GMDC MOCK 3 /80 26 Quiz 1 / 80 Regarding missed abortion, all of the following are CORRECT, EXCEPT: Disseminated intra-vascular coagulation may occur as a sequele of missed abortion Ultrasound should be done to confirm the diagnosis Immediate evacuation should be done once the diagnosis is made Per vaginal bleeding may be one of the presenting symptom Patient may present with loss of the symptoms of pregnancy 2 / 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 commonest in the third trimester Is associated with trophoblastic disease Associated with multiple pregnancy 3 / 80 The relationship of the long axis of the fetus to the long axis of the mother is called: Lie. None of the above. Attitude. Position. Presentation. 4 / 80 The source of progesterone that maintains the pregnancy during early 1st trimester is: Adrenal glands. Endometrium. Corpus albicans. Placenta. Corpus luteum. 5 / 80 The commonest site for carcinoma of the tongue is the: Tip Dorsum Posterior one-third Lateral margin 6 / 80 About severe acute malnutrition (SAM). Diagnostic features include mid upper arm circumference < 115mm Hypoglycaemia is present when the blood glucose is <4mmol/l sensory stimulation is not helpful ORS is the fluid of choice for correcting dehydration There is usually unilateral pitting pedal oedema 7 / 80 Antenatal booking investigations include all of the following, EXCEPT: Hepatitis screening Stool routine examination Complete blood count Thyroid function Urine routine examination 8 / 80 In burns: 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. 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. 9 / 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 Renal artery stenosis Post renal obstruction Acute tubular necrosis 10 / 80 Adverse effects of corticosteroids include all EXCEPT Cataract Avascular necrosis of the hip. Euphoria Osteomalacia 11 / 80 The following are associated with oral candidiasis except; Glucose 6 Phosphate Dehydrogenase Retroviral infection Lymphoma Malignancy 12 / 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 Carcinoma of the bronchus Left ventricular failure Silicosis 13 / 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. 14 / 80 The heart rate of a normal fetus at term is: 100-120 bpm. 80-100 bpm. 120-160 bpm. There is no baseline heart rate. 160-180 bpm. 15 / 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 16 / 80 The last menstrual period was June 20th. The expected date of delivery (EDD) is approximately: April 23. March 23. March 27. March 28. April 7. 17 / 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: Congital cyanotic heart disease Congenital postero-lateral diaphragmatic hernia (stabilized) Emphysematous bullae Congenital cystic lung disease 18 / 80 In a vertex presentation, the position is determined by the relationship of what fetal part to the Mother's pelvis: Sinciput. Mentum. Occiput. Sacrum. Acromian. 19 / 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 . 20 / 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 21 / 80 This is not true about autism most cases have normal intelligence commoner in males than in females with a male:female ratio of 3:1 it's characterised by restricted and repetitive behavior it is pervasive developmental disorder there is severe language and speech developmental disorder 22 / 80 Rupture of membranes is suspected with all of the followings EXCEPT: Contractions seen on the CTG. Pooling of amniotic fluid on speculum examination. Positive Fern test. Positive Nitrazine test. Observing amniotic fluid drain through the cervix during speculum examination. 23 / 80 A bloody nipple discharge in a 35 year old West African is most likely to be caused by: Intraductal comedo-carcinoma Scirrhous breast carcinoma Chronic breast abscess Duct ectasia 24 / 80 The following are causes of spastic paraparesis except; Guillain Barre syndrome Transverse myelitis Disc prolapse Potts disease 25 / 80 Cause of ptosis include the following except 4th nerve palsy tick paralysis horner syndrome botulism myasthenia gravis 26 / 80 Facial features of fetal alcohol syndrome include the following except microcephaly thick upper lip smooth philtrum short palpebral tissue ptosis 27 / 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 28 / 80 Neonatal resuscitation most effective action is ventilation of the baby's lungs chest compression is initiated when heart rate is below 100 bpm clearing airway preceeds keeping baby warm involves administration of iv aminophylline to preterms atropine is administered when heart rate is below 100 bpm 29 / 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 30 / 80 Molding of the fetal head: Usually cause brain damage. Does NOT have time to occur in breech delivery. Increase the difficulty of delivery. Does not happen when maternal pelvis is adequate. Becomes progressively easier as gestational age increase. 