GMDC MOCK 3 /80 26 Quiz 1 / 80 Cause of neonatal seizures include the following except bilirubin encephalopathy hypermagnesaemia intracranial hemorrhage pyridoxine deficiency hypoxic ischaemic encephalopathy 2 / 80 In bronchiolitis, all these are true except most commonly caused by respiratory syncytial virus may present with with low grade fever it's usually a self-limiting disease primarily affects children less than 2 years old drug of choice is acyclovir 3 / 80 Which of the following anti diabetic drugs increases insulin sensitivity? Pioglitazone DPP4 inhibitors Metformin Glibenclamide 4 / 80 These are causes of acute stridor except diphtheria laryngomalacia croup bacterial tracheitis acute epiglottitis 5 / 80 Concerning febrile seizures Main risk factor for recurrence is the temperature at time of seizure. Complex features is not a risk factor for recurrence Overall, 30% develop epilepsy Overall risk for recurrence is 3-4% They usually have a poor prognosis 6 / 80 This is not a cause of hypoglycaemia in newborns intrauterine growth retardate sepsis hypoinsulinaemia infant of a diabetic mother prematurity 7 / 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 8 / 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? Cyst of the epididymis Irreducible incomplete inguinal hernia, probably containing omentum Encysted hydrocele of the cord Sebaceous cyst of the scrotum 9 / 80 Molding of the fetal head: Usually cause brain damage. Becomes progressively easier as gestational age increase. Does NOT have time to occur in breech delivery. Increase the difficulty of delivery. Does not happen when maternal pelvis is adequate. 10 / 80 Neonatal resuscitation atropine is administered when heart rate is below 100 bpm most effective action is ventilation of the baby's lungs involves administration of iv aminophylline to preterms clearing airway preceeds keeping baby warm chest compression is initiated when heart rate is below 100 bpm 11 / 80 These are gross motor skills except sits with support transfers object from hand to hand walks up stairs with help steadiness of head when placed in supported position stands alone 12 / 80 Squamous cell carcinoma of the anus: Is the commonest malignant tumour of the anus Usually presents as a localized ulcer with sloping edges Bleeds but does not cause pain on defaecation Is treated by abdomino-perineal resection of the rectum and anus in all patients 13 / 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 Acute rheumatic carditis. Viral hepatitis Sub acute bacterial endocarditis 14 / 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 renal failure Acute tubular necrosis Post-renal renal failure 15 / 80 The following are associated with oral candidiasis except; Lymphoma Glucose 6 Phosphate Dehydrogenase Retroviral infection Malignancy 16 / 80 The pelvis includes which of the following bones: Trochanter, hip socket, ischium, sacrum and pubis. Sacrum, Tibia, ilium and pubis. Ilium, scapula, ischium and pubis. Trochanter, sacrum, coccyx, ilium and pubis Ilium, ischium, pubis, sacrum and coccyx. 17 / 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 Streptococcus pneumoniae Staphylococcus aureus 18 / 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 Bacterial content of the wound at end of operation Glove puncture in the course of surgery 19 / 80 About severe acute malnutrition (SAM). Diagnostic features include mid upper arm circumference < 115mm sensory stimulation is not helpful ORS is the fluid of choice for correcting dehydration There is usually unilateral pitting pedal oedema Hypoglycaemia is present when the blood glucose is <4mmol/l 20 / 80 In normal pregnancy, the value of ß-hCG doubles every: 8 days. 14 days. 2 days. 10 days. 4 days. 21 / 80 These are chronic complications associated with sickle cell disease except chronic lung disease priapism aseptic necrosis of the hip or shoulder leg ulcers congestive heart failure 22 / 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 The cervix dilates at consistent rate of 3 cm per hour in the first stage Forceps or ventose may be useful in slow progress of the late 1st stage 23 / 80 The main tissues which provide support to the uterus include: Perineal body and the Broad ligaments Uterosacral ligaments and the Broad ligaments Broad ligaments and the Uterosacral ligaments Round ligament and the Broad ligaments Cardinal ligaments and the Uterosacral ligaments 24 / 80 For adequate and stable haemostasis the following should obtain: Retraction of the injured vessel Increased pressure within the injured vessel A minimum platelet count of 90,000 per mm3 Endothelial cell secretion of factor VIII 25 / 80 The following are causes of spastic paraparesis except; Disc prolapse Transverse myelitis Guillain Barre syndrome Potts disease 26 / 80 Regarding missed abortion, all of the following are CORRECT, EXCEPT: Per vaginal bleeding may be one of the presenting symptom 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 27 / 80 Which of the following is NOT a characteristic of normal labour: Progressive cervical dilation. Moderate bleeding. Uterine relaxation between contractions. Moderate pain. Increasing intensity of contractions. 