GMDC MOCK 3 /80 26 Quiz 1 / 80 An ectopic pregnancy: Occurs only in the fallopian tubes Pain always presents before the bleeding Can only be treated surgically Gives an increased risk of Hyperemisis Gravidarium Usually presents with pain before bleeding 2 / 80 The most effective surgical procedure in stress ulceration is: Total gastrectomy Vogotomy and pyloroplasty with suturing of bleeding points Polya partial gastrectomy Vogitomy and hemigastrectomy 3 / 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 Diffuse spasm of the oesophageal muscles Bulbar paralysis Myasthenia gravis 4 / 80 Cause of ptosis include the following except horner syndrome tick paralysis botulism myasthenia gravis 4th nerve palsy 5 / 80 The prime cause of a venous leg ulcer is: Failure of valves of the perforating and deep veins Stasis in the deep veins High venous pressure in the leg veins generally Varicosity of the long (greater) saphenous vein 6 / 80 These are causes of acute stridor except croup laryngomalacia diphtheria bacterial tracheitis acute epiglottitis 7 / 80 All these conditions cause conjugated hyperbilirubinemia in newborns except sepsis galactosemia torch infections breast milk jaundice biliary atresia 8 / 80 Cause of neonatal seizures include the following except intracranial hemorrhage hypermagnesaemia pyridoxine deficiency bilirubin encephalopathy hypoxic ischaemic encephalopathy 9 / 80 The features listed below may be associated with migraine headache EXCEPT Neck stiffness may be present Nausea Pulsatile or throbbing headache Photophobia. 10 / 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 Strapping of the affected side of the chest External fixation Watchful administration of adequate doses of systemic analgesic agent 11 / 80 The second stage of labour involves: Expulsion of the fetus. Dilation of the cervix. Separation of the placenta. Expulsion of the placenta. Effacement of the cervix. 12 / 80 In bronchiolitis, all these are true except drug of choice is acyclovir may present with with low grade fever primarily affects children less than 2 years old it's usually a self-limiting disease most commonly caused by respiratory syncytial virus 13 / 80 Stroke due involving the right middle cerebral artery pathology in most people usually causes the symptoms and signs below EXCEPT Motor aphasia No effect on the muscles in the upper part of the face. May cause incontinence of urine Paralysis of lower facial muscles on the left. 14 / 80 Which one of the drugs or measures do not worsen uraemia? Paracetamol Gentamycin Diarrhoea Hypotension 15 / 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 Supracondylar fracture Monteggia fracture dislocation 16 / 80 Causes of macrocephaly include the following except mucopolysaccharidosis fetal alcohol syndrome hydrocephalus thalassaemia achondroplasia 17 / 80 The last menstrual period was June 20th. The expected date of delivery (EDD) is approximately: March 28. March 27. April 7. April 23. March 23. 18 / 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. to observe his blood pressure for a further 10 months before initiating treatment . Refer him to the specialist for investigations. Start him on nifedipine XL 30 mg once a day 19 / 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 20 / 80 The following are contraindications for lumbar puncture except Acute spinal cord injury skin infection at or near the site of the lumbar puncture Coagulopathy Cervical spondylosis Raised intracranial pressure 21 / 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? Viral hepatitis Sub acute bacterial endocarditis Acute bacterial endocarditis Acute rheumatic carditis. 22 / 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 23 / 80 Which of the following patients should you prescribe aspirin if there is no contraindication. Select the MOST appropriate Any patient with hypertension and aged over 50 years Any patient with severe hypertension and 50 years and cardiovascular disease All the answers below Anyone with hypertension, over 50 years and has cardiovascular risk of <20% over 20 years. 