GMDC MOCK 3 /80 26 Quiz 1 / 80 The prime cause of a venous leg ulcer is: Varicosity of the long (greater) saphenous vein High venous pressure in the leg veins generally Stasis in the deep veins Failure of valves of the perforating and deep veins 2 / 80 All these conditions cause conjugated hyperbilirubinemia in newborns except biliary atresia breast milk jaundice galactosemia torch infections sepsis 3 / 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 4 / 80 The following are contraindications for lumbar puncture except skin infection at or near the site of the lumbar puncture Coagulopathy Raised intracranial pressure Cervical spondylosis Acute spinal cord injury 5 / 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. Through the tonsils to the cervical lymph nodes. The genitourinary mucosa-urethra and bladder. 6 / 80 The following are treatment for simple malaria except artemether - lumefantrine dihydroartemisinin - lumefantrine artesunate - amodiaquine oral quinine dihydroartemisinin - piperaquine 7 / 80 These are gross motor skills except sits with support walks up stairs with help transfers object from hand to hand steadiness of head when placed in supported position stands alone 8 / 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 Respiratory rate> 30 per minute Diastolic pressure <60 mm Hg. Confusion 9 / 80 All these conditions cause hypokalemia in children except renal tubular acidosis type 1 acute tubular necrosis gastroenteritis frusemide pyloric stenosis 10 / 80 These are causes of acute stridor except diphtheria croup acute epiglottitis laryngomalacia bacterial tracheitis 11 / 80 Concerning febrile seizures Complex features is not a risk factor for recurrence They usually have a poor prognosis Overall, 30% develop epilepsy Overall risk for recurrence is 3-4% Main risk factor for recurrence is the temperature at time of seizure. 12 / 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 13 / 80 Which of these pairs does not match with regards to neurocutaneous disorders. café - au-lait spots and neurofibromatosis shagreen patch and tuberous sclerosis cortical tuber in neurofibromatosis port wine stain and sturge weber syndrome adenoma sebaceum and tuberous sclerosis 14 / 80 In hypopituitarism all these hormones may be deficient except Adrenocorticotropic hormone Growth hormone Follicle stimulating hormone Prolactin Cholecystokinin 15 / 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? Sebaceous cyst of the scrotum Encysted hydrocele of the cord Irreducible incomplete inguinal hernia, probably containing omentum Cyst of the epididymis 16 / 80 The source of progesterone that maintains the pregnancy during early 1st trimester is: Placenta. Corpus albicans. Endometrium. Corpus luteum. Adrenal glands. 17 / 80 Which of these discriptions adequately describe malena stools? Loose very shining black stools Black stools Black tarry or sticky stools Dark stools 18 / 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 19 / 80 In burns: There is initial vasodilatation followed by vasoconstriction in the burnt tissue. The increased capillary permeability is restricted to the burnt area. 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. 20 / 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 Age of the patient Preoperative showering for the patient Glove puncture in the course of surgery 21 / 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 22 / 80 Regarding Hyperemesis gravidarum, which one of the following items is TRUE? Not known to happen in molar pregnancy Is a complication of multiple pregnancy Liver function test is not required Urine for culture and sensitivity is not important Worsen in missed abortion 23 / 80 The most effective surgical procedure in stress ulceration is: Total gastrectomy Vogotomy and pyloroplasty with suturing of bleeding points Vogitomy and hemigastrectomy Polya partial gastrectomy 24 / 80 Cause of neonatal seizures include the following except pyridoxine deficiency hypoxic ischaemic encephalopathy hypermagnesaemia bilirubin encephalopathy intracranial hemorrhage 25 / 80 The commonest site for carcinoma of the tongue is the: Lateral margin Posterior one-third Tip Dorsum 26 / 80 Neonatal resuscitation involves administration of iv aminophylline to preterms atropine is administered when heart rate is below 100 bpm most effective action is ventilation of the baby's lungs chest compression is initiated when heart rate is below 100 bpm clearing airway preceeds keeping baby warm 27 / 80 The relationship of the long axis of the fetus to the long axis of the mother is called: Position. None of the above. Presentation. Lie. Attitude. 