GMDC MOCK 3 /80 26 Quiz 1 / 80 The features listed below may be associated with migraine headache EXCEPT Pulsatile or throbbing headache Neck stiffness may be present Photophobia. Nausea 2 / 80 These are chronic complications associated with sickle cell disease except congestive heart failure priapism chronic lung disease leg ulcers aseptic necrosis of the hip or shoulder 3 / 80 Cause of ptosis include the following except horner syndrome 4th nerve palsy tick paralysis botulism myasthenia gravis 4 / 80 Antenatal booking investigations include all of the following, EXCEPT: Thyroid function Hepatitis screening Urine routine examination Stool routine examination Complete blood count 5 / 80 Squamous cell carcinoma of the anus: Is treated by abdomino-perineal resection of the rectum and anus in all patients Usually presents as a localized ulcer with sloping edges Is the commonest malignant tumour of the anus Bleeds but does not cause pain on defaecation 6 / 80 Causes of macrocephaly include the following except fetal alcohol syndrome thalassaemia hydrocephalus mucopolysaccharidosis achondroplasia 7 / 80 About severe acute malnutrition (SAM). ORS is the fluid of choice for correcting dehydration 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 8 / 80 This is not a cause of hypoglycaemia in newborns infant of a diabetic mother prematurity sepsis hypoinsulinaemia intrauterine growth retardate 9 / 80 The last menstrual period was June 20th. The expected date of delivery (EDD) is approximately: March 23. April 23. March 27. March 28. April 7. 10 / 80 Facial features of fetal alcohol syndrome include the following except microcephaly ptosis thick upper lip smooth philtrum short palpebral tissue 11 / 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 hypertension and aged over 50 years Any patient with severe hypertension and 50 years and cardiovascular disease All the answers below 12 / 80 Cause of neonatal seizures include the following except pyridoxine deficiency intracranial hemorrhage hypermagnesaemia hypoxic ischaemic encephalopathy bilirubin encephalopathy 13 / 80 Which of these pairs does not match with regards to neurocutaneous disorders. café - au-lait spots and neurofibromatosis port wine stain and sturge weber syndrome shagreen patch and tuberous sclerosis adenoma sebaceum and tuberous sclerosis cortical tuber in neurofibromatosis 14 / 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 Sebaceous cyst of the scrotum Encysted hydrocele of the cord 15 / 80 Which of the following is NOT a characteristic of normal labour: Progressive cervical dilation. Uterine relaxation between contractions. Moderate bleeding. Increasing intensity of contractions. Moderate pain. 16 / 80 The pelvis includes which of the following bones: Sacrum, Tibia, ilium and pubis. Ilium, scapula, ischium and pubis. Ilium, ischium, pubis, sacrum and coccyx. Trochanter, sacrum, coccyx, ilium and pubis Trochanter, hip socket, ischium, sacrum and pubis. 17 / 80 The relationship of the long axis of the fetus to the long axis of the mother is called: None of the above. Attitude. Presentation. Position. Lie. 18 / 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. 19 / 80 These are gross motor skills except sits with support walks up stairs with help transfers object from hand to hand stands alone steadiness of head when placed in supported position 20 / 80 These are causes of acute stridor except diphtheria laryngomalacia acute epiglottitis bacterial tracheitis croup 21 / 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. 22 / 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 Staphylococcus aureus Klebsiella pneumoniae 23 / 80 The following are contraindications for lumbar puncture except skin infection at or near the site of the lumbar puncture Raised intracranial pressure Cervical spondylosis Coagulopathy Acute spinal cord injury 24 / 80 An ectopic pregnancy: Can only be treated surgically Usually presents with pain before bleeding Occurs only in the fallopian tubes Pain always presents before the bleeding Gives an increased risk of Hyperemisis Gravidarium 25 / 80 The thyroid gland in thyrotoxicosis: Is enlarged in all patients so affected If secondary is firm and multinodular in all patients In over 95 percent has a thrill and a bruit over it If primary is uniformly enlarged and rather soft or firm 26 / 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 ? Rapidly progressively glomerulonephriitis Acute tubular necrosis Post renal obstruction Renal artery stenosis 27 / 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 28 / 80 All these conditions cause conjugated hyperbilirubinemia in newborns except torch infections biliary