GMDC MOCK 3 /80 26 Quiz 1 / 80 The main tissues which provide support to the uterus include: Uterosacral ligaments and the Broad ligaments Round ligament and the Broad ligaments Broad ligaments and the Uterosacral ligaments Perineal body and the Broad ligaments Cardinal ligaments and the Uterosacral ligaments 2 / 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: External fixation Blockage of the appropriate intercostal nerve and active physiotherapy Watchful administration of adequate doses of systemic analgesic agent Strapping of the affected side of the chest 3 / 80 Which of the following patients should you prescribe aspirin if there is no contraindication. Select the MOST appropriate Any patient with severe hypertension and 50 years and cardiovascular disease 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. 4 / 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) Congital cyanotic heart disease Emphysematous bullae Congenital cystic lung disease 5 / 80 This is not true about autism it's characterised by restricted and repetitive behavior there is severe language and speech developmental disorder it is pervasive developmental disorder commoner in males than in females with a male:female ratio of 3:1 most cases have normal intelligence 6 / 80 Which of the of the following is a LEAST likely presentations of myocardial infarction ? No chest pain in an elderly female diabetic Sharp piercing pain in the left which worsens with breathing Shock . Severe crushing pain in the precordium 7 / 80 Causes of macrocephaly include the following except hydrocephalus mucopolysaccharidosis thalassaemia fetal alcohol syndrome achondroplasia 8 / 80 A bloody nipple discharge in a 35 year old West African is most likely to be caused by: Chronic breast abscess Intraductal comedo-carcinoma Scirrhous breast carcinoma Duct ectasia 9 / 80 These are chronic complications associated with sickle cell disease except aseptic necrosis of the hip or shoulder priapism leg ulcers congestive heart failure chronic lung disease 10 / 80 The prime cause of a venous leg ulcer is: Stasis in the deep veins Failure of valves of the perforating and deep veins High venous pressure in the leg veins generally Varicosity of the long (greater) saphenous vein 11 / 80 Neonatal resuscitation clearing airway preceeds keeping baby warm atropine is administered when heart rate is below 100 bpm chest compression is initiated when heart rate is below 100 bpm most effective action is ventilation of the baby's lungs involves administration of iv aminophylline to preterms 12 / 80 Cause of neonatal seizures include the following except intracranial hemorrhage hypoxic ischaemic encephalopathy hypermagnesaemia bilirubin encephalopathy pyridoxine deficiency 13 / 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. 14 / 80 These are gross motor skills except walks up stairs with help steadiness of head when placed in supported position transfers object from hand to hand sits with support stands alone 15 / 80 Features found in nephrotic syndrome include the following EXCEPT: Hypertriglyceridemia Normal renal function Oedema Hypoalbuminsemia 16 / 80 The second stage of labour involves: Expulsion of the fetus. Expulsion of the placenta. Effacement of the cervix. Separation of the placenta. Dilation of the cervix. 17 / 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 Refer him to the specialist for investigations. to observe his blood pressure for a further 10 months before initiating treatment . 18 / 80 Adverse effects of corticosteroids include all EXCEPT Osteomalacia Euphoria Cataract Avascular necrosis of the hip. 19 / 80 These are causes of acute stridor except laryngomalacia acute epiglottitis bacterial tracheitis diphtheria croup 20 / 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? Streptococcus pneumoniae Klebsiella pneumoniae Staphylococcus aureus Mycoplasma pneumonia 21 / 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 Immediate evacuation should be done once the diagnosis is made Ultrasound should be done to confirm the diagnosis 22 / 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 Irreducible incomplete inguinal hernia, probably containing omentum Cyst of the epididymis Encysted hydrocele of the cord 23 / 80 The management of retroexposed babies include zidovudine for six months mixed feeding at 1 month PCR at 6 weeks of age lamivudine and zidovudine for 6 weeks for high risk babies cotrimoxazole at birth 24 / 80 Which of these pairs does not match with regards to neurocutaneous disorders. port wine stain and sturge weber syndrome cortical tuber in neurofibromatosis shagreen patch and tuberous sclerosis adenoma sebaceum and tuberous sclerosis café - au-lait spots and neurofibromatosis 25 / 80 The following are contraindications for lumbar