28 / 80 The risk of postpartum uterine atony is associated with: Labour associated with an active rate of change of 1 cm per hour. Hypotension. Median episiotomy. Epidural anesthesia. Twin pregnancy. 29 / 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 Dislocation of the elbow Monteggia fracture dislocation Supracondylar fracture 30 / 80 Cause of ptosis include the following except myasthenia gravis 4th nerve palsy horner syndrome botulism tick paralysis 31 / 80 The main tissues which provide support to the uterus include: Round ligament and the Broad ligaments Cardinal ligaments and the Uterosacral ligaments Uterosacral ligaments and the Broad ligaments Perineal body and the Broad ligaments Broad ligaments and the Uterosacral ligaments 32 / 80 Squamous cell carcinoma 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 Is the commonest malignant tumour of the anus Usually presents as a localized ulcer with sloping edges 33 / 80 This is not a cause of hypoglycaemia in newborns sepsis infant of a diabetic mother intrauterine growth retardate hypoinsulinaemia prematurity 34 / 80 In bronchiolitis, all these are true except most commonly caused by respiratory syncytial virus primarily affects children less than 2 years old drug of choice is acyclovir may present with with low grade fever it's usually a self-limiting disease 35 / 80 Adverse effects of corticosteroids include all EXCEPT Osteomalacia Cataract Euphoria Avascular necrosis of the hip. 36 / 80 Facial features of fetal alcohol syndrome include the following except thick upper lip smooth philtrum microcephaly ptosis short palpebral tissue 37 / 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 38 / 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. 39 / 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 Blockage of the appropriate intercostal nerve and active physiotherapy External fixation 40 / 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 Klebsiella pneumoniae Staphylococcus aureus 41 / 80 An ectopic pregnancy: Usually presents with pain before bleeding Pain always presents before the bleeding Can only be treated surgically Gives an increased risk of Hyperemisis Gravidarium Occurs only in the fallopian tubes 42 / 80 Stages of labour The first stage commences at the time of membrane rupture Forceps or ventose may be useful in slow progress of the late 1st 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 cervix dilates at consistent rate of 3 cm per hour in the first stage 43 / 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 Acute tubular necrosis Acute renal failure Pre-renal renal failure 44 / 80 The heart rate of a normal fetus at term is: 160-180 bpm. There is no baseline heart rate. 120-160 bpm. 80-100 bpm. 100-120 bpm. 45 / 80 In normal pregnancy, the value of ß-hCG doubles every: 8 days. 10 days. 4 days. 2 days. 14 days. 46 / 80 The second stage of labour involves: Dilation of the cervix. Effacement of the cervix. Expulsion of the placenta. Separation of the placenta. Expulsion of the fetus. 47 / 80 Regarding missed abortion, all of the following are CORRECT, EXCEPT: Immediate evacuation should be done once the diagnosis is made Disseminated intra-vascular coagulation may occur as a sequele of missed abortion 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 48 / 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 Hypoglycaemia is present when the blood glucose is <4mmol/l ORS is the fluid of choice for correcting dehydration 49 / 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 to observe his blood pressure for a further 10 months before initiating treatment . Refer him to the specialist for investigations. 50 / 80 These are chronic complications associated with sickle cell disease except leg ulcers priapism aseptic necrosis of the hip or shoulder congestive heart failure chronic lung disease 51 / 80 Causes of macrocephaly include the following except mucopolysaccharidosis achondroplasia hydrocephalus thalassaemia fetal alcohol syndrome 52 / 80 Molding of the fetal head: Does NOT have time to occur in breech delivery. Does not happen when maternal pelvis is adequate. Becomes progressively easier as gestational age increase. Usually cause brain damage. Increase the difficulty of delivery. 