atresia sepsis breast milk jaundice galactosemia 29 / 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 body of the pancreas Primary liver cell carcinoma Amoebic liver abscess Carcinoma of the stomach 30 / 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 Shock . No chest pain in an elderly female diabetic Severe crushing pain in the precordium 31 / 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 Acute bacterial endocarditis Viral hepatitis 32 / 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 Watchful administration of adequate doses of systemic analgesic agent Blockage of the appropriate intercostal nerve and active physiotherapy Strapping of the affected side of the chest 33 / 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 to observe his blood pressure for a further 10 months before initiating treatment . Refer him to the specialist for investigations. Start amlodipine therapy. 34 / 80 In bronchiolitis, all these are true except it's usually a self-limiting disease may present with with low grade fever primarily affects children less than 2 years old most commonly caused by respiratory syncytial virus drug of choice is acyclovir 35 / 80 The risk of postpartum uterine atony is associated with: Median episiotomy. Epidural anesthesia. Labour associated with an active rate of change of 1 cm per hour. Twin pregnancy. Hypotension. 36 / 80 The following are causes of spastic paraparesis except; Disc prolapse Transverse myelitis Potts disease Guillain Barre syndrome 37 / 80 Regarding missed abortion, all of the following are CORRECT, EXCEPT: Ultrasound should be done to confirm the diagnosis Per vaginal bleeding may be one of the presenting symptom Immediate evacuation should be done once the diagnosis is made Patient may present with loss of the symptoms of pregnancy Disseminated intra-vascular coagulation may occur as a sequele of missed abortion 38 / 80 Regarding Hyperemesis gravidarum, which one of the following items is TRUE? Not known to happen in molar pregnancy Urine for culture and sensitivity is not important Worsen in missed abortion Is a complication of multiple pregnancy Liver function test is not required 39 / 80 Features found in nephrotic syndrome include the following EXCEPT: Oedema Hypertriglyceridemia Normal renal function Hypoalbuminsemia 40 / 80 The second stage of labour involves: Dilation of the cervix. Separation of the placenta. Effacement of the cervix. Expulsion of the placenta. Expulsion of the fetus. 41 / 80 Rupture of membranes is suspected with all of the followings EXCEPT: Positive Fern test. Pooling of amniotic fluid on speculum examination. Contractions seen on the CTG. Positive Nitrazine test. Observing amniotic fluid drain through the cervix during speculum examination. 42 / 80 The main tissues which provide support to the uterus include: Uterosacral ligaments and the Broad ligaments Cardinal ligaments and the Uterosacral ligaments Broad ligaments and the Uterosacral ligaments Perineal body and the Broad ligaments Round ligament and the Broad ligaments 43 / 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? Urinary tract infection Haemolysis Renal stone Drug induced 44 / 80 Which of the following anti diabetic drugs increases insulin sensitivity? Metformin Pioglitazone DPP4 inhibitors Glibenclamide 45 / 80 Stages of labour Syntometrine is a combination of oxytocin and Ergometrine which is used in the treatment of secondary postpartum haemorrhage (PPH) 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 The third stage end with the delivery of the placenta and membranes The first stage commences at the time of membrane rupture 46 / 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 Dislocation of the elbow Fracture of the olecranon process 47 / 80 In hypopituitarism all these hormones may be deficient except Prolactin Growth hormone Cholecystokinin Follicle stimulating hormone Adrenocorticotropic hormone 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: Emphysematous bullae Congenital cystic lung disease Congital cyanotic heart disease Congenital postero-lateral diaphragmatic hernia (stabilized) 49 / 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 50 / 80 All these conditions cause hypokalemia in children except renal tubular acidosis type 1 frusemide acute tubular necrosis gastroenteritis pyloric stenosis 51 / 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 52 / 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 a patient is on cytotoxic agents. When wounds are exposed to heat. 53 / 80 The commonest site for carcinoma of the tongue is the: Lateral margin Tip Posterior one-third Dorsum 54 / 80 In normal pregnancy, the value of ß-hCG