GMDC MOCK 3 /80 26 Quiz 1 / 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 2 / 80 The following are associated with oral candidiasis except; Malignancy Lymphoma Retroviral infection Glucose 6 Phosphate Dehydrogenase 3 / 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 hypertension and aged over 50 years 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 4 / 80 Neonatal resuscitation involves administration of iv aminophylline to preterms most effective action is ventilation of the baby's lungs 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 5 / 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. Heart rate >100 Confusion Respiratory rate> 30 per minute 6 / 80 An ectopic pregnancy: Can only be treated surgically Occurs only in the fallopian tubes Usually presents with pain before bleeding Pain always presents before the bleeding Gives an increased risk of Hyperemisis Gravidarium 7 / 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 8 / 80 All these conditions cause conjugated hyperbilirubinemia in newborns except torch infections biliary atresia sepsis breast milk jaundice galactosemia 9 / 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 Staphylococcus aureus Streptococcus pneumoniae Klebsiella pneumoniae 10 / 80 Facial features of fetal alcohol syndrome include the following except smooth philtrum ptosis short palpebral tissue thick upper lip microcephaly 11 / 80 The last menstrual period was June 20th. The expected date of delivery (EDD) is approximately: March 23. March 27. April 23. March 28. April 7. 12 / 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 Atonic bladder Injury to sacral nerve plexus 13 / 80 Causes of macrocephaly include the following except fetal alcohol syndrome thalassaemia achondroplasia mucopolysaccharidosis hydrocephalus 14 / 80 The pelvis includes which of the following bones: Ilium, scapula, ischium and pubis. Trochanter, hip socket, ischium, sacrum and pubis. Trochanter, sacrum, coccyx, ilium and pubis Ilium, ischium, pubis, sacrum and coccyx. Sacrum, Tibia, ilium and pubis. 15 / 80 The second stage of labour involves: Expulsion of the fetus. Expulsion of the placenta. Dilation of the cervix. Effacement of the cervix. Separation of the placenta. 16 / 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) Congital cyanotic heart disease Congenital cystic lung disease Emphysematous bullae 17 / 80 These are chronic complications associated with sickle cell disease except priapism congestive heart failure aseptic necrosis of the hip or shoulder leg ulcers chronic lung disease 18 / 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 Preoperative showering for the patient Bacterial content of the wound at end of operation 19 / 80 Which one of the drugs or measures do not worsen uraemia? Paracetamol Diarrhoea Gentamycin Hypotension 20 / 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. They usually have a poor prognosis Complex features is not a risk factor for recurrence 21 / 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 Carcinoma of the stomach Amoebic liver abscess Carcinoma of the body of the pancreas Primary liver cell carcinoma 22 / 80 The thyroid gland in thyrotoxicosis: In over 95 percent has a thrill and a bruit over it If secondary is firm and multinodular in all patients Is enlarged in all patients so affected If primary is uniformly enlarged and rather soft or firm 23 / 80 The commonest site for carcinoma of the tongue is the: Tip Dorsum Lateral margin Posterior one-third 24 / 80 The main tissues which provide support to the uterus include: Cardinal ligaments and the Uterosacral ligaments Round ligament and the Broad ligaments Uterosacral ligaments and the Broad ligaments Broad ligaments and the Uterosacral ligaments Perineal body and the Broad ligaments 25 / 80 A bloody nipple discharge in a 35 year old West African is most likely to be caused by: Scirrhous breast carcinoma Chronic breast abscess Duct ectasia Intraductal comedo-carcinoma 26 / 80 The following statement are all TRUE about vomiting in pregnancy, EXCEPT: Is commonest in the third trimester May be cured by admission to hospital Is associated with urinary tract infection Associated with multiple pregnancy Is associated with trophoblastic disease 27 / 80 The following are causes of spastic paraparesis except; Transverse myelitis Potts disease Disc prolapse Guillain Barre syndrome 28 / 80 These are gross motor skills except walks up stairs with help stands alone transfers object from hand to hand sits with