31 / 80 In intestinal obstruction at the sigmoid colon due to stenosis, perforation is most likely to occur in the Terminal ileum Transverse colon Caecum Descending colon 32 / 80 Squamous cell carcinoma 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 Is the commonest malignant tumour of the anus Bleeds but does not cause pain on defaecation 33 / 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. Acute bacterial endocarditis Viral hepatitis Sub acute bacterial endocarditis 34 / 80 The features listed below may be associated with migraine headache EXCEPT Nausea Neck stiffness may be present Pulsatile or throbbing headache Photophobia. 35 / 80 Neuro hormones which are activated in cardiac failure include all EXCEPT: Aldosterone Nordrenaline Thyroxine Brain naturetic protein 36 / 80 Which one of the drugs or measures do not worsen uraemia? Gentamycin Diarrhoea Hypotension Paracetamol 37 / 80 In hypopituitarism all these hormones may be deficient except Follicle stimulating hormone Growth hormone Cholecystokinin Adrenocorticotropic hormone Prolactin 38 / 80 An ectopic pregnancy: Occurs only in the fallopian tubes Gives an increased risk of Hyperemisis Gravidarium Pain always presents before the bleeding Usually presents with pain before bleeding Can only be treated surgically 39 / 80 In normal pregnancy, the value of ß-hCG doubles every: 14 days. 8 days. 2 days. 4 days. 10 days. 40 / 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 41 / 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? Irreducible incomplete inguinal hernia, probably containing omentum Sebaceous cyst of the scrotum Encysted hydrocele of the cord Cyst of the epididymis 42 / 80 Features found in nephrotic syndrome include the following EXCEPT: Oedema Hypoalbuminsemia Hypertriglyceridemia Normal renal function 43 / 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 Myasthenia gravis Scleroderma 44 / 80 In bronchiolitis, all these are true except may present with with low grade fever it's usually a self-limiting disease drug of choice is acyclovir most commonly caused by respiratory syncytial virus primarily affects children less than 2 years old 45 / 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? Post renal uraemia Hypovolaemia Atonic bladder Injury to sacral nerve plexus 46 / 80 Regarding Hyperemesis gravidarum, which one of the following items is TRUE? Worsen in missed abortion Not known to happen in molar pregnancy Is a complication of multiple pregnancy Liver function test is not required Urine for culture and sensitivity is not important 47 / 80 Which of the of the following is a LEAST likely presentations of myocardial infarction ? Severe crushing pain in the precordium No chest pain in an elderly female diabetic Shock . Sharp piercing pain in the left which worsens with breathing 48 / 80 The following are treatment for simple malaria except artesunate - amodiaquine dihydroartemisinin - piperaquine artemether - lumefantrine oral quinine dihydroartemisinin - lumefantrine 49 / 80 The risk of postpartum uterine atony is associated with: Twin pregnancy. Median episiotomy. Epidural anesthesia. Labour associated with an active rate of change of 1 cm per hour. Hypotension. 50 / 80 These are chronic complications associated with sickle cell disease except leg ulcers congestive heart failure priapism aseptic necrosis of the hip or shoulder chronic lung disease 51 / 80 Stages of labour The cervix dilates at consistent rate of 3 cm per hour in the first stage The first stage commences at the time of membrane rupture 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 third stage end with the delivery of the placenta and membranes 52 / 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 53 / 80 The pelvis includes which of the following bones: Ilium, ischium, pubis, sacrum and coccyx. Trochanter, sacrum, coccyx, ilium and pubis Sacrum, Tibia, ilium and pubis. Ilium, scapula, ischium and pubis. Trochanter, hip socket, ischium, sacrum and pubis. 