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