support steadiness of head when placed in supported position 29 / 80 These are causes of acute stridor except croup diphtheria acute epiglottitis bacterial tracheitis laryngomalacia 30 / 80 The following are contraindications for lumbar puncture except Cervical spondylosis Coagulopathy Acute spinal cord injury Raised intracranial pressure skin infection at or near the site of the lumbar puncture 31 / 80 Cause of ptosis include the following except botulism tick paralysis horner syndrome 4th nerve palsy myasthenia gravis 32 / 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 Monteggia fracture dislocation Supracondylar fracture 33 / 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 Scleroderma Myasthenia gravis Bulbar paralysis 34 / 80 The features listed below may be associated with migraine headache EXCEPT Photophobia. Nausea Pulsatile or throbbing headache Neck stiffness may be present 35 / 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 Abstinence should be maintained for 10 days prior to "production" of the sample Teratozoospermia indicates abnormal motility Asthenozoospermia indicates abnormal forms 36 / 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 Cyst of the epididymis Encysted hydrocele of the cord Sebaceous cyst of the scrotum 37 / 80 Which of the following is NOT a characteristic of normal labour: Moderate bleeding. Increasing intensity of contractions. Progressive cervical dilation. Moderate pain. Uterine relaxation between contractions. 38 / 80 Neuro hormones which are activated in cardiac failure include all EXCEPT: Nordrenaline Thyroxine Brain naturetic protein Aldosterone 39 / 80 Which of these discriptions adequately describe malena stools? Black tarry or sticky stools Dark stools Loose very shining black stools Black stools 40 / 80 Squamous cell carcinoma 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 Is the commonest malignant tumour of the anus Usually presents as a localized ulcer with sloping edges 41 / 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 renal failure Acute tubular necrosis Post-renal renal failure 42 / 80 The heart rate of a normal fetus at term is: 160-180 bpm. 100-120 bpm. There is no baseline heart rate. 80-100 bpm. 120-160 bpm. 43 / 80 The most effective surgical procedure in stress ulceration is: Vogotomy and pyloroplasty with suturing of bleeding points Total gastrectomy Polya partial gastrectomy Vogitomy and hemigastrectomy 44 / 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 45 / 80 In bronchiolitis, all these are true except most commonly caused by respiratory syncytial virus may present with with low grade fever drug of choice is acyclovir primarily affects children less than 2 years old it's usually a self-limiting disease 46 / 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: Strapping of the affected side of the chest External fixation Watchful administration of adequate doses of systemic analgesic agent Blockage of the appropriate intercostal nerve and active physiotherapy 47 / 80 In intestinal obstruction at the sigmoid colon due to stenosis, perforation is most likely to occur in the Terminal ileum Transverse colon Caecum Descending colon 48 / 80 About severe acute malnutrition (SAM). Hypoglycaemia is present when the blood glucose is <4mmol/l 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 49 / 80 All these conditions cause hypokalemia in children except acute tubular necrosis pyloric stenosis renal tubular acidosis type 1 frusemide gastroenteritis 50 / 80 Rupture of membranes is suspected with all of the followings EXCEPT: Observing amniotic fluid drain through the cervix during speculum examination. Contractions seen on the CTG. Positive Fern test. Positive Nitrazine test. Pooling of amniotic fluid on speculum examination. 51 / 80 In hypopituitarism all these hormones may be deficient except Follicle stimulating hormone Adrenocorticotropic hormone Prolactin Cholecystokinin Growth hormone 52 / 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 amlodipine therapy. Start him on nifedipine XL 30 mg once a day Refer him to the specialist for investigations. to observe his blood pressure for a further 10 months before initiating treatment . 53 / 80 The risk of postpartum uterine atony is associated with: Hypotension. Labour associated with an active rate of change of 1 cm per hour. Epidural anesthesia. Twin pregnancy. Median episiotomy. 54 / 80 The source of progesterone that maintains the pregnancy during early 1st trimester is: Endometrium. Corpus albicans. Adrenal glands. Placenta. Corpus luteum. 