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