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