24 / 80 All these conditions cause hypokalemia in children except acute tubular necrosis gastroenteritis pyloric stenosis frusemide renal tubular acidosis type 1 25 / 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. Pooling of amniotic fluid on speculum examination. Contractions seen on the CTG. Positive Nitrazine test. 26 / 80 The management of retroexposed babies include PCR at 6 weeks of age mixed feeding at 1 month zidovudine for six months cotrimoxazole at birth lamivudine and zidovudine for 6 weeks for high risk babies 27 / 80 The following statement are all TRUE about vomiting in pregnancy, EXCEPT: Associated with multiple pregnancy Is commonest in the third trimester Is associated with urinary tract infection Is associated with trophoblastic disease May be cured by admission to hospital 28 / 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 Carcinoma of the body of the pancreas Primary liver cell carcinoma Amoebic liver abscess 29 / 80 Which of the following anti diabetic drugs increases insulin sensitivity? DPP4 inhibitors Pioglitazone Metformin Glibenclamide 30 / 80 The source of progesterone that maintains the pregnancy during early 1st trimester is: Corpus luteum. Endometrium. Placenta. Corpus albicans. Adrenal glands. 31 / 80 The main tissues which provide support to the uterus include: Cardinal ligaments and the Uterosacral ligaments Round ligament and the Broad ligaments Perineal body and the Broad ligaments Broad ligaments and the Uterosacral ligaments Uterosacral ligaments and the Broad ligaments 32 / 80 Antenatal booking investigations include all of the following, EXCEPT: Hepatitis screening Urine routine examination Thyroid function Stool routine examination Complete blood count 33 / 80 Facial features of fetal alcohol syndrome include the following except smooth philtrum thick upper lip microcephaly short palpebral tissue ptosis 34 / 80 The heart rate of a normal fetus at term is: There is no baseline heart rate. 100-120 bpm. 120-160 bpm. 160-180 bpm. 80-100 bpm. 35 / 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 36 / 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. Increase the difficulty of delivery. Usually cause brain damage. 37 / 80 This is not true about autism most cases have normal intelligence 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 there is severe language and speech developmental disorder 38 / 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 Glove puncture in the course of surgery Bacterial content of the wound at end of operation Preoperative showering for the patient 39 / 80 The following are treatment for simple malaria except artemether - lumefantrine dihydroartemisinin - piperaquine oral quinine dihydroartemisinin - lumefantrine artesunate - amodiaquine 40 / 80 Neuro hormones which are activated in cardiac failure include all EXCEPT: Nordrenaline Thyroxine Brain naturetic protein Aldosterone 41 / 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 42 / 80 Which of these pairs does not match with regards to neurocutaneous disorders. port wine stain and sturge weber syndrome cortical tuber in neurofibromatosis café - au-lait spots and neurofibromatosis shagreen patch and tuberous sclerosis adenoma sebaceum and tuberous sclerosis 43 / 80 Regarding missed abortion, all of the following are CORRECT, EXCEPT: Ultrasound should be done to confirm the diagnosis Disseminated intra-vascular coagulation may occur as a sequele of missed abortion Per vaginal bleeding may be one of the presenting symptom Patient may present with loss of the symptoms of pregnancy Immediate evacuation should be done once the diagnosis is made 44 / 80 The following are causes of spastic paraparesis except; Potts disease Disc prolapse Guillain Barre syndrome Transverse myelitis 45 / 80 About severe acute malnutrition (SAM). sensory stimulation is not helpful Hypoglycaemia is present when the blood glucose is <4mmol/l Diagnostic features include mid upper arm circumference < 115mm There is usually unilateral pitting pedal oedema ORS is the fluid of choice for correcting dehydration 46 / 80 Adverse effects of corticosteroids include all EXCEPT Osteomalacia Avascular necrosis of the hip. Euphoria Cataract 47 / 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. Hypotension. Twin pregnancy. Median episiotomy. 48 / 80 Features found in nephrotic syndrome include the following EXCEPT: Hypoalbuminsemia Oedema Normal renal function Hypertriglyceridemia 49 / 80 Neonatal resuscitation chest compression is initiated when heart rate is below 100 bpm 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 clearing airway preceeds keeping baby warm 50 / 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 51 / 80 These are gross motor skills except stands alone walks up stairs with help transfers object from hand to hand sits with support steadiness of head when placed in supported position 52 / 80 Which of the following is not part of the criteria considered for CURB 65 used to determine the severity of community pneumonia. Confusion Diastolic pressure <60 mm Hg. Heart rate >100 Respiratory rate> 30 per minute 53 / 80 In burns: 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. There is initial vasodilatation followed by vasoconstriction in the burnt tissue. The maximum oedema fluid obtainable is about 10% of the body weight or 50% of total E.C.F. 54 / 80 On assessment of Semen Fluid Analysis: Teratozoospermia indicates abnormal motility Azoospermia indicates a sperm count more than 5 million/ml 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 Asthenozoospermia indicates abnormal forms 55 / 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. 