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