FINAL MOCK EXAM (rd Mock)

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There are two section;
Section A: 250 multiple Choice Questions
Section B: 50 Picture Test Questions
There is no negative markings (Attempt all questions)
YOU HAVE A TOTAL OF 3HRS FOR THIS EXAM.

1: Co-axial Mapleson D system is?

1 point

Lack system

Bain system

Close system

Ayres T-piece

Margill system

Clear selection

2: Which of these systems is used for neonatal anesthesia?

1 point

Lack system

Margill system

Mapleson D system

Brain system

Ayres T piece (aka Mapleson E)

Clear selection

3: The airways could be maintained with one of the above

1 point

Stylet

Magill system

Nasal catheter

Guedel's airway

Venti-mask

Clear selection

4: The following have ASA 3 and 4 physical status except

1 point

Ruptured uterus

Severe pre-eclampsia

Constructive pericarditis

Age greater than 65 years

Bleeding placenta praevia

Clear selection

5: Which of these is not an essential part of anesthetic machine ?

1 point

Vapourizer

Flow meter

Oxygen alarm

Calcium hydroxide

Sodium hydroxide flow meter

Clear selection

6: Soda lime absorption system is made up of the following except

1 point

Calcium hydroxide

Sodium hydroxide

Moisture

Magnesium

Silicate

Clear selection

7: Soda lime absorption is made up of the following except

1 point

Moisture

Calcium hydroxide

Silicate

Zinc

Sodium hydroxide

Clear selection

8: Which of the following is a neuro-axial block?

1 point

Retrobulbar

Subarachnoid block

Cervical plexus block

Sciatic nerve block

Brachial plexus block

Clear selection

9: The size of spinal needle used for subarachnoid block includes:

1 point

23G

40G

14G

12G

Clear selection

10: Regional anesthetic technique include the following except?

1 point

Nerve block

Bier's block

Epidural block

Brachial plexus block

Subarachnoid block

Clear selection

11: The following are anesthetic vapours excepts

1 point

Isoflurane

Ether

Nitrous oxide

Sevoflurane

Halothane

Clear selection

12: Inhalational anesthesia include the following except?

1 point

Etomidate

Diethyl ether

Halothane

Trichlorothylene

Isoflurane

Clear selection

13: Hypertension under anesthesia may be caused by all except

1 point

Hypothermia

Pre-operative hypertension

Hypercapnia

Pain

Light anesthesia

Clear selection

14: Causes of intra-operative hypoxemia include all except

1 point

Low fractional inspired oxygen concentration

30% of fractional improved oxygen concentration

Pain and awareness

Continuous ventilation without muscle relaxation

Kinking of endotracheal tube

Clear selection

15: The following are associated with full stomach except?

1 point

Hiatus hernia

Pregnancy

Ingestion of clear oral fluid 3 hours before induction of anesthesia

Ingestion of solid food 4 hours before induction of anesthesia

Intestional Obstruction

Clear selection

16: The family of premedicants include the following except?

1 point

H2 blockers

Benzodiazepine

Cholinergics

Phenothiazine

Butyrophynone

Clear selection

17: Raised PCO2 is expected in all the following except?

1 point

Diabetic coma

Vomiting due to pyloric stenosis

Renal failure

Severe chronic bronchitis

Pulmonary embolism

Clear selection

18: Balanced anaesthesia is?

1 point

Narcosis/ analgesia/ muscle relaxation

Analgesia/ sedation/hypnosis

Analgesia/excitement/ anaesthesia

Analgesia/muscle relaxation/sedation

Hypnosis/analgesia/sedation

Clear selection

19: Which of the following is used for monitoring ventilation under anaesthesia

1 point

Flow meter

Oxygen failure alarm

Vapourizer

Humidifier

Capnography

Clear selection

20: Correct placement of endotracheal tube confirmed by?

1 point

Capnography

Epigastric excursion

On the table X-ray of the neck

Auscultation

Direct visualization of the tube passing through the vocal cord

Clear selection

21: Which of the following about ESR is incorrect

1 point

Increase in severe anaemia

Is a measure of acute phase response

Low in polycythemia vera

Higher in males than females

Increase with age

Clear selection

22: First reaction in haemostasis

1 point

None of the above

Blood stasis

Blood aggulutination

Blood coagulation

Vascular spasm

Clear selection

23: Concerning galactosemia which of the following is not correct

1 point

If transferase activity is present in the RBC its diagonstic

Cataracts, lethargy and retarded mental dev also common

They vomit or have diarrhea after consuming milk, enlargement of the liver and jaundice are common progressing to cirrhosis occasionally

Inherited deficiency in galactose 1_P uridyltransferase

Infants fail to thrive

Clear selection

24: ABO incompatible transfusion is characterized by

1 point

Harmoglobubinaemia

Hypotension

fever chills

disseminated intravascular coagulation

localised bleeding

Clear selection

25: The sickling of sickle haemoglobin(HbS) etythrocytes may be ameliorated by any of these

1 point

decrease pH

none of the above

HbF

coexistence of HbS with thalasemia

coexistence of HbS with HbC

Clear selection

26: The aim of crossmatching during blood transfusion does not include

1 point

Identify atypical Ab

ABO compatibility

Ab screening of recipient

Ab screening of donor

Option 5

Clear selection

27: The preferred form of iron in the treatment of iron deficiency anemia is

1 point

IM iron dextran

Oral ferrous sulphate

Oral ferrous tumarate

Oral ferrous gluconate

IV iron dextran

Clear selection

28: Hypochromic microcytic anemia is classically caused by

1 point

Accelerated erythropoiesis

Iron deficiency

Recent blood loss

Folic acid deficiency

VitB 12 deficiency

Clear selection

29: Intravascular thrombous formation is most unlikely when there is

1 point

Hyperviscocity syndrome

Hypercoagulable state

Damage to endothelium

Stasis of blood

Warfarin theraphy

Clear selection

30: The philadelphia chromosome is most often associated with which disease

1 point

CML

follicular imphoma

burkitt lymphoma

ALL

down syndrome

Clear selection

31: Nlacin deficiency is associated with

1 point

dermatitis, diarrhea and dementia

night blindness

a bleeding diasthesis

neuromuscular cardiac prob and oedema

altered formation of connective tissue

Clear selection

32: Which of the following is false about vit C

1 point

necessary for synthesis of normal cartilage

deficiency state is termed scurvy

lack causes bleeding gum

water soluble vit

Clear selection

33: Lactate that is released into circulation can be converted back to glucose in the

1 point

Brain

Heart muscles

Erythrocytes

Liver

Adipose tissue

Clear selection

34: All of the following may characterize sickle cell anemia except that

1 point

. HbS has an unchanged electrophoretic mobility relative to normal hemoglobin

The solubility of deoxygenated HbS is abnormally low

Sickling occurs when there is a high concentration of the deoxygenation form of hemoglobin S

. The disease can be diagnosed in fetal DNA by restriction enzyme digestion

HbS is altered by the change of a single amino acid in the B chain

Clear selection

35: liver conversion of bilirubin to the hydrophillic form secreted in bile involves

