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