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