GMDC MOCK 3 /80 26 Quiz 1 / 80 Malignant degeneration of a healing wound is most likely to occur: When iodophor antiseptics are used for dressing. When wounds are exposed to heat. When a state of chronicity from (e.g) recurrent infection prevails. When a patient is on cytotoxic agents. 2 / 80 The management of retroexposed babies include cotrimoxazole at birth PCR at 6 weeks of age mixed feeding at 1 month lamivudine and zidovudine for 6 weeks for high risk babies zidovudine for six months 3 / 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 Viral hepatitis Acute rheumatic carditis. Sub acute bacterial endocarditis 4 / 80 Molding of the fetal head: Does NOT have time to occur in breech delivery. Increase the difficulty of delivery. Does not happen when maternal pelvis is adequate. Becomes progressively easier as gestational age increase. Usually cause brain damage. 5 / 80 Which of these pairs does not match with regards to neurocutaneous disorders. café - au-lait spots and neurofibromatosis shagreen patch and tuberous sclerosis port wine stain and sturge weber syndrome adenoma sebaceum and tuberous sclerosis cortical tuber in neurofibromatosis 6 / 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. Paralysis of lower facial muscles on the left. May cause incontinence of urine 7 / 80 A bloody nipple discharge in a 35 year old West African is most likely to be caused by: Scirrhous breast carcinoma Intraductal comedo-carcinoma Chronic breast abscess Duct ectasia 8 / 80 The following are contraindications for lumbar puncture except Acute spinal cord injury Raised intracranial pressure Cervical spondylosis skin infection at or near the site of the lumbar puncture Coagulopathy 9 / 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 Post-renal renal failure Acute tubular necrosis 10 / 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 Tuberculosis Silicosis Carcinoma of the bronchus 11 / 80 The following are associated with oral candidiasis except; Retroviral infection Glucose 6 Phosphate Dehydrogenase Lymphoma Malignancy 12 / 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 13 / 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 14 / 80 Adverse effects of corticosteroids include all EXCEPT Cataract Euphoria Avascular necrosis of the hip. Osteomalacia 15 / 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 16 / 80 Cause of ptosis include the following except myasthenia gravis horner syndrome tick paralysis botulism 4th nerve palsy 17 / 80 The pelvis includes which of the following bones: Trochanter, sacrum, coccyx, ilium and pubis Trochanter, hip socket, ischium, sacrum and pubis. Ilium, scapula, ischium and pubis. Ilium, ischium, pubis, sacrum and coccyx. Sacrum, Tibia, ilium and pubis. 18 / 80 Squamous cell carcinoma of the anus: Usually presents as a localized ulcer with sloping edges 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 19 / 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 . 20 / 80 Which of the following patients should you prescribe aspirin if there is no contraindication. Select the MOST appropriate Any patient with hypertension and aged over 50 years 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. All the answers below 21 / 80 Which of the following anti diabetic drugs increases insulin sensitivity? Metformin DPP4 inhibitors Glibenclamide Pioglitazone 22 / 80 Causes of macrocephaly include the following except achondroplasia fetal alcohol syndrome hydrocephalus mucopolysaccharidosis thalassaemia 23 / 80 The relationship of the long axis of the fetus to the long axis of the mother is called: Position. Attitude. Presentation. None of the above. Lie. 24 / 80 The following statement are all TRUE about vomiting in pregnancy, EXCEPT: Associated with multiple pregnancy May be cured by admission to hospital Is commonest in the third trimester Is associated with trophoblastic disease Is associated with urinary tract infection 25 / 80 Cause of neonatal seizures include the following except intracranial hemorrhage hypermagnesaemia pyridoxine deficiency hypoxic ischaemic encephalopathy bilirubin encephalopathy 26 / 80 The heart rate of a normal fetus at term is: 100-120 bpm. 80-100 bpm. 160-180 bpm. 120-160 bpm. There is no baseline heart rate. 27 / 80 These are gross motor skills except steadiness of head when placed in supported position sits with support transfers object from hand to hand walks up stairs with help stands alone 28 / 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 Diffuse spasm of the oesophageal muscles Bulbar paralysis Myasthenia gravis 29 / 80 The most common route of primary infection with Mycobacterium Tuberculosis is: Directly to the lung tissue establishing a Primary Complex (Gohn focus) Through the tonsils to the cervical lymph nodes. The genitourinary mucosa-urethra and bladder. Via the payer's patches to the mesenteric lymph nodes. 