55 / 80 For adequate and stable haemostasis the following should obtain: Increased pressure within the injured vessel Endothelial cell secretion of factor VIII A minimum platelet count of 90,000 per mm3 Retraction of the injured vessel 56 / 80 This is not a cause of hypoglycaemia in newborns infant of a diabetic mother hypoinsulinaemia sepsis prematurity intrauterine growth retardate 57 / 80 Which of the following anti diabetic drugs increases insulin sensitivity? Metformin DPP4 inhibitors Pioglitazone Glibenclamide 58 / 80 Molding of the fetal head: Increase the difficulty of delivery. Becomes progressively easier as gestational age increase. Does not happen when maternal pelvis is adequate. Usually cause brain damage. Does NOT have time to occur in breech delivery. 59 / 80 Adverse effects of corticosteroids include all EXCEPT Cataract Avascular necrosis of the hip. Osteomalacia Euphoria 60 / 80 In a vertex presentation, the position is determined by the relationship of what fetal part to the Mother's pelvis: Acromian. Sacrum. Occiput. Sinciput. Mentum. 61 / 80 Which of these pairs does not match with regards to neurocutaneous disorders. port wine stain and sturge weber syndrome cortical tuber in neurofibromatosis café - au-lait spots and neurofibromatosis shagreen patch and tuberous sclerosis adenoma sebaceum and tuberous sclerosis 62 / 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 most cases have normal intelligence it is pervasive developmental disorder there is severe language and speech developmental disorder 63 / 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 64 / 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. 65 / 80 In normal pregnancy, the value of ß-hCG doubles every: 8 days. 2 days. 10 days. 4 days. 14 days. 66 / 80 Malignant degeneration of a healing wound is most likely to occur: When a state of chronicity from (e.g) recurrent infection prevails. When a patient is on cytotoxic agents. When iodophor antiseptics are used for dressing. When wounds are exposed to heat. 67 / 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 Severe crushing pain in the precordium No chest pain in an elderly female diabetic Shock . 68 / 80 Stages of labour 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 The cervix dilates at consistent rate of 3 cm per hour in the first stage 69 / 80 Antenatal booking investigations include all of the following, EXCEPT: Urine routine examination Hepatitis screening Stool routine examination Thyroid function Complete blood count 70 / 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 ? Renal artery stenosis Post renal obstruction Rapidly progressively glomerulonephriitis Acute tubular necrosis 71 / 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 72 / 80 Features found in nephrotic syndrome include the following EXCEPT: Hypertriglyceridemia Hypoalbuminsemia Normal renal function Oedema 73 / 80 The following are treatment for simple malaria except dihydroartemisinin - lumefantrine dihydroartemisinin - piperaquine oral quinine artesunate - amodiaquine artemether - lumefantrine 74 / 80 Regarding Hyperemesis gravidarum, which one of the following items is TRUE? Urine for culture and sensitivity is not important Worsen in missed abortion Liver function test is not required Not known to happen in molar pregnancy Is a complication of multiple pregnancy 75 / 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 76 / 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 Acute bacterial endocarditis Sub acute bacterial endocarditis 77 / 80 The most common route of primary infection with Mycobacterium Tuberculosis is: Through the tonsils to the cervical lymph nodes. Directly to the lung tissue establishing a Primary Complex (Gohn focus) Via the payer's patches to the mesenteric lymph nodes. The genitourinary mucosa-urethra and bladder. 78 / 80 The relationship of the long axis of the fetus to the long axis of the mother is called: Position. Lie. Presentation. None of the above. Attitude. 79 / 80 Cause of neonatal seizures include the following except intracranial hemorrhage pyridoxine deficiency bilirubin encephalopathy hypermagnesaemia hypoxic ischaemic encephalopathy 80 / 80 The management of retroexposed babies include lamivudine and zidovudine for 6 weeks for high risk babies zidovudine for six months PCR at 6 weeks of age cotrimoxazole at birth mixed feeding at 1 month Your score is LinkedIn Facebook VKontakte 0% Restart quiz Send feedback