseptics are used for dressing. When a patient is on cytotoxic agents. 66 / 80 The commonest site for carcinoma of the tongue is the: Tip Lateral margin Dorsum Posterior one-third 67 / 80 Rupture of membranes is suspected with all of the followings EXCEPT: Contractions seen on the CTG. Positive Fern test. Positive Nitrazine test. Pooling of amniotic fluid on speculum examination. Observing amniotic fluid drain through the cervix during speculum examination. 68 / 80 The most effective surgical procedure in stress ulceration is: Total gastrectomy Polya partial gastrectomy Vogotomy and pyloroplasty with suturing of bleeding points Vogitomy and hemigastrectomy 69 / 80 The following are treatment for simple malaria except artemether - lumefantrine oral quinine dihydroartemisinin - lumefantrine artesunate - amodiaquine dihydroartemisinin - piperaquine 70 / 80 About severe acute malnutrition (SAM). Hypoglycaemia is present when the blood glucose is <4mmol/l There is usually unilateral pitting pedal oedema Diagnostic features include mid upper arm circumference < 115mm ORS is the fluid of choice for correcting dehydration sensory stimulation is not helpful 71 / 80 In hypopituitarism all these hormones may be deficient except Growth hormone Cholecystokinin Adrenocorticotropic hormone Prolactin Follicle stimulating hormone 72 / 80 For a 75 year old man with a single rib fracture as the sole injury in a Road Traffic Accident the best treatment is: Blockage of the appropriate intercostal nerve and active physiotherapy External fixation Watchful administration of adequate doses of systemic analgesic agent Strapping of the affected side of the chest 73 / 80 Cause of neonatal seizures include the following except hypoxic ischaemic encephalopathy intracranial hemorrhage bilirubin encephalopathy pyridoxine deficiency hypermagnesaemia 74 / 80 The last menstrual period was June 20th. The expected date of delivery (EDD) is approximately: March 23. March 27. April 7. April 23. March 28. 75 / 80 These are gross motor skills except transfers object from hand to hand steadiness of head when placed in supported position walks up stairs with help stands alone sits with support 76 / 80 Squamous cell carcinoma of the anus: Is treated by abdomino-perineal resection of the rectum and anus in all patients Usually presents as a localized ulcer with sloping edges Bleeds but does not cause pain on defaecation Is the commonest malignant tumour of the anus 77 / 80 A child of four presents with shortness of breath on exertion, dyspnoea after meals and failure to thrive. On examination cyanosis is evident soon after exertion and the (L) side of the chest is tympanitic. Plain x-ray of the chest shows a cystic shadow in the left hemithorax. The most likely diagnosis is: Congenital postero-lateral diaphragmatic hernia (stabilized) Congital cyanotic heart disease Emphysematous bullae Congenital cystic lung disease 78 / 80 A 55 year old man who has been working for many years blasting stones for building purposes presents with progressive dypsnoea on exertion, dry cough and progressive tiredness. On examination breath sounds were vesicular. There were medium crepitations on inspiration Percussion was resonant in all areas. Chest X ray showed diffuse milliary pattern in the upper lung fields. What is the MOST likely diagnosis? Silicosis Carcinoma of the bronchus Left ventricular failure Tuberculosis 79 / 80 Stages of labour Syntometrine is a combination of oxytocin and Ergometrine which is used in the treatment of secondary postpartum haemorrhage (PPH) Forceps or ventose may be useful in slow progress of the late 1st stage The cervix dilates at consistent rate of 3 cm per hour in the first stage The first stage commences at the time of membrane rupture The third stage end with the delivery of the placenta and membranes 80 / 80 Causes of macrocephaly include the following except thalassaemia achondroplasia mucopolysaccharidosis hydrocephalus fetal alcohol syndrome Your score is LinkedIn Facebook VKontakte 0% Restart quiz Send feedback