54 / 80 Malignant degeneration of a healing wound is most likely to occur: When a patient is on cytotoxic agents. When iodophor antiseptics are used for dressing. When a state of chronicity from (e.g) recurrent infection prevails. When wounds are exposed to heat. 55 / 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 adenoma sebaceum and tuberous sclerosis cortical tuber in neurofibromatosis shagreen patch and tuberous sclerosis 56 / 80 The most effective surgical procedure in stress ulceration is: Polya partial gastrectomy Vogotomy and pyloroplasty with suturing of bleeding points Total gastrectomy Vogitomy and hemigastrectomy 57 / 80 These are gross motor skills except transfers object from hand to hand sits with support stands alone steadiness of head when placed in supported position walks up stairs with help 58 / 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 59 / 80 All these conditions cause hypokalemia in children except frusemide gastroenteritis renal tubular acidosis type 1 acute tubular necrosis pyloric stenosis 60 / 80 The thyroid gland in thyrotoxicosis: If primary is uniformly enlarged and rather soft or firm 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 61 / 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. Via the payer's patches to the mesenteric lymph nodes. Through the tonsils to the cervical lymph nodes. 62 / 80 Concerning febrile seizures Complex features is not a risk factor for recurrence They usually have a poor prognosis Overall, 30% develop epilepsy Main risk factor for recurrence is the temperature at time of seizure. Overall risk for recurrence is 3-4% 63 / 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 64 / 80 Which of these discriptions adequately describe malena stools? Dark stools Black stools Black tarry or sticky stools Loose very shining black stools 65 / 80 This is not a cause of hypoglycaemia in newborns hypoinsulinaemia intrauterine growth retardate infant of a diabetic mother prematurity sepsis 66 / 80 The second stage of labour involves: Effacement of the cervix. Dilation of the cervix. Expulsion of the placenta. Expulsion of the fetus. Separation of the placenta. 67 / 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 68 / 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 Gastro-enteritis Acute high intestinal obstruction Acute pancreatitis Acute gastritis 69 / 80 All these conditions cause conjugated hyperbilirubinemia in newborns except biliary atresia sepsis breast milk jaundice torch infections galactosemia 70 / 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 Monteggia fracture dislocation Fracture of the olecranon process Supracondylar fracture 71 / 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? Renal stone Urinary tract infection Drug induced Haemolysis 72 / 80 Causes of macrocephaly include the following except fetal alcohol syndrome thalassaemia achondroplasia mucopolysaccharidosis hydrocephalus 73 / 80 The main tissues which provide support to the uterus include: Round ligament and the Broad ligaments Perineal body and the Broad ligaments Cardinal ligaments and the Uterosacral ligaments Broad ligaments and the Uterosacral ligaments Uterosacral ligaments and the Broad ligaments 74 / 80 Which of the following anti diabetic drugs increases insulin sensitivity? Glibenclamide DPP4 inhibitors Metformin Pioglitazone 75 / 80 These are causes of acute stridor except laryngomalacia acute epiglottitis diphtheria bacterial tracheitis croup 76 / 80 The following are contraindications for lumbar puncture except skin infection at or near the site of the lumbar puncture Cervical spondylosis Acute spinal cord injury Raised intracranial pressure Coagulopathy 77 / 80 Cause of neonatal seizures include the following except hypermagnesaemia intracranial hemorrhage hypoxic ischaemic encephalopathy bilirubin encephalopathy pyridoxine deficiency 78 / 80 Which of the following is NOT a characteristic of normal labour: Moderate pain. Progressive cervical dilation. Increasing intensity of contractions. Moderate bleeding. Uterine relaxation between contractions. 79 / 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 tubular necrosis Pre-renal renal failure Acute renal failure 80 / 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 Your score is LinkedIn Facebook Twitter 0% Restart quiz Send feedback