GMDC MOCK 3 /80 26 Quiz 1 / 80 Squamous cell carcinoma of the anus: Is the commonest malignant tumour of the anus Bleeds but does not cause pain on defaecation Is treated by abdomino-perineal resection of the rectum and anus in all patients Usually presents as a localized ulcer with sloping edges 2 / 80 This is not a cause of hypoglycaemia in newborns sepsis hypoinsulinaemia infant of a diabetic mother prematurity intrauterine growth retardate 3 / 80 These are gross motor skills except walks up stairs with help transfers object from hand to hand stands alone steadiness of head when placed in supported position sits with support 4 / 80 In hypopituitarism all these hormones may be deficient except Follicle stimulating hormone Growth hormone Adrenocorticotropic hormone Cholecystokinin Prolactin 5 / 80 Which of these pairs does not match with regards to neurocutaneous disorders. port wine stain and sturge weber syndrome cortical tuber in neurofibromatosis shagreen patch and tuberous sclerosis café - au-lait spots and neurofibromatosis adenoma sebaceum and tuberous sclerosis 6 / 80 The following are associated with oral candidiasis except; Retroviral infection Malignancy Glucose 6 Phosphate Dehydrogenase Lymphoma 7 / 80 Which of the following is not part of the criteria considered for CURB 65 used to determine the severity of community pneumonia. Diastolic pressure <60 mm Hg. Heart rate >100 Respiratory rate> 30 per minute Confusion 8 / 80 Rupture of membranes is suspected with all of the followings EXCEPT: Contractions seen on the CTG. Pooling of amniotic fluid on speculum examination. Positive Nitrazine test. Positive Fern test. Observing amniotic fluid drain through the cervix during speculum examination. 9 / 80 Causes of macrocephaly include the following except mucopolysaccharidosis fetal alcohol syndrome hydrocephalus thalassaemia achondroplasia 10 / 80 The heart rate of a normal fetus at term is: There is no baseline heart rate. 80-100 bpm. 100-120 bpm. 120-160 bpm. 160-180 bpm. 11 / 80 Malignant degeneration of a healing wound is most likely to occur: When a state of chronicity from (e.g) recurrent infection prevails. When iodophor antiseptics are used for dressing. When wounds are exposed to heat. When a patient is on cytotoxic agents. 12 / 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 13 / 80 About severe acute malnutrition (SAM). Hypoglycaemia is present when the blood glucose is <4mmol/l Diagnostic features include mid upper arm circumference < 115mm sensory stimulation is not helpful ORS is the fluid of choice for correcting dehydration There is usually unilateral pitting pedal oedema 14 / 80 Neuro hormones which are activated in cardiac failure include all EXCEPT: Aldosterone Thyroxine Nordrenaline Brain naturetic protein 15 / 80 Cause of ptosis include the following except myasthenia gravis tick paralysis horner syndrome botulism 4th nerve palsy 16 / 80 Stroke due involving the right middle cerebral artery pathology in most people usually causes the symptoms and signs below EXCEPT Motor aphasia Paralysis of lower facial muscles on the left. No effect on the muscles in the upper part of the face. May cause incontinence of urine 17 / 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 Hypovolaemia Atonic bladder 18 / 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? Viral hepatitis Sub acute bacterial endocarditis Acute bacterial endocarditis Acute rheumatic carditis. 19 / 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 In over 95 percent has a thrill and a bruit over it Is enlarged in all patients so affected 20 / 80 In intestinal obstruction at the sigmoid colon due to stenosis, perforation is most likely to occur in the Caecum Terminal ileum Descending colon Transverse colon 21 / 80 Regarding missed abortion, all of the following are CORRECT, EXCEPT: Patient may present with loss of the symptoms of pregnancy Per vaginal bleeding may be one of the presenting symptom Immediate evacuation should be done once the diagnosis is made Disseminated intra-vascular coagulation may occur as a sequele of missed abortion Ultrasound should be done to confirm the diagnosis 22 / 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? Carcinoma of the bronchus Silicosis Tuberculosis Left ventricular failure 23 / 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) Glove puncture in the course of surgery Bacterial content of the wound at end of operation Age of the patient Preoperative showering for the patient 24 / 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: Acute renal failure Post-renal renal failure Pre-renal renal failure Acute tubular necrosis 25 / 80 Which of these discriptions adequately describe malena stools? Black stools Dark stools Black tarry or sticky stools Loose very shining black stools 26 / 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 Rapidly progressively glomerulonephriitis Post renal obstruction Acute tubular necrosis 27 / 80 The management of retroexposed babies include PCR at 6 weeks of age cotrimoxazole at birth lamivudine and zidovudine for 6 weeks for high risk babies mixed feeding at 1 month zidovudine for six months 28 / 80 The last menstrual period was June 20th. The expected date of delivery (EDD) is approximately: March 23. March 28. April 7. April 23. March 27. 