1 point

● Conjugation with glucoronic acid

● Esterification with taurine

● Decarboxylation

● Conjugation with glycine

● The reduced form of nicotinamide adenine dinucleotide phosphate is dependent reduction to biliverdin

Clear selection

Option 1

Clear selection

37: Main platelet fxn test is

1 point

● Platelet aggregation time

● Coagulation time

● Prothrombin time

● Clotting time

● Bleeding time

Clear selection

38: Jaundice within the 1st 24hrs of life

1 point

● Maybe due to physiology

● Maybe due to Sepsis

● Mayb due to G6pd def

● Always abnormal

● maybe due to ABO incompatibility

Clear selection

39: Sickle cell anemia is an example of

1 point

● Genetic heterogeneity

● Co-dominance

● Variable expressivity

● Pleiotropism

● Polymorphism

Clear selection

40: Concerning bleeding disorders

1 point

● Thrombin time is reduced in fibrinogen deficiency

● PTTK is reduced with deficiencies of factors IX, X, XI, XII

● Prothrombin time is reduced in patients on warfarin therapy

● Bleeding time should not be performed in patients with high platelet counts

● Bleeding time measures platelet plug formation

Clear selection

41: Which of the following drugs is not likely to cause heamolysis in a patient with G6PD deficiency

1 point

● Quinolones

● Cefuroxime

● Dapsone

● Chloramphenicol

● Dimercaprol

Clear selection

42: Most likely cause of epistaxis in an uncontious Nigerian

1 point

● Raised intracranial pressure

● Sinusitis

● Hypertension

● CVA

● Fracture of the base of the skull

Clear selection

43:Acquired specific immunity

1 point

● May be an unwanted factor in achieving transplantation success Abolished by cyclosporine not cycloserine

● Cytotoxic reaction is type III hypersensitivity reaction

● Involves the activity of plasma cells

● Involves antibody production by T lymphocytes

can be abolished by administration of cycloserine

Clear selection

44: the following can cause tb reactivation in an individual xcept

1 point

● recurrent rhinitis

● steroid therapy

● cytotoxic therapy

● old age

● Immunosuppression

Clear selection

45: The major scavenger cell involved in the inflammatory response is

1 point

● Macrophages

● Neutrophil

● Plasma cell

● Eosinophil

● Lymphocyte

Clear selection

46:

1 point

● IgA antibody as the mediator of response

● Release of vasoactive amines

● Tuberculin type giant cell

● Reaction to an antigen on first exposure to the antibody

● An interaction of antibody with the eosinophilic leukocyte

Clear selection

47: Which of the following statements concerning IgG is correct

1 point

● Not normally produced until after birth

● Does not cross placenta

● Has high antigen affinity

● Abundant in secretions

● Least abundant Ig in serum

Clear selection

48: Concerning melanocytes

1 point

● Are derived from the neural crest, dendritic cells

● Melanocytes supply 12 keratinocytes

● Arranged in the basal layer in ratio 1:5

● The only cells responsible for pigmentation

● They directly produce melanin

Clear selection

49: Neutrophils

1 point

● Carry out oxygen dependent microbial killing by lysosomal enzymes

● Predominate in chronic inflammation

● Have bilobed nuclei

● May fuse to form multinucleate giant cells

● Have a lifespan of only few hours in inflamed tissue

Clear selection

50:Which category of hypersensitivity reactions best describes hemolytic disease of the newborn caused by rhesus incompatibility

1 point

● Immune complex

● IgE mediated

● Cytotoxic

● Delayed

● Atopic

Clear selection

51: Regarding diagnostic screening test

1 point

● Specificity refers to the ability of a test to detect the presence of a disease

● The sensitivity of a test is not affected by the prevalence of the disease in the population

● Sensitivity and specificity are usually inversely related

● Sensitivity refers to the ability of a test to detect the absence of a disease

● The positive predictive value refers to the probability of a person with a positive test not having the disease

Clear selection

52: characteristics of chromosome except

1 point

● rodlike twisted spiral or Curved

● most are >46ug long

● contains DNA

● contains genetic information

● threadlike basophilic lines in nuclei of cells

Clear selection

53: Suppurative lymph adenopathy may be caused by the following except

1 point

● Sarcoidosis

● Cat scratch fever

● Plague

● Lymphogranuloma venerum

● Tuberculosis

Clear selection

54: Muscle pain, esinophilia, facial oedema and GI Upsets are classical symptoms of clinical

1 point

● Pediculosis

● Onchocerciasis

● Toxoplasmosis

● Trichinosis

● Hookworm infection

Clear selection

55: Which of the following is true of viral hepatitis

1 point

● HbsAg is a marker of viral replication.

● Hepatitis D occurs only in association with hepatitis C

● Hepatitis E is not fatal in pregnant women

● Hepatitis C commonly present with jaundice

● Hepatitis A is a risk factors to hepatoma.

Clear selection

56: Meningitis is a feature of the following except

1 point

● Leptospirosis

● Anthrax

● Viral infection

● meningism

● mumps

Clear selection

57: Praziquantel is effective for treatment of the following except

1 point

● Paragonimiasis

● Pork tapeworm

● Schistosomiasis

● Diphyllobotriasis

● Beef tapeworm

Clear selection

58: in rabies

1 point

● skin specimen can be used for dx

● has a DSRNA genome enclosed within a bullet shaped capsid

● aerophobia can be a feature

● lewi bodies are seen on brain histology

● i.p is 2__16days

Clear selection

59: Which of the following substances has the lowest renal cleaeance

1 point

● Creatinine

● Glucose

● Potassium

● Sodium

● Para-aminohippuric acid

Clear selection

60: The following vaccines is NOT contraindicated in patients with HIV infection

1 point

● Hepatitis B

● Live attenuated

● MMR

● Small pox

● varicella

Clear selection

61: In a patient with chronic hepatitis B, which one of this would suggest that the infection is in a chronic phase stage?

1 point

● Detected level of HbeAb

● Undetected level of HBV DNA

● A normal liver biopsy

● Elevated level of ALT

● Detected level of HbsAB

Clear selection

62: The following is true of viral hepatitis

1 point

● Presence of anti Hbs is evidence of post infection immunisation

● Presence of antibody against HbcAg is indicative of current infection

● HbsAg is detectable during incubation period

● Acute viral hepatitis b infection does not progress to carrier state

● Hepatitis C is a common cause of Acute symptomatic hepatitis

Clear selection

63: Diphyllobotum latum causes anemia by

1 point

● Competition with host for vit B12

● Occlusion of common bile duct

● Blood sucking activity

● Production of toxin that affects RBCs

● Inhibition of iron absorbtion

Clear selection

64: Skeletal muscle, cardiac and CNS tissue involvement occurs with which of the following

1 point

● Wuchereria Bancrofti

● Onchocercia volvulus

● Necator americanus

● Trichenella spirallis

● Enterobius vermicularis

Clear selection

65: A rising titre of antistreptolysin O indicates a diagnosis of

1 point

● Erypsipelas

● Glomerulonephritis

● Acute rheumatic fever

● Scarlet fever

● A recent streptococcal infection

Clear selection

66: Agents that should be used initially in the mgt of Ascaris or enterobius vermicularis include