doubles every: 14 days. 10 days. 2 days. 4 days. 8 days. 55 / 80 Stroke due involving the right middle cerebral artery pathology in most people usually causes the symptoms and signs below EXCEPT May cause incontinence of urine Paralysis of lower facial muscles on the left. Motor aphasia No effect on the muscles in the upper part of the face. 56 / 80 Adverse effects of corticosteroids include all EXCEPT Cataract Osteomalacia Euphoria Avascular necrosis of the hip. 57 / 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 Diffuse spasm of the oesophageal muscles Scleroderma Myasthenia gravis 58 / 80 Molding of the fetal head: Does NOT have time to occur in breech delivery. Usually cause brain damage. Increase the difficulty of delivery. Becomes progressively easier as gestational age increase. Does not happen when maternal pelvis is adequate. 59 / 80 The following are associated with oral candidiasis except; Retroviral infection Lymphoma Glucose 6 Phosphate Dehydrogenase Malignancy 60 / 80 The prime cause of a venous leg ulcer is: Varicosity of the long (greater) saphenous vein Failure of valves of the perforating and deep veins Stasis in the deep veins High venous pressure in the leg veins generally 61 / 80 Which of these discriptions adequately describe malena stools? Dark stools Black tarry or sticky stools Loose very shining black stools Black stools 62 / 80 Which one of the drugs or measures do not worsen uraemia? Paracetamol Hypotension Diarrhoea Gentamycin 63 / 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 64 / 80 The management of retroexposed babies include cotrimoxazole at birth 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 65 / 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 Acute renal failure Post-renal renal failure Pre-renal renal failure 66 / 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 67 / 80 The following statement are all TRUE about vomiting in pregnancy, EXCEPT: Is associated with urinary tract infection Is commonest in the third trimester May be cured by admission to hospital Is associated with trophoblastic disease Associated with multiple pregnancy 68 / 80 In intestinal obstruction at the sigmoid colon due to stenosis, perforation is most likely to occur in the Caecum Terminal ileum Transverse colon Descending colon 69 / 80 This is not true about autism most cases have normal intelligence it is pervasive developmental disorder there is severe language and speech developmental disorder it's characterised by restricted and repetitive behavior commoner in males than in females with a male:female ratio of 3:1 70 / 80 Neuro hormones which are activated in cardiac failure include all EXCEPT: Thyroxine Brain naturetic protein Nordrenaline Aldosterone 71 / 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 Asthenozoospermia indicates abnormal forms Teratozoospermia indicates abnormal motility Abstinence should be maintained for 3 days prior to production of the sample 72 / 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 high intestinal obstruction Gastro-enteritis Acute pancreatitis 73 / 80 The source of progesterone that maintains the pregnancy during early 1st trimester is: Endometrium. Corpus luteum. Placenta. Corpus albicans. Adrenal glands. 74 / 80 The following are treatment for simple malaria except artemether - lumefantrine artesunate - amodiaquine dihydroartemisinin - lumefantrine dihydroartemisinin - piperaquine oral quinine 75 / 80 The most effective surgical procedure in stress ulceration is: Vogotomy and pyloroplasty with suturing of bleeding points Polya partial gastrectomy Total gastrectomy Vogitomy and hemigastrectomy 76 / 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 Post renal uraemia Injury to sacral nerve plexus 77 / 80 In a vertex presentation, the position is determined by the relationship of what fetal part to the Mother's pelvis: Sacrum. Sinciput. Acromian. Mentum. Occiput. 78 / 80 Concerning febrile seizures They usually have a poor prognosis Overall, 30% develop epilepsy Overall risk for recurrence is 3-4% Complex features is not a risk factor for recurrence Main risk factor for recurrence is the temperature at time of seizure. 79 / 80 Neonatal resuscitation clearing airway preceeds keeping baby warm chest compression is initiated when heart rate is below 100 bpm most effective action is ventilation of the baby's lungs atropine is administered when heart rate is below 100 bpm involves administration of iv aminophylline to preterms 80 / 80 The heart rate of a normal fetus at term is: 120-160 bpm. 100-120 bpm. 160-180 bpm. There is no baseline heart rate. 80-100 bpm. Your score is LinkedIn Facebook Twitter 0% Restart quiz Send feedback