28 / 80 The features listed below may be associated with migraine headache EXCEPT Pulsatile or throbbing headache Photophobia. Nausea Neck stiffness may be present 29 / 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 30 / 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. Confusion Heart rate >100 Respiratory rate> 30 per minute 31 / 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? Injury to sacral nerve plexus Post renal uraemia Hypovolaemia Atonic bladder 32 / 80 Facial features of fetal alcohol syndrome include the following except microcephaly thick upper lip smooth philtrum short palpebral tissue ptosis 33 / 80 The last menstrual period was June 20th. The expected date of delivery (EDD) is approximately: March 28. April 7. April 23. March 23. March 27. 34 / 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 35 / 80 Which of these pairs does not match with regards to neurocutaneous disorders. port wine stain and sturge weber syndrome shagreen patch and tuberous sclerosis adenoma sebaceum and tuberous sclerosis cortical tuber in neurofibromatosis café - au-lait spots and neurofibromatosis 36 / 80 The thyroid gland in thyrotoxicosis: Is enlarged in all patients so affected If secondary is firm and multinodular in all patients If primary is uniformly enlarged and rather soft or firm In over 95 percent has a thrill and a bruit over it 37 / 80 The management of retroexposed babies include lamivudine and zidovudine for 6 weeks for high risk babies PCR at 6 weeks of age zidovudine for six months mixed feeding at 1 month cotrimoxazole at birth 38 / 80 Causes of macrocephaly include the following except mucopolysaccharidosis fetal alcohol syndrome thalassaemia achondroplasia hydrocephalus 39 / 80 Adverse effects of corticosteroids include all EXCEPT Avascular necrosis of the hip. Cataract Osteomalacia Euphoria 40 / 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 Supracondylar fracture Monteggia fracture dislocation Dislocation of the elbow 41 / 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 Bulbar paralysis Scleroderma Myasthenia gravis 42 / 80 In a vertex presentation, the position is determined by the relationship of what fetal part to the Mother's pelvis: Occiput. Acromian. Sinciput. Mentum. Sacrum. 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 ? Refer him to the specialist for investigations. Start him on nifedipine XL 30 mg once a day Start amlodipine therapy. to observe his blood pressure for a further 10 months before initiating treatment . 44 / 80 In hypopituitarism all these hormones may be deficient except Adrenocorticotropic hormone Cholecystokinin Growth hormone Follicle stimulating hormone Prolactin 45 / 80 Which of these discriptions adequately describe malena stools? Black stools Black tarry or sticky stools Dark stools Loose very shining black stools 46 / 80 The relationship of the long axis of the fetus to the long axis of the mother is called: Lie. Attitude. Position. None of the above. Presentation. 47 / 80 The source of progesterone that maintains the pregnancy during early 1st trimester is: Placenta. Corpus luteum. Corpus albicans. Adrenal glands. Endometrium. 48 / 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 Nitrazine test. Positive Fern test. Contractions seen on the CTG. 49 / 80 Neuro hormones which are activated in cardiac failure include all EXCEPT: Brain naturetic protein Thyroxine Aldosterone Nordrenaline 50 / 80 The risk of postpartum uterine atony is associated with: Hypotension. Median episiotomy. Labour associated with an active rate of change of 1 cm per hour. Epidural anesthesia. Twin pregnancy. 51 / 80 A bloody nipple discharge in a 35 year old West African is most likely to be caused by: Chronic breast abscess Duct ectasia Scirrhous breast carcinoma Intraductal comedo-carcinoma 52 / 80 Malignant degeneration of a healing wound is most likely to occur: 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. When wounds are exposed to heat. 53 / 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: Blockage of the appropriate intercostal nerve and active physiotherapy Watchful administration of adequate doses of systemic analgesic agent External fixation Strapping of the affected side of the chest 54 / 80 Antenatal booking investigations include all of the following, EXCEPT: Hepatitis screening Urine routine examination Thyroid function Stool routine examination Complete blood count 55 / 80 Which of the of the following is a LEAST likely presentations of myocardial infarction ? Shock . No chest pain in an elderly female diabetic Severe crushing pain in the precordium Sharp piercing pain in the left which worsens with breathing 56 / 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. 