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