56 / 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 Encysted hydrocele of the cord Cyst of the epididymis 57 / 80 The following are associated with oral candidiasis except; Lymphoma Glucose 6 Phosphate Dehydrogenase Malignancy Retroviral infection 58 / 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 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 The third stage end with the delivery of the placenta and membranes 59 / 80 In a vertex presentation, the position is determined by the relationship of what fetal part to the Mother's pelvis: Sinciput. Mentum. Occiput. Acromian. Sacrum. 60 / 80 Which of these discriptions adequately describe malena stools? Black tarry or sticky stools Loose very shining black stools Dark stools Black stools 61 / 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 62 / 80 The most common route of primary infection with Mycobacterium Tuberculosis is: Via the payer's patches to the mesenteric lymph nodes. 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. 63 / 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 Congital cyanotic heart disease Congenital postero-lateral diaphragmatic hernia (stabilized) 64 / 80 The relationship of the long axis of the fetus to the long axis of the mother is called: Attitude. Position. Presentation. None of the above. Lie. 65 / 80 The pelvis includes which of the following bones: Ilium, scapula, ischium and pubis. Trochanter, hip socket, ischium, sacrum and pubis. Sacrum, Tibia, ilium and pubis. Trochanter, sacrum, coccyx, ilium and pubis Ilium, ischium, pubis, sacrum and coccyx. 66 / 80 These are chronic complications associated with sickle cell disease except aseptic necrosis of the hip or shoulder congestive heart failure chronic lung disease priapism leg ulcers 67 / 80 For adequate and stable haemostasis the following should obtain: Increased pressure within the injured vessel A minimum platelet count of 90,000 per mm3 Retraction of the injured vessel Endothelial cell secretion of factor VIII 68 / 80 In hypopituitarism all these hormones may be deficient except Follicle stimulating hormone Adrenocorticotropic hormone Growth hormone Prolactin Cholecystokinin 69 / 80 In normal pregnancy, the value of ß-hCG doubles every: 8 days. 10 days. 4 days. 2 days. 14 days. 70 / 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 Post-renal renal failure Acute tubular necrosis 71 / 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 Shock . No chest pain in an elderly female diabetic 72 / 80 The thyroid gland in thyrotoxicosis: In over 95 percent has a thrill and a bruit over it Is enlarged in all patients so affected If primary is uniformly enlarged and rather soft or firm If secondary is firm and multinodular in all patients 73 / 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 Staphylococcus aureus Streptococcus pneumoniae 74 / 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 75 / 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 ? Post renal obstruction Acute tubular necrosis Rapidly progressively glomerulonephriitis Renal artery stenosis 76 / 80 The commonest site for carcinoma of the tongue is the: Tip Lateral margin Posterior one-third Dorsum 77 / 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 pancreatitis Acute high intestinal obstruction Acute gastritis Gastro-enteritis 78 / 80 This is not a cause of hypoglycaemia in newborns sepsis infant of a diabetic mother intrauterine growth retardate hypoinsulinaemia prematurity 79 / 80 Which of the following is NOT a characteristic of normal labour: Uterine relaxation between contractions. Moderate pain. Moderate bleeding. Increasing intensity of contractions. Progressive cervical dilation. 80 / 80 Concerning febrile seizures They usually have a poor prognosis Overall, 30% develop epilepsy Complex features is not a risk factor for recurrence Overall risk for recurrence is 3-4% Main risk factor for recurrence is the temperature at time of seizure. Your score is LinkedIn Facebook Twitter 0% Restart quiz Send feedback