GMDC MOCK 3 /80 26 Quiz 1 / 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 2 / 80 In bronchiolitis, all these are true except drug of choice is acyclovir most commonly caused by respiratory syncytial virus it's usually a self-limiting disease primarily affects children less than 2 years old may present with with low grade fever 3 / 80 Which one of the drugs or measures do not worsen uraemia? Paracetamol Diarrhoea Gentamycin Hypotension 4 / 80 All these conditions cause conjugated hyperbilirubinemia in newborns except galactosemia biliary atresia sepsis torch infections breast milk jaundice 5 / 80 This is not true about autism most cases have normal intelligence there is severe language and speech developmental disorder it is pervasive developmental disorder it's characterised by restricted and repetitive behavior commoner in males than in females with a male:female ratio of 3:1 6 / 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 Shock . No chest pain in an elderly female diabetic Severe crushing pain in the precordium 7 / 80 These are gross motor skills except sits with support transfers object from hand to hand steadiness of head when placed in supported position walks up stairs with help stands alone 8 / 80 Which of these discriptions adequately describe malena stools? Black tarry or sticky stools Black stools Loose very shining black stools Dark stools 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? Klebsiella pneumoniae Streptococcus pneumoniae Mycoplasma pneumonia Staphylococcus aureus 10 / 80 All these conditions cause hypokalemia in children except renal tubular acidosis type 1 acute tubular necrosis gastroenteritis frusemide pyloric stenosis 11 / 80 The pelvis includes which of the following bones: Sacrum, Tibia, ilium and pubis. Ilium, ischium, pubis, sacrum and coccyx. Ilium, scapula, ischium and pubis. Trochanter, sacrum, coccyx, ilium and pubis Trochanter, hip socket, ischium, sacrum and pubis. 12 / 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 Rapidly progressively glomerulonephriitis Acute tubular necrosis Post renal obstruction 13 / 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 14 / 80 The following are associated with oral candidiasis except; Retroviral infection Glucose 6 Phosphate Dehydrogenase Lymphoma Malignancy 15 / 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 rheumatic carditis. Sub acute bacterial endocarditis Acute bacterial endocarditis 16 / 80 The features listed below may be associated with migraine headache EXCEPT Neck stiffness may be present Pulsatile or throbbing headache Photophobia. Nausea 17 / 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 pancreatitis Acute gastritis 18 / 80 Stages of labour The cervix dilates at consistent rate of 3 cm per hour in the first stage The first stage commences at the time of membrane rupture 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) Forceps or ventose may be useful in slow progress of the late 1st stage 19 / 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: Myasthenia gravis Bulbar paralysis Scleroderma Diffuse spasm of the oesophageal muscles 20 / 80 In a vertex presentation, the position is determined by the relationship of what fetal part to the Mother's pelvis: Mentum. Acromian. Sinciput. Occiput. Sacrum. 21 / 80 Which of the following anti diabetic drugs increases insulin sensitivity? Metformin DPP4 inhibitors Glibenclamide Pioglitazone 22 / 80 The following are treatment for simple malaria except artesunate - amodiaquine dihydroartemisinin - piperaquine dihydroartemisinin - lumefantrine artemether - lumefantrine oral quinine 23 / 80 In normal pregnancy, the value of ß-hCG doubles every: 10 days. 2 days. 4 days. 14 days. 8 days. 24 / 80 Regarding Hyperemesis gravidarum, which one of the following items is TRUE? Is a complication of multiple pregnancy Not known to happen in molar pregnancy Worsen in missed abortion Liver function test is not required Urine for culture and sensitivity is not important 25 / 80 Malignant degeneration of a healing wound is most likely to occur: When a patient is on cytotoxic agents. When iodophor antiseptics are used for dressing. When wounds are exposed to heat. When a state of chronicity from (e.g) recurrent infection prevails. 