1 point

● Antimony potassium tartate

● Thiabendazole

● Diethyl carbamazipine

● Tetrachloroethylene

● Pyrantel parmoate

Clear selection

67: Which statement about HIV virus is not true

1 point

● Reverse transcriptase is a DNA dependent polymerase

● It is a retrovirus

● Genetic material is RNA

● They re transcribed by reverse transcriptase

● The virus do not have their genetic information transcribed into DNA molecule

Clear selection

68: Which of the following statements concerning S.Mansoni infestation is false

1 point

● The eggs are usually shed in the faeces

● It is a frequent cause of hematuria

● One of the phases in the life cycle includes the fresh water snail

● The initial phase of infection in humans is from water contact with the skin

● Liver fibrosis may be a long term complication

Clear selection

69: which is not recommended for PEP

1 point

● abacavir

● NVP

● efavirenz

● didanosibe

● lopinavir+ritonavir

Clear selection

70: The most common cause of meningitis in children in the age range 6months-5yrs.

0 points

● S. Agalactatie

● Meningococcus

● H. Influenza B

● Pneumococcus

● E. Coli

Clear selection

71: Risk of congenital rubella is highest in an infant when the mother becomes infected

1 point

● During the first trimester of pregnancy

● One month b4 a full term delivery

● Hours before child birth

● One week before full term delivery

● During third trimester of pregnancy

Clear selection

72: Muscle pains, eosinophilia, fascial edema, gastrointestinal upsets are classical symptoms of

1 point

● Pediculosis

● Onchocerciasis

● Hookworm infestation

● Toxoplasmosis

● Trichinosis

Clear selection

73: Which of the following parasitic disease is wrongly matched against vector

1 point

● Leishmaniasis— sandflies

● Loasis— chrysops flies

● American trypanosomiasis— tse tse fly

● Lymphatic filariasis— culex mosquito

● onchocerciasis— simulum spp

Clear selection

74: Which of the following disease is most commonly prevented with orally administered vaccines

1 point

● Hepatitis

● Rabies

● Cholera

● Typhoid

● Polio

Clear selection

75: Parasites which infect humans by penetrating the skin include which of the following

1 point

● Trichuris trishuria

● Necator americanus

● Strongyloides stercoralis

● Ascariasis lumbricoides

Clear selection

76: The following is true of viral hepatitis

1 point

● Presence of anti Hbs is evidence of post infection immunisation

● Presence of antibody against HbcAg is indicative of current infection

● HbsAg is detectable during incubation period

● Acute viral hepatitis b infection does not progress to viral state

● Hepatitis C is a common cause of Acute symptomatic hepatitis

Clear selection

77: In a patient with chronic hepatitis B, which one of this would suggest that the infection is in a chronic phase stage?

1 point

● Detected level of HbeAb

● Undetected level of HBV DNA

● A normal liver biopsy

● Elevated level of ALT

● Detected level of HbsAB

Clear selection

78: the fully developed cyst of e histolytica contains

1 point

● 8 nuclei

● 2 nuclei

● 3nuclei

● 4 nuclei

● 1 nucleus

Clear selection

79: Persistent diarrhoea in AIDS is caused by

1 point

● Gardia lamblia

● Balantidium coli

● Isospora belli

● Staphylococcus aureus

● H. Pylori

Clear selection

80: A skin swelling with a punctum is likely to be a

1 point

● Epididymal cyst

● Sebaceous cyst

● Branchial cyst

● Dermoid cyst

● Rheumatoid nodule

Clear selection

81: AIDS defining illness

1 point

● Chronic mucocutaneous herpes simplex

● Chronic diarrhoea

● Weight loss

● Herpes zoster

● Recurrent oesophageal candidiasis

Clear selection

82: Herpes zoster

1 point

● May be reactivated from a case of chicken pox

● Post herpetic neuralgia does not respond to gabapentin

● Is treated with oral acyclovir 400mg 5x daily

● Corneal ulceration is not a feature

● May not involve bowel and bladder dysfunction

Clear selection

83: Potts disease

1 point

● Can be treated for less than a month

● Pain along the spine is a diagnostic criterion

● Causes hemiplegia

● Occurs only in patients who are immunocompromised

● May present with a gibbus

Clear selection

84: Zidovudine inhibits the following viruses

1 point

● E. A and C

● D. A and B

● CMV

● HBV

● HIV

Clear selection

85: The following are true except: In typhoid fever

0 points

● Intestinal haemorrhage is due to mucosal erosion from massive Infection.

● The causative organisms enter only by the alimentary canal

● Intestinal perforations can occur without signs and symptoms of peritonitis

● Only positive blood cultures are diagnostic of the infection

● The organisms can be cultured from bone marrow aspirates

Clear selection

86: Malaria may be associated with

1 point

● Acute glomerulonephritis

● Nephrotic Syndrome

● Zencker’s myonecrosis

● Black water fever

● Blindness

Clear selection

87: Complications of salmonella infection include

1 point

● Pneumonia

● Nephritis

● Orchitis

● Lymphadenopathy

● Osteomyelitis

Clear selection

88: Pyrexia of undetermined origin may be traced to

1 point

● Tuberculosis

● Neoplasia

● Drug reaction

● Hypothrodidism

● Factitious manipulation

Clear selection

89: Opportunistic infections in AIDS include

1 point

● Enterocolitis due to E. Histolytica

● Oesophagitis due to Candida infection

● Pneumonia due to Pneumocystis carini

● Stomatitis due to herpes simplex

● Pneumonia due to Streptococcal infection

Clear selection

90: During the sero-conversion period of HIV Infection the following may occur

1 point

● Oral ulcers

● Chronic nephritis

● The patient may be asymptomatic

● Lymphadenopathy

● Intermittent Fever

Clear selection

91: The following statements about infection are true except

1 point

● Transmission in infectious mononucleosis is usually by oral contact.

● Resistant strains of gonococcus should be treated with spectinomycin.

● Non-gonococcal urethritis is usually the first lesion in Reiter’s Syndrome

● Whipworm infestation may cause persistent diarrhea and/or rectal prolapse in children

● Adult pinworms lay eggs around the anus

Clear selection

92: In ancylostomiasis

1 point

● Blood stained sputum may be produced in heavy infection

● Frequent loose stools is a clinical feature.

● Ground itch may be experienced at the time of infection

● Vomiting and epigastric pain may occur

● The filarial form penetrates human skin

Clear selection

93: Engagement is strictly defined as:

1 point

When the presenting part goes through the pelvic inlet.

When the presenting part is level with the ischial spines.

When the greatest Biparietal diameter of the fetal head passes the pelvic inlet.

When the greatest Biparietal diameter of the fetal head is at the level of ischial spines.

None of the above

Clear selection

The heart rate of a normal fetus at term:

0 points

80-100 bpm.

100-120 bpm.

120-160 bpm.