puncture except Acute spinal cord injury Coagulopathy Raised intracranial pressure Cervical spondylosis skin infection at or near the site of the lumbar puncture 26 / 80 About severe acute malnutrition (SAM). Hypoglycaemia is present when the blood glucose is <4mmol/l sensory stimulation is not helpful Diagnostic features include mid upper arm circumference < 115mm ORS is the fluid of choice for correcting dehydration There is usually unilateral pitting pedal oedema 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: Pre-renal renal failure Acute tubular necrosis Acute renal failure Post-renal renal failure 28 / 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, scapula, ischium and pubis. Ilium, ischium, pubis, sacrum and coccyx. 29 / 80 The source of progesterone that maintains the pregnancy during early 1st trimester is: Corpus luteum. Endometrium. Adrenal glands. Corpus albicans. Placenta. 30 / 80 Molding of the fetal head: Increase the difficulty of delivery. Becomes progressively easier as gestational age increase. Usually cause brain damage. Does NOT have time to occur in breech delivery. Does not happen when maternal pelvis is adequate. 31 / 80 All these conditions cause conjugated hyperbilirubinemia in newborns except breast milk jaundice biliary atresia sepsis galactosemia torch infections 32 / 80 The following are associated with oral candidiasis except; Malignancy Glucose 6 Phosphate Dehydrogenase Retroviral infection Lymphoma 33 / 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 34 / 80 Malignant degeneration of a healing wound is most likely to occur: When iodophor antiseptics are used for dressing. When a state of chronicity from (e.g) recurrent infection prevails. When wounds are exposed to heat. When a patient is on cytotoxic agents. 35 / 80 Which of these discriptions adequately describe malena stools? Loose very shining black stools Black stools Dark stools Black tarry or sticky stools 36 / 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 37 / 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 38 / 80 The following are causes of spastic paraparesis except; Guillain Barre syndrome Disc prolapse Transverse myelitis Potts disease 39 / 80 In intestinal obstruction at the sigmoid colon due to stenosis, perforation is most likely to occur in the Descending colon Terminal ileum Caecum Transverse colon 40 / 80 Which of the following anti diabetic drugs increases insulin sensitivity? Metformin DPP4 inhibitors Glibenclamide Pioglitazone 41 / 80 The last menstrual period was June 20th. The expected date of delivery (EDD) is approximately: April 23. March 28. March 27. April 7. March 23. 42 / 80 Regarding Hyperemesis gravidarum, which one of the following items is TRUE? Urine for culture and sensitivity is not important Is a complication of multiple pregnancy Worsen in missed abortion Liver function test is not required Not known to happen in molar pregnancy 43 / 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. Motor aphasia May cause incontinence of urine 44 / 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 45 / 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 Glove puncture in the course of surgery Age of the patient Bacterial content of the wound at end of operation 46 / 80 The following are treatment for simple malaria except oral quinine artemether - lumefantrine artesunate - amodiaquine dihydroartemisinin - piperaquine dihydroartemisinin - lumefantrine 47 / 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 Acute tubular necrosis Rapidly progressively glomerulonephriitis 48 / 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 Left ventricular failure Tuberculosis Silicosis 49 / 80 The features listed below may be associated with migraine headache EXCEPT Nausea Photophobia. Neck stiffness may be present Pulsatile or throbbing headache 50 / 80 In hypopituitarism all these hormones may be deficient except Follicle stimulating hormone Cholecystokinin Growth hormone Adrenocorticotropic hormone Prolactin 51 / 80 Concerning febrile seizures Main risk factor for recurrence is the temperature at time of seizure. Overall risk for recurrence is 3-4% Overall, 30% develop epilepsy Complex features is not a risk factor for recurrence They usually have a poor prognosis 52 / 80 Cause of ptosis include the following except horner syndrome tick paralysis 4th nerve palsy myasthenia gravis botulism 53 / 80 All these conditions cause hypokalemia in children except pyloric stenosis gastroenteritis renal tubular acidosis type 1 acute tubular necrosis frusemide 54 / 80 In bronchiolitis, all these are true except primarily affects children less than 2 years old may present with with low grade fever it's usually a self-limiting disease most commonly caused by respiratory syncytial virus drug of choice is acyclovir 55 / 80 Stages of labour 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 Syntometrine is a combination of oxytocin and Ergometrine which is used in the treatment of secondary postpartum haemorrhage (PPH) 56 / 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: Bulbar paralysis Scleroderma Diffuse spasm of the oesophageal muscles Myasthenia gravis 57 / 80 Which one of the drugs or measures do not worsen uraemia? Hypotension Paracetamol Diarrhoea Gentamycin 58 / 80 The risk of postpartum uterine atony is associated with: Epidural anesthesia. Labour associated with an active rate of change of 1 cm per hour. Twin pregnancy. Hypotension. Median episiotomy. 