30 / 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 Streptococcus pneumoniae Staphylococcus aureus Klebsiella pneumoniae 31 / 80 Regarding Hyperemesis gravidarum, which one of the following items is TRUE? Urine for culture and sensitivity is not important Worsen in missed abortion Is a complication of multiple pregnancy Liver function test is not required Not known to happen in molar pregnancy 32 / 80 In burns: The maximum oedema fluid obtainable is about 10% of the body weight or 50% of total E.C.F. The increased capillary permeability is restricted to the burnt area. There is initial vasodilatation followed by vasoconstriction in the burnt tissue. The rate of fluid exudation from the capillaries is highest in the first 4 hours and falls in 48 hours. 33 / 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 Gastro-enteritis Acute gastritis Acute pancreatitis 34 / 80 Which of the following is not part of the criteria considered for CURB 65 used to determine the severity of community pneumonia. Respiratory rate> 30 per minute Confusion Heart rate >100 Diastolic pressure <60 mm Hg. 35 / 80 The main tissues which provide support to the uterus include: Broad ligaments and the Uterosacral ligaments Cardinal ligaments and the Uterosacral ligaments Perineal body and the Broad ligaments Round ligament and the Broad ligaments Uterosacral ligaments and the Broad ligaments 36 / 80 Which one of the drugs or measures do not worsen uraemia? Diarrhoea Paracetamol Gentamycin Hypotension 37 / 80 These are causes of acute stridor except laryngomalacia acute epiglottitis diphtheria bacterial tracheitis croup 38 / 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 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 Forceps or ventose may be useful in slow progress of the late 1st stage 39 / 80 This is not true about autism commoner in males than in females with a male:female ratio of 3:1 it is pervasive developmental disorder most cases have normal intelligence it's characterised by restricted and repetitive behavior there is severe language and speech developmental disorder 40 / 80 The following are treatment for simple malaria except artemether - lumefantrine dihydroartemisinin - lumefantrine artesunate - amodiaquine dihydroartemisinin - piperaquine oral quinine 41 / 80 Regarding missed abortion, all of the following are CORRECT, EXCEPT: Disseminated intra-vascular coagulation may occur as a sequele of missed abortion Ultrasound should be done to confirm the diagnosis 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 42 / 80 All these conditions cause conjugated hyperbilirubinemia in newborns except breast milk jaundice biliary atresia torch infections sepsis galactosemia 43 / 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 Injury to sacral nerve plexus Atonic bladder Post renal uraemia 44 / 80 Which of these discriptions adequately describe malena stools? Black tarry or sticky stools Loose very shining black stools Dark stools Black stools 45 / 80 The prime cause of a venous leg ulcer is: Failure of valves of the perforating and deep veins Stasis in the deep veins Varicosity of the long (greater) saphenous vein High venous pressure in the leg veins generally 46 / 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 47 / 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 Primary liver cell carcinoma Amoebic liver abscess Carcinoma of the body of the pancreas 48 / 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 Supracondylar fracture Fracture of the olecranon process Monteggia fracture dislocation Dislocation of the elbow 49 / 80 The source of progesterone that maintains the pregnancy during early 1st trimester is: Adrenal glands. Endometrium. Corpus albicans. Placenta. Corpus luteum. 50 / 80 Antenatal booking investigations include all of the following, EXCEPT: Urine routine examination Complete blood count Thyroid function Stool routine examination Hepatitis screening 51 / 80 In normal pregnancy, the value of ß-hCG doubles every: 2 days. 10 days. 14 days. 4 days. 8 days. 52 / 80 Neuro hormones which are activated in cardiac failure include all EXCEPT: Aldosterone Thyroxine Brain naturetic protein Nordrenaline 53 / 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 Strapping of the affected side of the chest Blockage of the appropriate intercostal nerve and active physiotherapy Watchful administration of adequate doses of systemic analgesic agent 54 / 80 The thyroid gland in thyrotoxicosis: If primary is uniformly enlarged and rather soft or firm If secondary is firm and multinodular in all patients In over 95 percent has a thrill and a bruit over it Is enlarged in all patients so affected 55 / 80 The following are causes of spastic paraparesis except; Disc prolapse Transverse myelitis Potts disease Guillain Barre syndrome 56 / 80 The second stage of labour involves: Dilation of the cervix. Expulsion of the placenta. Effacement of the cervix. Expulsion of the fetus. Separation of the placenta. 