53 / 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 Congital cyanotic heart disease Congenital postero-lateral diaphragmatic hernia (stabilized) 54 / 80 Features found in nephrotic syndrome include the following EXCEPT: Normal renal function Hypertriglyceridemia Hypoalbuminsemia Oedema 55 / 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 Post renal uraemia Atonic bladder 56 / 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 Gastro-enteritis Acute pancreatitis Acute high intestinal obstruction Acute gastritis 57 / 80 Antenatal booking investigations include all of the following, EXCEPT: Hepatitis screening Urine routine examination Thyroid function Complete blood count Stool routine examination 58 / 80 The features listed below may be associated with migraine headache EXCEPT Neck stiffness may be present Photophobia. Pulsatile or throbbing headache Nausea 59 / 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. Contractions seen on the CTG. Pooling of amniotic fluid on speculum examination. Positive Nitrazine test. 60 / 80 Which of the following anti diabetic drugs increases insulin sensitivity? Glibenclamide Metformin Pioglitazone DPP4 inhibitors 61 / 80 The following are causes of spastic paraparesis except; Disc prolapse Potts disease Transverse myelitis Guillain Barre syndrome 62 / 80 Which one of the drugs or measures do not worsen uraemia? Paracetamol Gentamycin Diarrhoea Hypotension 63 / 80 Malignant degeneration of a healing wound is most likely to occur: When wounds are exposed to heat. 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. 64 / 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 rheumatic carditis. Acute bacterial endocarditis 65 / 80 The following statement are all TRUE about vomiting in pregnancy, EXCEPT: Associated with multiple pregnancy Is associated with trophoblastic disease May be cured by admission to hospital Is commonest in the third trimester Is associated with urinary tract infection 66 / 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 Severe crushing pain in the precordium No chest pain in an elderly female diabetic Shock . 67 / 80 In a vertex presentation, the position is determined by the relationship of what fetal part to the Mother's pelvis: Sacrum. Acromian. Occiput. Mentum. Sinciput. 68 / 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 Post renal obstruction Rapidly progressively glomerulonephriitis Acute tubular necrosis 69 / 80 Which of the following is NOT a characteristic of normal labour: Uterine relaxation between contractions. Increasing intensity of contractions. Moderate bleeding. Progressive cervical dilation. Moderate pain. 70 / 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 Asthenozoospermia indicates abnormal forms Abstinence should be maintained for 10 days prior to "production" of the sample Teratozoospermia indicates abnormal motility 71 / 80 The following are associated with oral candidiasis except; Lymphoma Glucose 6 Phosphate Dehydrogenase Retroviral infection Malignancy 72 / 80 Neuro hormones which are activated in cardiac failure include all EXCEPT: Thyroxine Brain naturetic protein Aldosterone Nordrenaline 73 / 80 The management of retroexposed babies include cotrimoxazole at birth mixed feeding at 1 month lamivudine and zidovudine for 6 weeks for high risk babies zidovudine for six months PCR at 6 weeks of age 74 / 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: Diffuse spasm of the oesophageal muscles Scleroderma Myasthenia gravis Bulbar paralysis 75 / 80 Which of the following patients should you prescribe aspirin if there is no contraindication. Select the MOST appropriate All the answers below 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 76 / 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 Left ventricular failure Carcinoma of the bronchus Tuberculosis 77 / 80 In intestinal obstruction at the sigmoid colon due to stenosis, perforation is most likely to occur in the Transverse colon Caecum Terminal ileum Descending colon 78 / 80 The last menstrual period was June 20th. The expected date of delivery (EDD) is approximately: March 28. March 27. March 23. April 23. April 7. 79 / 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 Duct ectasia Intraductal comedo-carcinoma 80 / 80 This is not true about autism it is pervasive developmental disorder commoner in males than in females with a male:female ratio of 3:1 it's characterised by restricted and repetitive behavior most cases have normal intelligence there is severe language and speech developmental disorder Your score is LinkedIn Facebook Twitter 0% Restart quiz Send feedback