160-180bpm.

There is no baseline heart rate

Clear selection

In a pregnant patient with bicornuate uterus the following complications may occur, except:

1 point

Polyhydramnios

Abortion

Preterm labor

Abnormal fetal lie

Retained placenta

Clear selection

Which of the following is suggestive of ovulation?

1 point

a) Basal body temperature drops at least 0.5C in the second half of the cycle

b) Day 21 estrogen level is elevated

c) Progesterone level on day ten of the cycle is elevated

d) Regular cycle with dysmenorrhea

e) Oligomenorrhoea

Clear selection

In normal physiological changes in pregnancy, all of the following are increased EXCEPT:

1 point

a) Glomerular filtration rate.

b) Stroke volume.

c) Peripheral resistance.

d) Plasma volume.

e) White blood cells.

Clear selection

All of the following causes Oligohydromnios except:

1 point

a) Renal agenesis

b) Poor placental perfusion

c) Post term pregnancy

d) Anencephaly

e) Urinary obstruction

Clear selection

The following statements are all TRUE about vomiting in pregnancy, except:

1 point

a) May be cured by admission to hospital

b) Is commonest in the third trimester

c) Associated with multiple pregnancy

d) Is associated with trophoblastic disease

e) Is associated with urinary tract infection

Clear selection

An Ultrasound in the 1st trimester of pregnancy is done for:

1 point

a) Placental localization

b) Detecting of fetal weight

c) Assessment of amniotic fluid volume

d) Detection of fetal breathing

e) Dating of the pregnancy

Clear selection

In normal pregnancy, the value of β-hCG doubles every:

1 point

a) 2 days

b) 4 days

c) 8 days

d) 10 days

e) 14 days

Clear selection

Which of the following is NOT a presumptive symptom/sign of pregnancy?

1 point

a) Cessation of menstruation.

b) Quickening.

c) Nausea & vomiting.

d) Breast changes.

e) Darkening of the skin on the palms of the hands

Clear selection

Which of the following procedures allow the earliest retrieval of DNA for prenatal diagnosis in pregnancy:

1 point

a) Fetoscopy.

b) Amniocentesis.

c) Chorionic Villi Sampling (CVS)

d) Percutaneous Umbilical Blood Sampling (PUBS)

e) Fetal biopsy.

Clear selection

All of the following are increased in multiple gestation EXCEPT:

1 point

a) Blood loss at delivery.

b) The incidence of congenital anomalies.

c) The incidence of cephalopelvic disproportion.

d) The incidence of placental abruption.

e) The incidence of Malpresentation.

Clear selection

Excessive increased level of β-HCG is expected in:

1 point

a) Ectopic pregnancy

b) Pregnancy of diabetic mothers

c) Twin pregnancy

d) Incomplete abortion

e) Cervical carcinoma

Clear selection

14 weeks pregnant woman had abortion and she was told that it is a complete abortion. This is true regarding complete abortion:

1 point

a) Uterus is usually bigger than date

b) Cervical OS is opened with tissue inside the cervix

c) Need to have evacuation of the uterus

d) After complete abortion, there is minimal or no pain and minimal or no bleeding

e) Follow up with β-hCG for one year.

Clear selection

Regarding cervical incompetence, all of the following are true, EXCEPT:

1 point

a) Typically causes painful abortions

b) Typically causes mid-trimester abortions

c) Is treated by Shirodkar suture (cervical cerclage) which is best

d) Performed early in the second trimester

e) Can occur in patient with history of cone biopsy

Clear selection

A 25-year-old primigravida with 8 weeks threatened abortion, ultrasound would most likely reveal:

1 point

a) Thickened endometrium with no gestational sac

b) Fetal heart motion in the adnexa

c) Empty gestational sac

d) Collapsed gestational sac

e) An intact gestational sac with fetal heart beat

Clear selection

A consultant in the neonatal intensive care unit is recommending a trial of pyridoxine for a patient. Which of the following problems in a newborn infant might respond to a pharmacologic dose of pyridoxine?

1 point

(A) blindness

(B) seizures

(D) rash

(E) urinary retention

Clear selection

A newborn infant gags and chokes with feedings. He has just had an apneic spell during a feed resulting in significant cyanosis. Which of the following is the most likely diagnosis?

1 point

(A) proximal esophageal atresia

(B) hypoplastic left heart syndrome

(D) neonatal herpes simplex infection

(E) pyloric stenosis

Clear selection

A 7-day-old infant develops white, cheesy patches on the tongue and buccal mucosa with mild inflammation of the mucosa. Which of the following organisms is most likely the cause of these oral lesions?

1 point

(A) Candida albicans

(B) Listeria monocytogenes

(D) group A streptococcus

(E) group B streptococcus

Clear selection

A 35-week-gestation infant is delivered weighing 3.9 kg, with an omphalocele and a large tongue. No other abnormalities are detected. Which of the following is the most likely diagnosis?

1 point

(A) congenital hypothyroidism

(B) trisomy 18

(D) fetal alcohol syndrome

(E) Beckwith-Wiedemann syndrome

Clear selection

A mother presents for prenatal care with a complicated medical history as listed in the following choices. Which of the conditions most predisposes her fetus to congenital heart disease?

1 point

(A) hypertension

(B) diabetes mellitus

(D) anemia

(E) rheumatoid arthritis

Clear selection

A 3-day-old infant is requiring phototherapy for hyperbilirubinemia. Which of the following risk factors best predicts the occurrence of ABO isoimmune hemolytic disease in a newborn?

1 point

(A) first pregnancy

(B) more than four pregnancies

(D) maternal blood type is O and infant is type A

(E) preexisting maternal anemia

Clear selection

The pediatric surgeon is requesting an echocardiogram on a hospitalized newborn with a congenital defect of the gastrointestinal tract. Which of the following defects has the highest incidence of associated cardiac defects?

1 point

(A) omphalocele

(B) congenital volvulus

(D) gastroschisis

(E) pyloric stenosis

Clear selection

A patient with streptococcal pharyngitis develops tender red bumps along her entire tibia. What is the most likely diagnosis?

1 point

(A) sarcoidosis

(B) cellulitis

(D) insect bites

(E) erythema nodosum

Clear selection

A newborn boy has deficiency of the abdominal muscles and urinary tract abnormalities. What other anomaly will you most likely find?

1 point

(A) imperforate anus

(B) undescended testes

(D) congenital heart disease

(E) congenital aganglionic megacolon

Clear selection

A 6-year-old girl with short stature has webbing of the neck, a low posterior hairline, a broad chest, and cubitus valgus. Which organ is affected most frequently in patients with this syndrome?

1 point

(A) heart

(B) kidneys

(D) thyroid

(E) intestines

Clear selection

A 3-month-old infant has persistent stridor. What is the most likely cause?

1 point

(A) vascular ring

(B) laryngomalacia

(D) laryngeal cleft

(E) subglottic stenosis

Clear selection

A 14-year-old boy has an acutely painful and swollen scrotum. What should be the next step?

