GMDC MOCK 3 /80 26 Quiz 1 / 80 The source of progesterone that maintains the pregnancy during early 1st trimester is: Corpus luteum. Endometrium. Adrenal glands. Placenta. Corpus albicans. 2 / 80 In bronchiolitis, all these are true except it's usually a self-limiting disease primarily affects children less than 2 years old may present with with low grade fever most commonly caused by respiratory syncytial virus drug of choice is acyclovir 3 / 80 The following are associated with oral candidiasis except; Malignancy Lymphoma Retroviral infection Glucose 6 Phosphate Dehydrogenase 4 / 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 severe hypertension and 50 years and cardiovascular disease Any patient with hypertension and aged over 50 years All the answers below 5 / 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 No chest pain in an elderly female diabetic Severe crushing pain in the precordium Shock . 6 / 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 shagreen patch and tuberous sclerosis café - au-lait spots and neurofibromatosis cortical tuber in neurofibromatosis 7 / 80 An ectopic pregnancy: Occurs only in the fallopian tubes Gives an increased risk of Hyperemisis Gravidarium Usually presents with pain before bleeding Pain always presents before the bleeding Can only be treated surgically 8 / 80 The following are treatment for simple malaria except oral quinine artesunate - amodiaquine artemether - lumefantrine dihydroartemisinin - piperaquine dihydroartemisinin - lumefantrine 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 Scirrhous breast carcinoma Intraductal comedo-carcinoma 10 / 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 External fixation Strapping of the affected side of the chest Blockage of the appropriate intercostal nerve and active physiotherapy 11 / 80 Which one of the drugs or measures do not worsen uraemia? Hypotension Diarrhoea Paracetamol Gentamycin 12 / 80 Squamous cell carcinoma of the anus: Is the commonest malignant tumour of the anus Bleeds but does not cause pain on defaecation Is treated by abdomino-perineal resection of the rectum and anus in all patients Usually presents as a localized ulcer with sloping edges 13 / 80 Regarding Hyperemesis gravidarum, which one of the following items is TRUE? Liver function test is not required Urine for culture and sensitivity is not important Is a complication of multiple pregnancy Worsen in missed abortion Not known to happen in molar pregnancy 14 / 80 For adequate and stable haemostasis the following should obtain: Endothelial cell secretion of factor VIII Retraction of the injured vessel A minimum platelet count of 90,000 per mm3 Increased pressure within the injured vessel 15 / 80 These are chronic complications associated with sickle cell disease except congestive heart failure leg ulcers chronic lung disease aseptic necrosis of the hip or shoulder priapism 16 / 80 In intestinal obstruction at the sigmoid colon due to stenosis, perforation is most likely to occur in the Transverse colon Terminal ileum Descending colon Caecum 17 / 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) Bacterial content of the wound at end of operation Age of the patient Glove puncture in the course of surgery Preoperative showering for the patient 18 / 80 These are causes of acute stridor except laryngomalacia acute epiglottitis bacterial tracheitis croup diphtheria 19 / 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 Dislocation of the elbow Monteggia fracture dislocation Fracture of the olecranon process Supracondylar fracture 20 / 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 Urinary tract infection Drug induced Renal stone 21 / 80 Cause of ptosis include the following except tick paralysis 4th nerve palsy myasthenia gravis botulism horner syndrome 22 / 80 Malignant degeneration of a healing wound is most likely to occur: When a state of chronicity from (e.g) recurrent infection prevails. When wounds are exposed to heat. When iodophor antiseptics are used for dressing. When a patient is on cytotoxic agents. 23 / 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 24 / 80 These are gross motor skills except transfers object from hand to hand sits with support stands alone walks up stairs with help steadiness of head when placed in supported position 25 / 80 The last menstrual period was June 20th. The expected date of delivery (EDD) is approximately: March 27. April 23. March 23. April 7. March 28. 26 / 80 The second stage of labour involves: Separation of the placenta. Expulsion of the placenta. Effacement of the cervix. Dilation of the cervix. Expulsion of the fetus. 