26 / 80 This is not a cause of hypoglycaemia in newborns intrauterine growth retardate prematurity infant of a diabetic mother sepsis hypoinsulinaemia 27 / 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 28 / 80 The most effective surgical procedure in stress ulceration is: Vogotomy and pyloroplasty with suturing of bleeding points Polya partial gastrectomy Total gastrectomy Vogitomy and hemigastrectomy 29 / 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 cortical tuber in neurofibromatosis adenoma sebaceum and tuberous sclerosis 30 / 80 Molding of the fetal head: Does NOT have time to occur in breech delivery. Usually cause brain damage. Increase the difficulty of delivery. Does not happen when maternal pelvis is adequate. Becomes progressively easier as gestational age increase. 31 / 80 In burns: 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. The maximum oedema fluid obtainable is about 10% of the body weight or 50% of total E.C.F. 32 / 80 In hypopituitarism all these hormones may be deficient except Prolactin Cholecystokinin Follicle stimulating hormone Adrenocorticotropic hormone Growth hormone 33 / 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 Dislocation of the elbow Monteggia fracture dislocation Fracture of the olecranon process Supracondylar fracture 34 / 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) Age of the patient Bacterial content of the wound at end of operation Preoperative showering for the patient Glove puncture in the course of surgery 35 / 80 Regarding missed abortion, all of the following are CORRECT, EXCEPT: Disseminated intra-vascular coagulation may occur as a sequele of missed abortion 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 Per vaginal bleeding may be one of the presenting symptom 36 / 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 37 / 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. All the answers below Any patient with severe hypertension and 50 years and cardiovascular disease Any patient with hypertension and aged over 50 years 38 / 80 Neuro hormones which are activated in cardiac failure include all EXCEPT: Brain naturetic protein Thyroxine Nordrenaline Aldosterone 39 / 80 The following are contraindications for lumbar puncture except Acute spinal cord injury skin infection at or near the site of the lumbar puncture Raised intracranial pressure Coagulopathy Cervical spondylosis 40 / 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: Post-renal renal failure Pre-renal renal failure Acute renal failure Acute tubular necrosis 41 / 80 In intestinal obstruction at the sigmoid colon due to stenosis, perforation is most likely to occur in the Terminal ileum Caecum Transverse colon Descending colon 42 / 80 These are chronic complications associated with sickle cell disease except priapism leg ulcers aseptic necrosis of the hip or shoulder congestive heart failure chronic lung disease 43 / 80 The source of progesterone that maintains the pregnancy during early 1st trimester is: Placenta. Endometrium. Adrenal glands. Corpus luteum. Corpus albicans. 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 For adequate and stable haemostasis the following should obtain: Increased pressure within the injured vessel Retraction of the injured vessel A minimum platelet count of 90,000 per mm3 Endothelial cell secretion of factor VIII 46 / 80 The prime cause of a venous leg ulcer is: Failure of valves of the perforating and deep veins Varicosity of the long (greater) saphenous vein Stasis in the deep veins High venous pressure in the leg veins generally 47 / 80 The management of retroexposed babies include zidovudine for six months PCR at 6 weeks of age lamivudine and zidovudine for 6 weeks for high risk babies cotrimoxazole at birth mixed feeding at 1 month 48 / 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. 49 / 80 The main tissues which provide support to the uterus include: Cardinal ligaments and the Uterosacral ligaments Broad ligaments and the Uterosacral ligaments Perineal body and the Broad ligaments Round ligament and the Broad ligaments Uterosacral ligaments and the Broad ligaments 50 / 80 The following statement are all TRUE about vomiting in pregnancy, EXCEPT: May be cured by admission to hospital Is associated with trophoblastic disease Associated with multiple pregnancy Is commonest in the third trimester Is associated with urinary tract infection 51 / 80 The second stage of labour involves: Separation of the placenta. Effacement of the cervix. Expulsion of the placenta. Dilation of the cervix. Expulsion of the fetus. 