1 point

(A) fine needle aspiration

(B) bone marrow aspiration

(D) oral antibiotics

(E) bed rest and analgesia

Clear selection

A 16-year-old adolescent has morbid obesity. Which of the following conditions is the most common cause for pulmonary insufficiency in obese adolescents?

1 point

(A) pneumothorax

(B) gastric esophageal reflux disease

(D) asthma

(E) sleep apnea

Clear selection

A 2-year-old boy from Sudan has failure to thrive, chronic diarrhea, and severe candidiasis. You suspect HIV infection. Which of the followingorganisms would most likely be foundon stool examination?

1 point

(A) rotavirus

(B) Salmonella

(D) Giardia

(E) Yersinia enterocolitica

Clear selection

A7-year-old girl develops secondary nocturnal enuresis. What is the next best study?

1 point

(A) renal ultrasound

(B) voiding cystourethrogram

(D) urine analysis

(E) creatinine clearance

Clear selection

A newborn has been diagnosed with aniridia. Which of the following tests should be performed on this patient?

1 point

(A) chest radiograph

(B) alpha-fetoprotein measurement

(D) testicular examination

(E) renal ultrasound

Clear selection

A 38-week infant is born to a mother with gestational diabetes. Birth weight is 4255 g. What would you expect to see most commonly in this infant?

1 point

(A) neural tube defect

(B) small left colon syndrome

(D) hydronephrosis

(E) renal dysplasia

Clear selection

An infant has been diagnosed with congenital hypoparathyroidism. What are you most likely to find on evaluation?

1 point

(A) microcephaly

(B) hyponatremia

(D) goiter

(E) candidiasis

Clear selection

A 2-year-old toddler has a large abdominal mass and pancytopenia. Which of the following diagnoses would most likely be established by bone marrow aspiration?

1 point

(A) hepatoblastoma

(B) neuroblastoma

(D) rhabdomyosarcoma

(E) Wilms tumor

Clear selection

A 4-year-old boy has failed to grow and has evidence of exocrine pancreatic insufficiency. What is the most likely cause for this?

1 point

(A) acute pancreatitis

(B) biliary atresia

(D) congenital absence of the pancreas

(E) cystic fibrosis

Clear selection

An 8-month-old child has vomiting and screaming episodes for 12 hours. Physical examination reveals a sausage-shaped mass in the right upper quadrant. Which of the following would be most useful?

1 point

(A) passage of nasogastric tube

(B) examination of a stool specimen for ova and parasites

(D) abdominal ultrasound

(E) barium enema study

Clear selection

A6-year-old girl presents with unilateral nonpainful, nonsuppurative conjunctivitis and preauricular lymphadenitis. What is the most likely causative organism?

1 point

(A) Mycobacterium avium

(B) Bartonella henselae

(D) Staphylococcus aureus

(E) Chlamydia trachomatis

Clear selection

Which of the following is not a common ophthalmic emergency?

1 point

a. Fist blow to the upper eyelid.

b. Gonococcal conjunctivitis.

c. Seen cobwebs in one’s eye.

d.Penetrating trauma to the eye.

e. Migrainous headache.

Clear selection

What radiological investigation is most useful in breast cancer screening?

1 point

a. Mammography.

b. Chest Radiography.

c. Radionuclide study.

d. Ultrasonography.

e. Breast CT scan.

Clear selection

Which of the following is an invasive radiological imaging technique?

1 point

a. Ultrasonography.

b. Conventional CT scan.

c. Magnetic Resonance Imaging.

d. Chest Radiography.

e. Intravenous urography.

Clear selection

Which of the following statement is true of general anaesthesia?

1 point

a. The patient cannot be intubated.

b. The Surgeon can talk to the patient.

c. The patient can talk to the Anaesthetist at the head of the table.

d. Control over the airway and ventilation can be done by the anaesthetist.

e. The operating team is not allowed to position the patient.

Clear selection

Which of these statements is NOT correct about spinal anaesthesia?

1 point

a. It is safe to perform in skilled hands.

b. It can be performed in the ward.

c. It has a rapid onset.

d. It requires preloading with normal saline.

e. It sometimes results in higher level block.

Clear selection

Which of the following is NOT an indication for Tracheostomy?

1 point

a. Foreign body in the larynx.

b. Pharyngeal/ laryngeal tumours.

c. Bulbar paralysis.

d. Unilateral recurrent laryngeal nerve injury.

e. Bilateral recurrent laryngeal nerve injury.

Clear selection

The common complications of otitis media do NOT include

1 point

a. Mastoiditis

b. Conduction deafness

c. Upper respiratory tract infection

d. Intracerebral abscess

e. Meningitis

Clear selection

Which one of these is NOTa common foreign body seen in the ear of children?

1 point

a. Cotton balls.

b. Eraser.

c. Coin.

d. Nuts.

e. Beads.

Clear selection

Which of the following is NOT a common cause of epistaxis?

1 point

a. Nose picking.

b. Uncontrolled hypertension.

c. Nasal trauma.

d. Nasal polyp.

e. Chronic sinusitis.

Clear selection

Which of the following is NOT useful in the management of malignant pleural effusion?

1 point

a. Tube drainage.

b. Thoracocentesis.

c. Radioactive gold.

d. Thiotepa.

e. Ethacrynic acid.

Clear selection

Which one of these procedures is carried out during the removal of a chest tube?

1 point

a. Suction is first discontinued.

b. The patient expires deeply and holds the breath.

c. Vaseline gauze dressing is applied soon after the tube is removed.

d. Antibiotic cover is essential.

e. A chest radiograph is optional.

Clear selection

The commonest cause of oesophageal rupture is

1 point

a. Bouginage

b. Foreign body ingestion

c. Spontaneous rupture

d. Stab wound in the neck

e. Oesophago-gastroscopy

Clear selection

Which of the following features is specific in osteogenesis imperfecta?

1 point

a. Lability to fractures.

b. Ligamentous laxity.

c. Blue sclera.

d. Dentinogenesis imperfecta.

e. Osteosclerosis.

Clear selection

Concerning tetanus, which of these is NOT true?

1 point

a. It is common in road traffic injuries.

b. It is caused by an obligate anaerobe.

c. Period of onset and incubation period have similar prognostic importance

d. The name ‘lock-jaw’ drives from trismus

e. Anti-tetanus serum gives longer protection than the vaccination.

Clear selection

Which is incorrect concerning the application of a plaster castfor a fractured tibia in a 7-year old boy?

1 point

a. The cast should be an above knee cast.

b. The requirement includes plaster of paris, orthoban and water.

c. The plaster cast is expected to set in 5 minutes and dry in 20 minutes.

d. The cast can be removed after 6 weeks when the fracture should have healed.

e. Compartment syndrome can be a complication of casting.

Clear selection

Which of the following should NOT be included in the early management of ankle injuries?

1 point

1. Rest the limb.

2. Massaging with hot water.

3. Elevation of the limb.

4. Application of ice compress.

5. Compression of the ankle with crepe bandage.

Clear selection

Which of the following is NOT characteristicof chronic osteomyelitis?

