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