GMDC MOCK 3 /80 26 Quiz 1 / 80 Adverse effects of corticosteroids include all EXCEPT Osteomalacia Avascular necrosis of the hip. Cataract Euphoria 2 / 80 The most common route of primary infection with Mycobacterium Tuberculosis is: The genitourinary mucosa-urethra and bladder. Through the tonsils to the cervical lymph nodes. Via the payer's patches to the mesenteric lymph nodes. Directly to the lung tissue establishing a Primary Complex (Gohn focus) 3 / 80 The features listed below may be associated with migraine headache EXCEPT Photophobia. Neck stiffness may be present Pulsatile or throbbing headache Nausea 4 / 80 On assessment of Semen Fluid Analysis: Azoospermia indicates a sperm count more than 5 million/ml Abstinence should be maintained for 3 days prior to production of the sample Teratozoospermia indicates abnormal motility Asthenozoospermia indicates abnormal forms Abstinence should be maintained for 10 days prior to "production" of the sample 5 / 80 Neuro hormones which are activated in cardiac failure include all EXCEPT: Nordrenaline Brain naturetic protein Aldosterone Thyroxine 6 / 80 Regarding missed abortion, all of the following are CORRECT, EXCEPT: Immediate evacuation should be done once the diagnosis is made Per vaginal bleeding may be one of the presenting symptom Patient may present with loss of the symptoms of pregnancy Ultrasound should be done to confirm the diagnosis Disseminated intra-vascular coagulation may occur as a sequele of missed abortion 7 / 80 The risk of postpartum uterine atony is associated with: Median episiotomy. Hypotension. Labour associated with an active rate of change of 1 cm per hour. Epidural anesthesia. Twin pregnancy. 8 / 80 Facial features of fetal alcohol syndrome include the following except short palpebral tissue smooth philtrum ptosis microcephaly thick upper lip 9 / 80 The following are treatment for simple malaria except artemether - lumefantrine dihydroartemisinin - lumefantrine dihydroartemisinin - piperaquine oral quinine artesunate - amodiaquine 10 / 80 The most effective surgical procedure in stress ulceration is: Vogotomy and pyloroplasty with suturing of bleeding points Polya partial gastrectomy Vogitomy and hemigastrectomy Total gastrectomy 11 / 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 The first stage commences at the time of membrane rupture 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) 12 / 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: Congital cyanotic heart disease Emphysematous bullae Congenital postero-lateral diaphragmatic hernia (stabilized) Congenital cystic lung disease 13 / 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 14 / 80 The thyroid gland in thyrotoxicosis: Is enlarged in all patients so affected If primary is uniformly enlarged and rather soft or firm In over 95 percent has a thrill and a bruit over it If secondary is firm and multinodular in all patients 15 / 80 The main tissues which provide support to the uterus include: Perineal body and the Broad ligaments Round ligament and the Broad ligaments Cardinal ligaments and the Uterosacral ligaments Uterosacral ligaments and the Broad ligaments Broad ligaments and the Uterosacral ligaments 16 / 80 In intestinal obstruction at the sigmoid colon due to stenosis, perforation is most likely to occur in the Descending colon Terminal ileum Caecum Transverse colon 17 / 80 The commonest site for carcinoma of the tongue is the: Dorsum Posterior one-third Tip Lateral margin 18 / 80 For adequate and stable haemostasis the following should obtain: A minimum platelet count of 90,000 per mm3 Endothelial cell secretion of factor VIII Increased pressure within the injured vessel Retraction of the injured vessel 19 / 80 The following are contraindications for lumbar puncture except skin infection at or near the site of the lumbar puncture Coagulopathy Cervical spondylosis Acute spinal cord injury Raised intracranial pressure 20 / 80 About severe acute malnutrition (SAM). Diagnostic features include mid upper arm circumference < 115mm ORS is the fluid of choice for correcting dehydration There is usually unilateral pitting pedal oedema Hypoglycaemia is present when the blood glucose is <4mmol/l sensory stimulation is not helpful 21 / 80 The last menstrual period was June 20th. The expected date of delivery (EDD) is approximately: March 27. April 23. April 7. March 23. March 28. 