1 point

1. Development of a sequestrum.

2. Presence of an involucrum.

3. Persistence of a discharging sinus.

4. Presence of an unrelenting Fever.

5. X-ray appearance of a cloacae.

Clear selection

The commonest microorganism implicated in the aetiology of osteomyelitis is

1 point

1. HaemophilusInfuenza

2. Staphylococcus aureus

3. Streptococcus spp.

4. Salmonella spp.

5. Pseudomonas aeruginosa

Clear selection

Which of the following is NOTassociated with Cleft palate?

1 point

1. Otitis media.

2. Malnutrition.

3. Upper respiratory tract infection.

4. Migraine.

5. Speech disorder.

Clear selection

A 65-year old man has an ulcer on the nose, with raised and rolled up edges. The likely diagnosis is

1 point

a. Syphilitic ulcer

b. Malignant melanoma

c. Basal cell carcinoma

d. Non-specific ulcer

e. Squamous cell carcinoma

Clear selection

The cut-off period of increase in size between hypertrophic scar and keloid is

1 point

1. 6 months

2. 10 months

3. 7 months

4. 5 months

5. 11 months

Clear selection

Which among the following is the commonest cause of neonatal intestinal obstruction?

1 point

1. Hirschsprungs disease.

2. Neonatal sepsis.

3. Obstructed hernia.

4. Jejuno-ileal atresia.

5. Rectal atresia.

Clear selection

The causes of hypertension in Nephroblastoma include

1 point

1. Bilaterality

2. Nephroblastoma in a solitary kidney

3. Paraneoplastic manifestation

4. Neuroblastoma

5. Occurrence in a set of Twins

Clear selection

Which one of the following statements is NOT trueconcerning childhood abdominal masses?

1 point

1. Most of these masses are intraperitoneal.

2. The causes can arise from any of the intra-abdominal structures.

3. Majority ofthese masses are non-neoplastic.

4. 60% of retroperitoneal masses are of renal origin.

5. Abdominal masses is a common clinical presentation in children.

Clear selection

Which of the following is correctconcerning Wingspread classification of anorectal malformation?

1 point

1. Anorectal agenesis is an intermediate anomaly.

2. Rectal atresia is a low anomaly.

3. Rectovaginal fistula is a high anomaly.

4. Anovestibular fistula is an intermediate anomaly.

5. Persistent cloaca is among the miscellaneous presentations.

Clear selection

Which of following is true concerning Spina bifida?

1 point

a. It is a congenital abnormality with a closed vertebral spinous process.

b. The spinal cord is always open to the exterior.

c. It is not associated with club foot.

d. A preconception use of folic acid is useful for its prevention.

e. Spina bifida occulta is the commonest mode of presentation.

Clear selection

Which of the following conditions is NOT associated with hydrocephalus?

1 point

a. Arnold-Chiari malformation.

b. Dandy-Walker syndrome.

c. Spina bifida.

d. Meningitis.

e. Arachnoid cyst.

Clear selection

The tumour from which of the following organsdoes NOT metastasize to the brain?

1 point

a. Stomach.

b. Breast.

c. Melanoma.

d. Thyroid gland.

e. Lung.

Clear selection

Side effects of OCP include all the following EXCEPT:

1 point

a) Breakthrough bleeding

b) Dysmenorrhea.

c) Nausea

d) Mastalgia

e) Mood swings

Clear selection

Which one of the following is NOT known to predispose to wound dehiscence?

1 point

1. Leakage of pancreatic juice

2. Early removal of stitches

3. Rickets

4. Malignant disease

5. Abdominal distension

Clear selection

A Glasgow Coma Score of 8 is indicative of which level of head injury?

1 point

1. Concussion.

2. Mild.

3. Severe.

4. Contusion.

5. Moderate.

Clear selection

What is the best radiological study for the initial evaluation of head injury?

1 point

1. Carotid Angiography.

2. Magnetic Resonance Imaging.

3. Skull Radiograph.

4. Computerized Tomographic scan.

5. Intracranial Pressure Monitor.

Clear selection

Which one of the following factors is associated withincreased risk of Erectile dysfunction?

1 point

1. Diabetes mellitus.

2. Hypertension.

3. Gout.

4. Cigarette smoking.

5. Depression.

Clear selection

The most common cause of incontinence in the elderly is

1 point

1. bladder outlet obstruction

2. stool impaction.

3. urethral hypermobility

4. meatal stenosis

5. detrusor areflexia

Clear selection

Bladder is palpable/percussable only when it contains at least

1 point

1. 80mls of urine

2. b. 100mlsof urine

3. 120mlsof urine

4. 200mlsof urine

5. 250mls of urine

Clear selection

Painful haematuria is NOT the classical presentation in

1 point

1. blunt bladder trauma.

2. urethral injury

3. nodular bladder tumor

4. active schistosomiasis

5. Tuberculous Urethritis

Clear selection

Undescended testis is commonly found

1 point

1. in the retroperitoneum

2. in the deep inguinal ring

3. in superficial inguinal pouch

4. In the femoral canal

5. In the perineal region

Clear selection

Carcinoma of the prostate

1 point

1. is typically a squamous cell carcinoma

2. is graded histologically using the Gleason Score

3. causes compressionof the rectum

4. is not influenced by hormonal manipulation

5. occurs predominantly in the central zone of the prostate

Clear selection

Which one of the following findings on rectal examination suggests BPH?

1 point

1. Rubbery and enlarged prostate gland.

2. Fixed rectal mucosa.

3. Obliterated median groove.

4. Smooth but hard prostate.

5. Tender prostate gland.

Clear selection

Which of these is NOT a common cause of haematuria in our environment?

1 point

1. Nephrolithiasis.

2. Malignancy of the bladder.

3. Benign prostatic hyperplasia.

4. Duplicated urethra.

5. Urinary Schistosomiasis.

Clear selection

Traumatic rupture of the membranous urethra

1 point

1. is usually diagnosed by radionuclide cystogram

2. rarely leads to long-term complications

3. is most often due to endoscopic surgery

4. is best treated by immediate urethral catheterisation

5. may show a "floating prostate" on rectal examination

Clear selection

Which of the following is an early symptom of BPH?

1 point

1. Haematuria.

2. Hesitancy.

3. Overflow incontinence.

4. Chronic retention of urine.

5. Erectile dysfunction.

Clear selection

The commonest histological type of carcinoma of the breast is

1 point

1. Papillary carcinoma

2. Squamous carcinoma

3. Lobular carcinoma

4. Medullary carcinoma

5. Invasive ductal carcinoma

Clear selection

A colostomy is

1 point

1. a form of fistula

2. surgically performed occasionally as permanent treatment

3. sometimes performed for inflammatory conditions

4. performed occasionally following abdominal trauma

5. usually performed for bowel preparation

Clear selection

Which of the following is correct about Goitre?

1 point

1. It is only palpable when both lobes are involved.

2. It is alwayseuthyroid.

3. It occurs almost invariably in mountainous areas.

4. It occurs in over a billion people.

5. It is usually neoplastic.

Clear selection

Which of the following is NOT a cause of gastrointestinal obstruction?