29 / 80 The second stage of labour involves: Separation of the placenta. Effacement of the cervix. Expulsion of the fetus. Expulsion of the placenta. Dilation of the cervix. 30 / 80 The following are causes of spastic paraparesis except; Potts disease Disc prolapse Transverse myelitis Guillain Barre syndrome 31 / 80 On assessment of Semen Fluid Analysis: Teratozoospermia indicates abnormal motility Azoospermia indicates a sperm count more than 5 million/ml Asthenozoospermia indicates abnormal forms 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 32 / 80 The main tissues which provide support to the uterus include: Broad ligaments and the Uterosacral ligaments Cardinal ligaments and the Uterosacral ligaments Perineal body and the Broad ligaments Round ligament and the Broad ligaments Uterosacral ligaments and the Broad ligaments 33 / 80 Which of the following anti diabetic drugs increases insulin sensitivity? DPP4 inhibitors Pioglitazone Metformin Glibenclamide 34 / 80 In bronchiolitis, all these are true except drug of choice is acyclovir may present with with low grade fever most commonly caused by respiratory syncytial virus primarily affects children less than 2 years old it's usually a self-limiting disease 35 / 80 Antenatal booking investigations include all of the following, EXCEPT: Stool routine examination Hepatitis screening Urine routine examination Complete blood count Thyroid function 36 / 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 Renal stone Drug induced Urinary tract infection 37 / 80 In a vertex presentation, the position is determined by the relationship of what fetal part to the Mother's pelvis: Sinciput. Acromian. Sacrum. Occiput. Mentum. 38 / 80 Cause of neonatal seizures include the following except intracranial hemorrhage hypoxic ischaemic encephalopathy pyridoxine deficiency bilirubin encephalopathy hypermagnesaemia 39 / 80 The following statement are all TRUE about vomiting in pregnancy, EXCEPT: Associated with multiple pregnancy May be cured by admission to hospital Is commonest in the third trimester Is associated with urinary tract infection Is associated with trophoblastic disease 40 / 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 ? to observe his blood pressure for a further 10 months before initiating treatment . Refer him to the specialist for investigations. Start amlodipine therapy. Start him on nifedipine XL 30 mg once a day 41 / 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 high intestinal obstruction Acute gastritis Acute pancreatitis 42 / 80 Which of the following is NOT a characteristic of normal labour: Moderate bleeding. Uterine relaxation between contractions. Increasing intensity of contractions. Progressive cervical dilation. Moderate pain. 43 / 80 The following are contraindications for lumbar puncture except skin infection at or near the site of the lumbar puncture Cervical spondylosis Raised intracranial pressure Acute spinal cord injury Coagulopathy 44 / 80 Regarding Hyperemesis gravidarum, which one of the following items is TRUE? Liver function test is not required 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 45 / 80 Stages of labour 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 cervix dilates at consistent rate of 3 cm per hour in the first stage The third stage end with the delivery of the placenta and membranes Syntometrine is a combination of oxytocin and Ergometrine which is used in the treatment of secondary postpartum haemorrhage (PPH) 46 / 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 Amoebic liver abscess Primary liver cell carcinoma 47 / 80 The commonest site for carcinoma of the tongue is the: Dorsum Posterior one-third Lateral margin Tip 48 / 80 For adequate and stable haemostasis the following should obtain: Retraction of the injured vessel A minimum platelet count of 90,000 per mm3 Increased pressure within the injured vessel Endothelial cell secretion of factor VIII 49 / 80 This is not true about autism it is pervasive developmental disorder commoner in males than in females with a male:female ratio of 3:1 it's characterised by restricted and repetitive behavior there is severe language and speech developmental disorder most cases have normal intelligence 50 / 80 An ectopic pregnancy: Occurs only in the fallopian tubes Usually presents with pain before bleeding Pain always presents before the bleeding Gives an increased risk of Hyperemisis Gravidarium Can only be treated surgically 51 / 80 The following are treatment for simple malaria except dihydroartemisinin - lumefantrine artesunate - amodiaquine dihydroartemisinin - piperaquine oral quinine artemether - lumefantrine 52 / 80 The most effective surgical procedure in stress ulceration is: Polya partial gastrectomy Total gastrectomy Vogotomy and pyloroplasty with suturing of bleeding points Vogitomy and hemigastrectomy 53 / 80 The most common route of primary infection with Mycobacterium Tuberculosis is: Directly to the lung tissue establishing a Primary Complex (Gohn focus) Through the tonsils to the cervical lymph nodes. The genitourinary mucosa-urethra and bladder. Via the payer's patches to the mesenteric lymph nodes. 