22 / 80 Antenatal booking investigations include all of the following, EXCEPT: Stool routine examination Hepatitis screening Complete blood count Urine routine examination Thyroid function 23 / 80 Which of these discriptions adequately describe malena stools? Black stools Dark stools Black tarry or sticky stools Loose very shining black stools 24 / 80 Molding of the fetal head: Becomes progressively easier as gestational age increase. Usually cause brain damage. Does NOT have time to occur in breech delivery. Increase the difficulty of delivery. Does not happen when maternal pelvis is adequate. 25 / 80 In a vertex presentation, the position is determined by the relationship of what fetal part to the Mother's pelvis: Mentum. Sacrum. Occiput. Acromian. Sinciput. 26 / 80 Cause of neonatal seizures include the following except bilirubin encephalopathy intracranial hemorrhage hypoxic ischaemic encephalopathy hypermagnesaemia pyridoxine deficiency 27 / 80 These are gross motor skills except stands alone sits with support steadiness of head when placed in supported position walks up stairs with help transfers object from hand to hand 28 / 80 The source of progesterone that maintains the pregnancy during early 1st trimester is: Corpus luteum. Endometrium. Corpus albicans. Adrenal glands. Placenta. 29 / 80 In hypopituitarism all these hormones may be deficient except Follicle stimulating hormone Cholecystokinin Prolactin Growth hormone Adrenocorticotropic hormone 30 / 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 Confusion Diastolic pressure <60 mm Hg. Respiratory rate> 30 per minute 31 / 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 32 / 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 33 / 80 This is not a cause of hypoglycaemia in newborns prematurity sepsis infant of a diabetic mother hypoinsulinaemia intrauterine growth retardate 34 / 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 Urinary tract infection Haemolysis 35 / 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 Supracondylar fracture Monteggia fracture dislocation Dislocation of the elbow 36 / 80 A bloody nipple discharge in a 35 year old West African is most likely to be caused by: Duct ectasia Scirrhous breast carcinoma Intraductal comedo-carcinoma Chronic breast abscess 37 / 80 Causes of macrocephaly include the following except mucopolysaccharidosis fetal alcohol syndrome thalassaemia achondroplasia hydrocephalus 38 / 80 All these conditions cause hypokalemia in children except pyloric stenosis frusemide gastroenteritis acute tubular necrosis renal tubular acidosis type 1 39 / 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 Tuberculosis Carcinoma of the bronchus Left ventricular failure 40 / 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 Sebaceous cyst of the scrotum Encysted hydrocele of the cord Irreducible incomplete inguinal hernia, probably containing omentum 41 / 80 Which of the following is NOT a characteristic of normal labour: Moderate bleeding. Moderate pain. Uterine relaxation between contractions. Progressive cervical dilation. Increasing intensity of contractions. 42 / 80 Which of the following anti diabetic drugs increases insulin sensitivity? Glibenclamide DPP4 inhibitors Metformin Pioglitazone 43 / 80 The second stage of labour involves: Expulsion of the fetus. Dilation of the cervix. Expulsion of the placenta. Effacement of the cervix. Separation of the placenta. 44 / 80 In bronchiolitis, all these are true except primarily affects children less than 2 years old may present with with low grade fever drug of choice is acyclovir it's usually a self-limiting disease most commonly caused by respiratory syncytial virus 45 / 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? Viral hepatitis Acute bacterial endocarditis Acute rheumatic carditis. Sub acute bacterial endocarditis 46 / 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. 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 47 / 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 48 / 80 Rupture of membranes is suspected with all of the followings EXCEPT: Positive Fern test. Observing amniotic fluid drain through the cervix during speculum examination. Positive Nitrazine test. Pooling of amniotic fluid on speculum examination. Contractions seen on the CTG. 49 / 80 The following are causes of spastic paraparesis except; Transverse myelitis Guillain Barre syndrome Disc prolapse Potts disease 50 / 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 Blockage of the appropriate intercostal nerve and active physiotherapy Strapping of the affected side of the chest External fixation 51 / 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 52 / 80 Cause of ptosis include the following except horner syndrome myasthenia gravis botulism tick paralysis 4th nerve palsy 53 / 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? Streptococcus pneumoniae Mycoplasma pneumonia Staphylococcus aureus Klebsiella pneumoniae 54 / 80 Which of these pairs does not match with regards to neurocutaneous disorders. port wine stain and sturge weber syndrome cortical tuber in neurofibromatosis shagreen patch and tuberous sclerosis adenoma sebaceum and tuberous sclerosis café - au-lait spots and neurofibromatosis 55 / 80 All these conditions cause conjugated hyperbilirubinemia in newborns except sepsis breast milk jaundice galactosemia torch infections biliary atresia 56 / 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. 