52 / 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? Carcinoma of the bronchus Silicosis Left ventricular failure Tuberculosis 53 / 80 Features found in nephrotic syndrome include the following EXCEPT: Hypertriglyceridemia Hypoalbuminsemia Oedema Normal renal function 54 / 80 On assessment of Semen Fluid Analysis: Azoospermia indicates a sperm count more than 5 million/ml Asthenozoospermia indicates abnormal forms Abstinence should be maintained for 10 days prior to "production" of the sample Abstinence should be maintained for 3 days prior to production of the sample Teratozoospermia indicates abnormal motility 55 / 80 Antenatal booking investigations include all of the following, EXCEPT: Urine routine examination Hepatitis screening Stool routine examination Complete blood count Thyroid function 56 / 80 Cause of neonatal seizures include the following except hypoxic ischaemic encephalopathy intracranial hemorrhage pyridoxine deficiency bilirubin encephalopathy hypermagnesaemia 57 / 80 These are causes of acute stridor except bacterial tracheitis diphtheria croup laryngomalacia acute epiglottitis 58 / 80 Neonatal resuscitation clearing airway preceeds keeping baby warm chest compression is initiated when heart rate is below 100 bpm 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 59 / 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 amlodipine therapy. Refer him to the specialist for investigations. Start him on nifedipine XL 30 mg once a day 60 / 80 Facial features of fetal alcohol syndrome include the following except smooth philtrum thick upper lip microcephaly ptosis short palpebral tissue 61 / 80 About severe acute malnutrition (SAM). Diagnostic features include mid upper arm circumference < 115mm Hypoglycaemia is present when the blood glucose is <4mmol/l sensory stimulation is not helpful There is usually unilateral pitting pedal oedema ORS is the fluid of choice for correcting dehydration 62 / 80 Adverse effects of corticosteroids include all EXCEPT Osteomalacia Cataract Euphoria Avascular necrosis of the hip. 63 / 80 The following are causes of spastic paraparesis except; Disc prolapse Potts disease Transverse myelitis Guillain Barre syndrome 64 / 80 Cause of ptosis include the following except botulism horner syndrome myasthenia gravis 4th nerve palsy tick paralysis 65 / 80 Concerning febrile seizures They usually have a poor prognosis Complex features is not a risk factor for recurrence Overall risk for recurrence is 3-4% Main risk factor for recurrence is the temperature at time of seizure. Overall, 30% develop epilepsy 66 / 80 The thyroid gland in thyrotoxicosis: 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 If primary is uniformly enlarged and rather soft or firm 67 / 80 The commonest site for carcinoma of the tongue is the: Posterior one-third Lateral margin Tip Dorsum 68 / 80 Causes of macrocephaly include the following except fetal alcohol syndrome hydrocephalus thalassaemia mucopolysaccharidosis achondroplasia 69 / 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. Respiratory rate> 30 per minute Heart rate >100 Confusion 70 / 80 The relationship of the long axis of the fetus to the long axis of the mother is called: Lie. Position. None of the above. Presentation. Attitude. 71 / 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 Renal stone Haemolysis Drug induced 72 / 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. 73 / 80 The last menstrual period was June 20th. The expected date of delivery (EDD) is approximately: March 28. March 23. April 23. April 7. March 27. 74 / 80 Squamous cell carcinoma of the anus: Is the commonest malignant tumour of the anus Bleeds but does not cause pain on defaecation Usually presents as a localized ulcer with sloping edges Is treated by abdomino-perineal resection of the rectum and anus in all patients 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. May cause incontinence of urine Motor aphasia 76 / 80 Which of the following is NOT a characteristic of normal labour: Progressive cervical dilation. Moderate bleeding. Uterine relaxation between contractions. Increasing intensity of contractions. Moderate pain. 77 / 80 An ectopic pregnancy: Usually presents with pain before bleeding Pain always presents before the bleeding Occurs only in the fallopian tubes Gives an increased risk of Hyperemisis Gravidarium Can only be treated surgically 78 / 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. 79 / 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 80 / 80 The heart rate of a normal fetus at term is: 120-160 bpm. 80-100 bpm. 160-180 bpm. There is no baseline heart rate. 100-120 bpm. Your score is LinkedIn Facebook Twitter 0% Restart quiz Send feedback