1 point

1. Adhesions.

2. Imperforate anus.

3. Ascariasis.

4. Tuberculosis.

5. Portal hypertension.

Clear selection

Which of the following is NOT true of haemorrhoids?

1 point

1. Portal pyemia could occur if haemorrhoids are not treated.

2. The classic positions of haemorrhoids are 3,7,11.

3. Bleeding from haemorrhoids is usually bright red.

4. The whole anal canal is approximately 4 cm long.

5. Haemorrhoids are not common in pregnant women.

Clear selection

Which of these organs is the most commonly injured in penetrating abdominal injury?

1 point

1. Small intestine.

2. Spleen.

3. Colon.

4. Liver.

5. Pancreas.

Clear selection

One feature that is NOT a risk factor in gastric malignancy is

1 point

1. Age group

2. Pernicious anaemia

3. Gastric ulcer

4. Blood group O

5. Adenomatous polyp

Clear selection

The commonest hernia in a female is

1 point

1. Inguinal

2. Umbilical

3. Femoral

4. Epigastric

5. Paraumbilical

Clear selection

Which of the following is NOT a complication of diverticular disease?

1 point

1. Abscess formation.

2. Fistulation formation.

3. Perforation.

4. Bleeding.

5. Intestinal Obstruction.

Clear selection

Which of the following is the worst prognostic factor in breast cancer?Patients age > 50years.

1 point

1. Involvement of apical axillary nodes.

2. Small size especially less 1cm.

3. Histologically well differentiated tumour.

4. ER and PR positivetumour.

Clear selection

In hypovolaemic shock, the most useful single monitoring tool is

1 point

1. hourly urine output

2. pulse and blood pressure every 15 minutes

3. colour of conjunctiva

4. central venous pressure

5. filling of cutaneous veins

Clear selection

Which of these is characteristic of a tuberculous ulcer?

1 point

1. It has an undermined edge.

2. It has an indurated base.

3. It has a regular outline.

4. It may be found just above the medial malleolus.

5. It has a floor covered with granulation tissue.

Clear selection

Which of the following is NOT true of indirect inguinal hernia?

1 point

1. It is commoner on the right.

2. Majority occurs after the age of 60 years.

3. It enters the scrotum via the triangle of Hasselbach.

4. Primary direct hernia is often acquired.

5. In females, fat prevents entry into the labia majora.

Clear selection

The most crucial obstacle to current safe surgery is considered to be

1 point

1. Haemostasis

2. Pain relief

3. Access to internal organs

4. Sepsis

5. Development of suture materials

Clear selection

Select one maneuver that CANNOT ascertain the position of nasogastric tube in the stomach.

1 point

1. Auscultating the epigastrium after injecting air into the stomach

2. Testing aspirate for acidity using buffer

3. Aspirating freely flowing content with a syringe

4. Taking a radiograph to identify tip

5. Testing aspirate for urease activity

Clear selection

Identify one feature NOT seen in obstructive jaundice.

1 point

1. Dark bulky stools

2. Dark coloured urine

3. Generalized itching

4. Anorexia

5. Fever chills and rigors

Clear selection

The most important factor in pyogenic infection is

1 point

1. Dose of the inoculum

2. Sutures contained in the tissues

3. Infectivity of the organism

4. Attendant tissue necrosis

5. Anaerobic environment in the tissue

Clear selection

Mechanisms of Oral Contraceptive Pills include all of the following EXCEPT:

1 point

a) Ovulation suppression

b) Enhanced ovarian androgen production

c) Altered cervical mucus

d) Altered endometrium

e) Altered tubal motility

Clear selection

All the following are considered to be complications of gestational diabetes, EXCEPT:

1 point

a) Polyhydramnios.

b) IUGR.

c) Fetal macrosomia.

d) Sudden unexpected intrauterine fetal death.

e) Neonatal hypoglycemia.

Clear selection

Which of the following is contraindication for delivery using vacuum extraction?

1 point

a) Face presentation

b) Second twin in vertex presentation

c) Post term pregnancy

d) Advanced maternal age

e) Chorioamnionitis

Clear selection

Trans placental infection occurs with all, EXCEPT:

1 point

a) Cytomegalovirus.

b) Toxoplasma

c)Rubella

d) Syphilis

e) Gonorrhea

Clear selection

A premature birth has been defined as:

1 point

a) Before 37 completed weeks' gestation.

b) Prior to the period of viability.

c) Weighing less than 1000 g.

d) Weighing more than 1000g but less than 2500g.

e) None of the above.

Clear selection

The following has a recognized relation with spontaneous preterm labor:

1 point

a) Fetus with anencephaly

b) Oligohydramnios

c) Maternal hypothyroidism

d) Bacterial Vaginosis

e) Transverse lie of the fetus

Clear selection

In cases with premature rupture of membranes, all the following are acceptable in the conservative management except:

1 point

a) Frequent vaginal examination to assess cervical dilatation

b) serial complete blood count to diagnose rising of WBC

c) Close monitoring of maternal vital signs

d) Ultrasound to assess fetal weight and amount of liquor

e) Monitoring of the fetus by doing cardiotocogram

Clear selection

Which of the followings is a contraindication to a trial of labor after cesarean delivery?

1 point

a) Prior classical incision.

b) Prior caesarean delivery for macrosomia

c) Prior IUFD.

d) Ultrasound estimation of fetal weight of 3500g.

e) Prior cesarean delivery for breech.

Clear selection

All the following are causes of DIC in pregnancy, EXCEPT:

1 point

a) Fetal demise.

b) Abortion.

c) Placental abruption.

d) Placenta previa.

e) Sepsis.

Clear selection

A 28 years old patient complains of the amenorrhea after D & C for postpartum bleeding. The most likely diagnosis:

1 point

a) Gonadal dysgenesis

b) Sheehan's syndrome

c) Kallman's syndrome

d) Mayer-Rokitansky- Kuster-Hauser syndrome

e) Ashermann's syndrome

Clear selection

A Rh-negative woman has increased chances of being immunized during pregnancy when:

1 point

a) Performing External cephalic version

b) Maternal anemia.

c) Premature labor.

d) Maternal Thyrotoxicosis.

e) Multiple pregnancy.

Clear selection

Anti-D prophylaxis:

1 point

a) Should be given to all sensitized Rhesus negative women after delivery

b) Should be given to all Rhesus negative women after amniocentesis.

c) Should be given to all Rhesus positive women who give birth to Rhesus negative babies.

d) Should be given to all women whose babies are Rhesus negative

e) Is contra-indicated during pregnancy if the woman is Rhesus negative

Clear selection

In placenta previa: Which is true?

1 point

a) It is common in primigravida

b) May cause abnormal lie

c) Causes recurrent painful bleeding

d) All patients should be induced with prostaglandin pessaries

e) Digital examination is mandatory to exclude local causes

Clear selection

A 33-year-old woman at 37 weeks’ gestation confirmed by early sonogram presents with moderate to severe vaginal bleeding, and is noted by sonogram to have placenta previa, which of the following is the best management for her.