57 / 80 This is not true about autism commoner in males than in females with a male:female ratio of 3:1 most cases have normal intelligence it is pervasive developmental disorder it's characterised by restricted and repetitive behavior there is severe language and speech developmental disorder 58 / 80 The heart rate of a normal fetus at term is: 100-120 bpm. There is no baseline heart rate. 160-180 bpm. 80-100 bpm. 120-160 bpm. 59 / 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 ? Post renal obstruction Rapidly progressively glomerulonephriitis Renal artery stenosis Acute tubular necrosis 60 / 80 Neonatal resuscitation involves administration of iv aminophylline to preterms most effective action is ventilation of the baby's lungs atropine is administered when heart rate is below 100 bpm clearing airway preceeds keeping baby warm chest compression is initiated when heart rate is below 100 bpm 61 / 80 Which one of the drugs or measures do not worsen uraemia? Hypotension Paracetamol Diarrhoea Gentamycin 62 / 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 63 / 80 The relationship of the long axis of the fetus to the long axis of the mother is called: Lie. Position. Presentation. None of the above. Attitude. 64 / 80 The prime cause of a venous leg ulcer is: Varicosity of the long (greater) saphenous vein Failure of valves of the perforating and deep veins High venous pressure in the leg veins generally Stasis in the deep veins 65 / 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 Atonic bladder Injury to sacral nerve plexus Post renal uraemia 66 / 80 An ectopic pregnancy: Usually presents with pain before bleeding Can only be treated surgically Gives an increased risk of Hyperemisis Gravidarium Occurs only in the fallopian tubes Pain always presents before the bleeding 67 / 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 stomach Carcinoma of the body of the pancreas 68 / 80 These are causes of acute stridor except bacterial tracheitis diphtheria croup laryngomalacia acute epiglottitis 69 / 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 Pre-renal renal failure Post-renal renal failure Acute tubular necrosis 70 / 80 Concerning febrile seizures Overall, 30% develop epilepsy Overall risk for recurrence is 3-4% They usually have a poor prognosis Complex features is not a risk factor for recurrence Main risk factor for recurrence is the temperature at time of seizure. 71 / 80 The management of retroexposed babies include lamivudine and zidovudine for 6 weeks for high risk babies mixed feeding at 1 month PCR at 6 weeks of age cotrimoxazole at birth zidovudine for six months 72 / 80 Features found in nephrotic syndrome include the following EXCEPT: Hypertriglyceridemia Hypoalbuminsemia Normal renal function Oedema 73 / 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 74 / 80 The following are associated with oral candidiasis except; Lymphoma Malignancy Retroviral infection Glucose 6 Phosphate Dehydrogenase 75 / 80 The following statement are all TRUE about vomiting in pregnancy, EXCEPT: Associated with multiple pregnancy Is associated with urinary tract infection May be cured by admission to hospital Is commonest in the third trimester Is associated with trophoblastic disease 76 / 80 In normal pregnancy, the value of ß-hCG doubles every: 10 days. 14 days. 2 days. 4 days. 8 days. 77 / 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. 78 / 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 Bacterial content of the wound at end of operation Age of the patient Preoperative showering for the patient 79 / 80 The pelvis includes which of the following bones: Trochanter, sacrum, coccyx, ilium and pubis Ilium, scapula, ischium and pubis. Trochanter, hip socket, ischium, sacrum and pubis. Sacrum, Tibia, ilium and pubis. Ilium, ischium, pubis, sacrum and coccyx. 80 / 80 Which of the of the following is a LEAST likely presentations of myocardial infarction ? Severe crushing pain in the precordium No chest pain in an elderly female diabetic Sharp piercing pain in the left which worsens with breathing Shock . Your score is LinkedIn Facebook Twitter 0% Restart quiz Send feedback