59 / 80 An ectopic pregnancy: Can only be treated surgically Usually presents with pain before bleeding Pain always presents before the bleeding Gives an increased risk of Hyperemisis Gravidarium Occurs only in the fallopian tubes 60 / 80 Which of the following is NOT a characteristic of normal labour: Increasing intensity of contractions. Moderate bleeding. Progressive cervical dilation. Moderate pain. Uterine relaxation between contractions. 61 / 80 This is not a cause of hypoglycaemia in newborns infant of a diabetic mother prematurity sepsis hypoinsulinaemia intrauterine growth retardate 62 / 80 On assessment of Semen Fluid Analysis: Abstinence should be maintained for 10 days prior to "production" of the sample Azoospermia indicates a sperm count more than 5 million/ml Teratozoospermia indicates abnormal motility Abstinence should be maintained for 3 days prior to production of the sample Asthenozoospermia indicates abnormal forms 63 / 80 Neuro hormones which are activated in cardiac failure include all EXCEPT: Aldosterone Nordrenaline Thyroxine Brain naturetic protein 64 / 80 In a vertex presentation, the position is determined by the relationship of what fetal part to the Mother's pelvis: Occiput. Acromian. Sacrum. Mentum. Sinciput. 65 / 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 rheumatic carditis. Sub acute bacterial endocarditis Viral hepatitis Acute bacterial endocarditis 66 / 80 The relationship of the long axis of the fetus to the long axis of the mother is called: Attitude. Position. Lie. None of the above. Presentation. 67 / 80 The commonest site for carcinoma of the tongue is the: Tip Posterior one-third Lateral margin Dorsum 68 / 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 Confusion Diastolic pressure <60 mm Hg. Heart rate >100 69 / 80 Facial features of fetal alcohol syndrome include the following except ptosis smooth philtrum short palpebral tissue thick upper lip microcephaly 70 / 80 The following statement are all TRUE about vomiting in pregnancy, EXCEPT: Is associated with trophoblastic disease Is associated with urinary tract infection Associated with multiple pregnancy Is commonest in the third trimester May be cured by admission to hospital 71 / 80 In normal pregnancy, the value of ß-hCG doubles every: 14 days. 4 days. 10 days. 8 days. 2 days. 72 / 80 The thyroid gland in thyrotoxicosis: 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 In over 95 percent has a thrill and a bruit over it 73 / 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 stomach Primary liver cell carcinoma Carcinoma of the body of the pancreas 74 / 80 Antenatal booking investigations include all of the following, EXCEPT: Urine routine examination Hepatitis screening Stool routine examination Complete blood count Thyroid function 75 / 80 Rupture of membranes is suspected with all of the followings EXCEPT: Pooling of amniotic fluid on speculum examination. Observing amniotic fluid drain through the cervix during speculum examination. Positive Fern test. Positive Nitrazine test. Contractions seen on the CTG. 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 high intestinal obstruction Acute pancreatitis Acute gastritis Gastro-enteritis 77 / 80 The most common route of primary infection with Mycobacterium Tuberculosis is: Through the tonsils to the cervical lymph nodes. 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) 78 / 80 For adequate and stable haemostasis the following should obtain: A minimum platelet count of 90,000 per mm3 Retraction of the injured vessel Endothelial cell secretion of factor VIII Increased pressure within the injured vessel 79 / 80 The heart rate of a normal fetus at term is: 100-120 bpm. There is no baseline heart rate. 160-180 bpm. 80-100 bpm. 120-160 bpm. 80 / 80 Squamous cell carcinoma of the anus: Is the commonest malignant tumour of the anus Usually presents as a localized ulcer with sloping edges Is treated by abdomino-perineal resection of the rectum and anus in all patients Bleeds but does not cause pain on defaecation Your score is LinkedIn Facebook Twitter 0% Restart quiz Send feedback