57 / 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 Left ventricular failure Carcinoma of the bronchus Silicosis 58 / 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? Drug induced Renal stone Urinary tract infection Haemolysis 59 / 80 Stroke due involving the right middle cerebral artery pathology in most people usually causes the symptoms and signs below EXCEPT Motor aphasia May cause incontinence of urine No effect on the muscles in the upper part of the face. Paralysis of lower facial muscles on the left. 60 / 80 An ectopic pregnancy: Occurs only in the fallopian tubes Gives an increased risk of Hyperemisis Gravidarium Usually presents with pain before bleeding Pain always presents before the bleeding Can only be treated surgically 61 / 80 On assessment of Semen Fluid Analysis: Azoospermia indicates a sperm count more than 5 million/ml Teratozoospermia indicates abnormal motility Asthenozoospermia indicates abnormal forms Abstinence should be maintained for 3 days prior to production of the sample Abstinence should be maintained for 10 days prior to "production" of the sample 62 / 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 ? Acute tubular necrosis Renal artery stenosis Rapidly progressively glomerulonephriitis Post renal obstruction 63 / 80 The second stage of labour involves: Separation of the placenta. Expulsion of the fetus. Effacement of the cervix. Expulsion of the placenta. Dilation of the cervix. 64 / 80 Features found in nephrotic syndrome include the following EXCEPT: Hypoalbuminsemia Normal renal function Oedema Hypertriglyceridemia 65 / 80 All these conditions cause hypokalemia in children except gastroenteritis renal tubular acidosis type 1 frusemide acute tubular necrosis pyloric stenosis 66 / 80 The heart rate of a normal fetus at term is: 120-160 bpm. There is no baseline heart rate. 160-180 bpm. 100-120 bpm. 80-100 bpm. 67 / 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 gastritis Gastro-enteritis Acute pancreatitis 68 / 80 The following are treatment for simple malaria except oral quinine artemether - lumefantrine dihydroartemisinin - piperaquine artesunate - amodiaquine dihydroartemisinin - lumefantrine 69 / 80 The following statement are all TRUE about vomiting in pregnancy, EXCEPT: Is associated with urinary tract infection May be cured by admission to hospital Is associated with trophoblastic disease Is commonest in the third trimester Associated with multiple pregnancy 70 / 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 71 / 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 Carcinoma of the stomach Primary liver cell carcinoma Carcinoma of the body of the pancreas Amoebic liver abscess 72 / 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. Any patient with severe hypertension and 50 years and cardiovascular disease All the answers below Any patient with hypertension and aged over 50 years 73 / 80 This is not true about autism it is pervasive developmental disorder most cases have normal intelligence it's characterised by restricted and repetitive behavior there is severe language and speech developmental disorder commoner in males than in females with a male:female ratio of 3:1 74 / 80 All these conditions cause conjugated hyperbilirubinemia in newborns except sepsis biliary atresia torch infections breast milk jaundice galactosemia 75 / 80 In burns: 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 rate of fluid exudation from the capillaries is highest in the first 4 hours and falls in 48 hours. The increased capillary permeability is restricted to the burnt area. 76 / 80 Which one of the drugs or measures do not worsen uraemia? Diarrhoea Paracetamol Hypotension Gentamycin 77 / 80 The commonest site for carcinoma of the tongue is the: Posterior one-third Dorsum Lateral margin Tip 78 / 80 Cause of ptosis include the following except tick paralysis botulism horner syndrome 4th nerve palsy myasthenia gravis 79 / 80 The following are contraindications for lumbar puncture except Cervical spondylosis Acute spinal cord injury Raised intracranial pressure skin infection at or near the site of the lumbar puncture Coagulopathy 80 / 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 Your score is LinkedIn Facebook VKontakte 0% Restart quiz Send feedback