27 / 80 All these conditions cause hypokalemia in children except gastroenteritis pyloric stenosis acute tubular necrosis renal tubular acidosis type 1 frusemide 28 / 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. There is initial vasodilatation followed by vasoconstriction in the burnt tissue. The maximum oedema fluid obtainable is about 10% of the body weight or 50% of total E.C.F. 29 / 80 This is not true about autism most cases have normal intelligence it's characterised by restricted and repetitive behavior 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 30 / 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. Viral hepatitis Sub acute bacterial endocarditis Acute bacterial endocarditis 31 / 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 Gastro-enteritis Acute gastritis Acute pancreatitis Acute high intestinal obstruction 32 / 80 Neonatal resuscitation chest compression is initiated when heart rate is below 100 bpm atropine is administered when heart rate is below 100 bpm clearing airway preceeds keeping baby warm involves administration of iv aminophylline to preterms most effective action is ventilation of the baby's lungs 33 / 80 Molding of the fetal head: Does not happen when maternal pelvis is adequate. Does NOT have time to occur in breech delivery. Usually cause brain damage. Becomes progressively easier as gestational age increase. Increase the difficulty of delivery. 34 / 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. Trochanter, sacrum, coccyx, ilium and pubis Ilium, ischium, pubis, sacrum and coccyx. 35 / 80 Regarding missed abortion, all of the following are CORRECT, EXCEPT: Immediate evacuation should be done once the diagnosis is made Patient may present with loss of the symptoms of pregnancy Per vaginal bleeding may be one of the presenting symptom Disseminated intra-vascular coagulation may occur as a sequele of missed abortion Ultrasound should be done to confirm the diagnosis 36 / 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) 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? Injury to sacral nerve plexus Post renal uraemia Atonic bladder Hypovolaemia 38 / 80 The most effective surgical procedure in stress ulceration is: Polya partial gastrectomy Vogotomy and pyloroplasty with suturing of bleeding points Total gastrectomy Vogitomy and hemigastrectomy 39 / 80 Causes of macrocephaly include the following except thalassaemia mucopolysaccharidosis fetal alcohol syndrome hydrocephalus achondroplasia 40 / 80 In a vertex presentation, the position is determined by the relationship of what fetal part to the Mother's pelvis: Occiput. Acromian. Sacrum. Sinciput. Mentum. 41 / 80 Neuro hormones which are activated in cardiac failure include all EXCEPT: Aldosterone Nordrenaline Thyroxine Brain naturetic protein 42 / 80 The management of retroexposed babies include lamivudine and zidovudine for 6 weeks for high risk babies zidovudine for six months mixed feeding at 1 month PCR at 6 weeks of age cotrimoxazole at birth 43 / 80 The features listed below may be associated with migraine headache EXCEPT Photophobia. Nausea Pulsatile or throbbing headache Neck stiffness may be present 44 / 80 All these conditions cause conjugated hyperbilirubinemia in newborns except galactosemia torch infections sepsis breast milk jaundice biliary atresia 45 / 80 The thyroid gland in thyrotoxicosis: 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 If secondary is firm and multinodular in all patients 46 / 80 The following are causes of spastic paraparesis except; Guillain Barre syndrome Transverse myelitis Disc prolapse Potts disease 47 / 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. 48 / 80 In hypopituitarism all these hormones may be deficient except Prolactin Growth hormone Cholecystokinin Adrenocorticotropic hormone Follicle stimulating hormone 49 / 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? Klebsiella pneumoniae Streptococcus pneumoniae Mycoplasma pneumonia Staphylococcus aureus 50 / 80 The following statement are all TRUE about vomiting in pregnancy, EXCEPT: Associated with multiple pregnancy Is commonest in the third trimester Is associated with trophoblastic disease Is associated with urinary tract infection May be cured by admission to hospital 51 / 80 Antenatal booking investigations include all of the following, EXCEPT: Urine routine examination Complete blood count Hepatitis screening Thyroid function Stool routine examination 52 / 80 Features found in nephrotic syndrome include the following EXCEPT: Oedema Hypertriglyceridemia Hypoalbuminsemia Normal renal function 53 / 80 The commonest site for carcinoma of the tongue is the: Lateral margin Tip Posterior one-third Dorsum 54 / 80 In normal pregnancy, the value of ß-hCG doubles every: 