54 / 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? Mycoplasma pneumonia Streptococcus pneumoniae Klebsiella pneumoniae Staphylococcus aureus 55 / 80 A bloody nipple discharge in a 35 year old West African is most likely to be caused by: Duct ectasia Chronic breast abscess Intraductal comedo-carcinoma Scirrhous breast carcinoma 56 / 80 These are causes of acute stridor except bacterial tracheitis laryngomalacia diphtheria croup acute epiglottitis 57 / 80 In burns: The maximum oedema fluid obtainable is about 10% of the body weight or 50% of total E.C.F. The increased capillary permeability is restricted to the burnt area. 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. 58 / 80 The source of progesterone that maintains the pregnancy during early 1st trimester is: Corpus luteum. Corpus albicans. Endometrium. Placenta. Adrenal glands. 59 / 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: Strapping of the affected side of the chest External fixation Blockage of the appropriate intercostal nerve and active physiotherapy Watchful administration of adequate doses of systemic analgesic agent 60 / 80 Which of the following patients should you prescribe aspirin if there is no contraindication. Select the MOST appropriate All the answers below Any patient with hypertension and aged over 50 years Any patient with severe hypertension and 50 years and cardiovascular disease Anyone with hypertension, over 50 years and has cardiovascular risk of <20% over 20 years. 61 / 80 All these conditions cause conjugated hyperbilirubinemia in newborns except breast milk jaundice biliary atresia galactosemia sepsis torch infections 62 / 80 The risk of postpartum uterine atony is associated with: Labour associated with an active rate of change of 1 cm per hour. Twin pregnancy. Hypotension. Epidural anesthesia. Median episiotomy. 63 / 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: Myasthenia gravis Bulbar paralysis Scleroderma Diffuse spasm of the oesophageal muscles 64 / 80 The prime cause of a venous leg ulcer is: High venous pressure in the leg veins generally Failure of valves of the perforating and deep veins Varicosity of the long (greater) saphenous vein Stasis in the deep veins 65 / 80 All these conditions cause hypokalemia in children except gastroenteritis acute tubular necrosis renal tubular acidosis type 1 pyloric stenosis frusemide 66 / 80 In normal pregnancy, the value of ß-hCG doubles every: 10 days. 14 days. 8 days. 2 days. 4 days. 67 / 80 These are chronic complications associated with sickle cell disease except congestive heart failure priapism chronic lung disease leg ulcers aseptic necrosis of the hip or shoulder 68 / 80 Concerning febrile seizures Main risk factor for recurrence is the temperature at time of seizure. 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 69 / 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 Supracondylar fracture Fracture of the olecranon process 70 / 80 The relationship of the long axis of the fetus to the long axis of the mother is called: Position. Presentation. None of the above. Attitude. Lie. 71 / 80 Neonatal resuscitation clearing airway preceeds keeping baby warm chest compression is initiated when heart rate is below 100 bpm most effective action is ventilation of the baby's lungs involves administration of iv aminophylline to preterms atropine is administered when heart rate is below 100 bpm 72 / 80 Which one of the drugs or measures do not worsen uraemia? Paracetamol Gentamycin Hypotension Diarrhoea 73 / 80 The pelvis includes which of the following bones: Sacrum, Tibia, ilium and pubis. Ilium, scapula, ischium and pubis. Trochanter, hip socket, ischium, sacrum and pubis. Ilium, ischium, pubis, sacrum and coccyx. Trochanter, sacrum, coccyx, ilium and pubis 74 / 80 Features found in nephrotic syndrome include the following EXCEPT: Oedema Hypoalbuminsemia Hypertriglyceridemia Normal renal function 75 / 80 Adverse effects of corticosteroids include all EXCEPT Osteomalacia Avascular necrosis of the hip. Euphoria Cataract 76 / 80 The features listed below may be associated with migraine headache EXCEPT Neck stiffness may be present Photophobia. Nausea Pulsatile or throbbing headache 77 / 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 78 / 80 Molding of the fetal head: Increase the difficulty of delivery. Does not happen when maternal pelvis is adequate. Does NOT have time to occur in breech delivery. Usually cause brain damage. Becomes progressively easier as gestational age increase. 79 / 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? Cyst of the epididymis Irreducible incomplete inguinal hernia, probably containing omentum Sebaceous cyst of the scrotum Encysted hydrocele of the cord 80 / 80 Facial features of fetal alcohol syndrome include the following except smooth philtrum short palpebral tissue thick upper lip ptosis microcephaly Your score is LinkedIn Facebook VKontakte 0% Restart quiz Send feedback