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