14 days. 2 days. 4 days. 8 days. 10 days. 55 / 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 Hypoglycaemia is present when the blood glucose is <4mmol/l ORS is the fluid of choice for correcting dehydration 56 / 80 Which of these discriptions adequately describe malena stools? Black stools Black tarry or sticky stools Loose very shining black stools Dark stools 57 / 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 Myasthenia gravis Diffuse spasm of the oesophageal muscles Bulbar paralysis 58 / 80 Which of the following anti diabetic drugs increases insulin sensitivity? Metformin Glibenclamide Pioglitazone DPP4 inhibitors 59 / 80 Rupture of membranes is suspected with all of the followings EXCEPT: Pooling of amniotic fluid on speculum examination. Positive Nitrazine test. Observing amniotic fluid drain through the cervix during speculum examination. Contractions seen on the CTG. Positive Fern test. 60 / 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 Forceps or ventose may be useful in slow progress of the late 1st stage 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) 61 / 80 Concerning febrile seizures Main risk factor for recurrence is the temperature at time of seizure. Complex features is not a risk factor for recurrence Overall, 30% develop epilepsy Overall risk for recurrence is 3-4% They usually have a poor prognosis 62 / 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 postero-lateral diaphragmatic hernia (stabilized) Congenital cystic lung disease Congital cyanotic heart disease Emphysematous bullae 63 / 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 Respiratory rate> 30 per minute Diastolic pressure <60 mm Hg. Confusion 64 / 80 On assessment of Semen Fluid Analysis: Azoospermia indicates a sperm count more than 5 million/ml Teratozoospermia indicates abnormal motility Asthenozoospermia indicates abnormal forms 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 65 / 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? Silicosis Carcinoma of the bronchus Left ventricular failure Tuberculosis 66 / 80 The relationship of the long axis of the fetus to the long axis of the mother is called: None of the above. Position. Presentation. Lie. Attitude. 67 / 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. 68 / 80 Cause of neonatal seizures include the following except hypermagnesaemia hypoxic ischaemic encephalopathy intracranial hemorrhage bilirubin encephalopathy pyridoxine deficiency 69 / 80 Facial features of fetal alcohol syndrome include the following except ptosis smooth philtrum microcephaly short palpebral tissue thick upper lip 70 / 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 Amoebic liver abscess Primary liver cell carcinoma Carcinoma of the body of the pancreas Carcinoma of the stomach 71 / 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? Irreducible incomplete inguinal hernia, probably containing omentum Sebaceous cyst of the scrotum Encysted hydrocele of the cord Cyst of the epididymis 72 / 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 Acute tubular necrosis Pre-renal renal failure Post-renal renal failure 73 / 80 Which of the following is NOT a characteristic of normal labour: Increasing intensity of contractions. Moderate pain. Moderate bleeding. Uterine relaxation between contractions. Progressive cervical dilation. 74 / 80 This is not a cause of hypoglycaemia in newborns intrauterine growth retardate hypoinsulinaemia infant of a diabetic mother sepsis prematurity 75 / 80 Adverse effects of corticosteroids include all EXCEPT Euphoria Cataract Avascular necrosis of the hip. Osteomalacia 76 / 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 ? Rapidly progressively glomerulonephriitis Post renal obstruction Acute tubular necrosis Renal artery stenosis 77 / 80 The risk of postpartum uterine atony is associated with: Epidural anesthesia. Hypotension. Labour associated with an active rate of change of 1 cm per hour. Twin pregnancy. Median episiotomy. 78 / 80 The following are contraindications for lumbar puncture except Coagulopathy Acute spinal cord injury skin infection at or near the site of the lumbar puncture Raised intracranial pressure Cervical spondylosis 79 / 80 The heart rate of a normal fetus at term is: 100-120 bpm. 160-180 bpm. 80-100 bpm. There is no baseline heart rate. 120-160 bpm. 80 / 80 The main tissues which provide support to the uterus include: Broad ligaments and the Uterosacral ligaments Perineal body and the Broad ligaments Cardinal ligaments and the Uterosacral ligaments Round ligament and the Broad ligaments Uterosacral ligaments and the Broad ligaments Your score is LinkedIn Facebook Twitter 0% Restart quiz Send feedback