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