57 / 80 The commonest site for carcinoma of the tongue is the: Dorsum Tip Posterior one-third Lateral margin 58 / 80 An ectopic pregnancy: Pain always presents before the bleeding Usually presents with pain before bleeding Occurs only in the fallopian tubes Gives an increased risk of Hyperemisis Gravidarium Can only be treated surgically 59 / 80 The last menstrual period was June 20th. The expected date of delivery (EDD) is approximately: March 23. March 27. April 23. April 7. March 28. 60 / 80 The most effective surgical procedure in stress ulceration is: Vogitomy and hemigastrectomy Vogotomy and pyloroplasty with suturing of bleeding points Polya partial gastrectomy Total gastrectomy 61 / 80 In bronchiolitis, all these are true except drug of choice is acyclovir it's usually a self-limiting disease most commonly caused by respiratory syncytial virus primarily affects children less than 2 years old may present with with low grade fever 62 / 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 Endothelial cell secretion of factor VIII Retraction of the injured vessel 63 / 80 The risk of postpartum uterine atony is associated with: Epidural anesthesia. Twin pregnancy. Median episiotomy. Labour associated with an active rate of change of 1 cm per hour. Hypotension. 64 / 80 Which of the following is NOT a characteristic of normal labour: Moderate bleeding. Uterine relaxation between contractions. Increasing intensity of contractions. Moderate pain. Progressive cervical dilation. 65 / 80 Features found in nephrotic syndrome include the following EXCEPT: Hypertriglyceridemia Normal renal function Oedema Hypoalbuminsemia 66 / 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 Glove puncture in the course of surgery Preoperative showering for the patient Age of the patient 67 / 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 Acute tubular necrosis Post renal obstruction Renal artery stenosis 68 / 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. Positive Fern test. Contractions seen on the CTG. Positive Nitrazine test. 69 / 80 The features listed below may be associated with migraine headache EXCEPT Neck stiffness may be present Pulsatile or throbbing headache Nausea Photophobia. 70 / 80 These are chronic complications associated with sickle cell disease except priapism chronic lung disease aseptic necrosis of the hip or shoulder leg ulcers congestive heart failure 71 / 80 All these conditions cause hypokalemia in children except frusemide renal tubular acidosis type 1 acute tubular necrosis gastroenteritis pyloric stenosis 72 / 80 On assessment of Semen Fluid Analysis: Abstinence should be maintained for 3 days prior to production of the sample Asthenozoospermia indicates abnormal forms Teratozoospermia indicates abnormal motility Abstinence should be maintained for 10 days prior to "production" of the sample Azoospermia indicates a sperm count more than 5 million/ml 73 / 80 Neonatal resuscitation clearing airway preceeds keeping baby warm 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 atropine is administered when heart rate is below 100 bpm 74 / 80 Facial features of fetal alcohol syndrome include the following except thick upper lip ptosis smooth philtrum microcephaly short palpebral tissue 75 / 80 In a vertex presentation, the position is determined by the relationship of what fetal part to the Mother's pelvis: Sinciput. Occiput. Sacrum. Acromian. Mentum. 76 / 80 In hypopituitarism all these hormones may be deficient except Growth hormone Follicle stimulating hormone Cholecystokinin Adrenocorticotropic hormone Prolactin 77 / 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) Emphysematous bullae Congenital cystic lung disease Congital cyanotic heart disease 78 / 80 About severe acute malnutrition (SAM). There is usually unilateral pitting pedal oedema sensory stimulation is not helpful Diagnostic features include mid upper arm circumference < 115mm ORS is the fluid of choice for correcting dehydration Hypoglycaemia is present when the blood glucose is <4mmol/l 79 / 80 This is not a cause of hypoglycaemia in newborns prematurity infant of a diabetic mother intrauterine growth retardate hypoinsulinaemia sepsis 80 / 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 Your score is LinkedIn Facebook VKontakte 0% Restart quiz Send feedback