1 point

a) Induction of labor

b) Give tocolytic drugs

c) Caesarean section

d) Expectant management

e) Artificial rupture of the membrane

Clear selection

Acceptable management of possible rupture ectopic pregnancy would include all of the following EXCEPT:

0 points

a) Exploratory laparotomy

b) Diagnostic laparoscopy.

c) Partial salpingectomy

d) Total salpingectomy.

e) Observation followed by Methotrexate.

Clear selection

Missed abortion may cause one of the following complication:

1 point

a) Bone marrow depression

b) Ruptured uterus

c) High positive serumβ-hCG

d) Skin allergies

e) Coagulopathy

Clear selection

A 25-year-old primigravida with 8 weeks threatened abortion, ultrasound would most likely reveal:

1 point

a) Thickened endometrium with no gestational sac

b) Fetal heart motion in the adnexa

c) Empty gestational sac

d) Collapsed gestational sac

e) An intact gestational sac with fetal heart beat

Clear selection

Regarding cervical incompetence, all of the following are true, EXCEPT:

1 point

a) Typically causes painful abortions

b) Typically causes mid-trimester abortions

c) Is treated by Shirodkar suture (cervical cerclage) which is best

d) Performed early in the second trimester

e) Can occur in patient with history of cone biopsy

Clear selection

14 weeks pregnant woman had abortion and she was told that it is a complete abortion. This is true regarding complete abortion:

1 point

a) Uterus is usually bigger than date

b) Cervical OS is opened with tissue inside the cervix

c) Need to have evacuation of the uterus

d) After complete abortion, there is minimal or no pain and minimal or no bleeding

e) Follow up with β-hCG for one year.

Clear selection

Excessive increased level of β-HCG is expected in:

1 point

a) Ectopic pregnancy

b) Pregnancy of diabetic mothers

c) Twin pregnancy

d) Incomplete abortion

e) Cervical carcinoma

Clear selection

The cardinal symptom of Acute Pancreatitis is

1 point

a. Fever

b. Vomiting

c. Epigastric pain

d. Constipation

e. Bleeding per rectum

Clear selection

Which of the following is the most important parameter in shock?

1 point

a. The blood volume is reduced.

b. There is cellular hypoxia.

c. Cardiac function is impaired.

d. There is vasoconstriction in the microcirculation.

e. There is adequate tissue perfusion.

Clear selection

A newborn is noted to have a darkened swelling of the scalp that does not cross the midline. This is most likely a:

1 point

a) Caput succedaneum

b) Subdural haemorrhage

c) Cephalohematoma.

d) Subarachnoid haemorrhage.

e) Subgaleal haematoma

Clear selection

Polyhydramnios is frequently observed in all of the following conditions except:

1 point

A. Esophageal atresia.

B. Duodenal atresia.

C. Pyloric atresia.

D. Hirschsprung's disease.

E. Congenital diaphragmatic hernia.

Clear selection

The pentalogy of Cantrell includes all of the following except:

1 point

A. Epigastric omphalocele.

B. Sternal cleft.

C. Intracardiac defect.

D. Pericardial cyst.

E. Ectopia cordis.

Clear selection

In infants with duodenal atresia all the following statements are true except:

1 point

A. There is an increased incidence of Down syndrome.

B. Duodenal atresia can be detected by prenatal ultrasound examination.

C. It may occur in infants with situs inversus, malrotation, annular pancreas, and anterior portal vein.

D. It is best treated by gastroenterostomy.

E. There is a high incidence of associated cardiac defects.

Clear selection

The calorie-nitrogen ratio for an infant should be maintained at:

1 point

A. 75:1.

B. 100:1.

C. 50:1.

D. 150:1.

E. 25:1.

Clear selection

A term infant 48 hours of age suddenly develops hypoxemia, irritability, and glucose and temperature instability. Which of the following statements are true?

1 point

a. Empiric antibiotic coverage for b-hemolytic Streptococci and Escherichia coli should be initiated

b. An intravenous infusion of prostaglandin E1 should be initiated immediately

c. Exogenous surfactant should be given immediately

d. The mortality rate for this child is approximately 20%

Clear selection

Which of the following is the most common primary lung tumor in infants and children?

1 point

a. Pulmonary blastoma

b. Squamous cell carcinoma

c. Endobronchial carcinoid

d. Leiomyoma

e. Metastatic osteogenic sarcoma

Clear selection

The following are not usual manifestations of atopy:

1 point

a. High serum IgE

b. Intense pruritus

c. Flexural dermatitis

d. Ichthyosis

e. Chronic rhinorrhoe

Clear selection

The following are endocrine causes of short stature except

1 point

a. Primary hypothyroidism

b. Glucocorticoid excess

c. Growth hormone resistance

d. Excess growth hormone secretion

e. Somatomedin C deficiency

Clear selection

Acromegaly

1 point

a. Is characterized by increased and unregulated growth hormone (GH) production

b. Is characterized by normal IGF-I production

c. Is more common in females than in males

d. Is of sudden onset

e. Is caused by adrenal tumour

Clear selection

The clinical diagnosis of rheumatic fever can be made using the Duckett Jone’s criteria in the presence of evidence of antecedent streptococcal infection. Which one of the five combinations below satisfies the diagnosis of Rheumatic fever?

1 point

a. One major and one minor criteria

b. Two major and one minor criteria

c. One major and two minor criteria

d. Chorea and prolonged PR-interval.

e. Fever and arthralgia.

Clear selection

You have just prescribed phenytoin for a 12-year-old boy with new onset of epilepsy. Of the following side effects, which is most likely to occur in this patient?

1 point

(A) lymphoma syndrome

(B) Raynaud phenomenon

(D) gingival hyperplasia

(E) optic atrophy

Clear selection

A term infant is born to a mother who has been using crack cocaine. This infant is at increased risk for which of the following?

1 point

(A) anemia

(B) intrauterine growth retardation

(D) macrosomia

(E) postmaturity

Clear selection

A 3-month-old infant presents with poor growth and inadequate weight gain. There is no history of vomiting or diarrhea. Except for the appearance of malnutrition and lack of subcutaneous fat, the physical examination is normal. What is the most likely cause of this child’s failure to thrive?

1 point

(A) renal disease

(B) a metabolic disorder

(D) an endocrine disorder

(E) a nonorganic cause

Clear selection

Missed abortion may cause one of the following complication:

1 point

a) Bone marrow depression

b) Ruptured uterus

c) High positive serumβ-hCG

d) Skin allergies

e) Coagulopathy

Clear selection

Acceptable management of possible rupture ectopic pregnancy would include all of the following EXCEPT:

1 point

a) Exploratory laparotomy

b) Diagnostic laparoscopy.

c) Partial salpingectomy

d) Total salpingectomy.

e) Observation followed by Methotrexate.

Clear selection

Congenital Hypothyroidism can occur

1 point

A. because of an anatomic defect in the gland,

B. as an inborn error of thyroid metabolism

C. Has two clinical forms

D. Usually lethal if untreated

E. All of the above

Clear selection

Isolated congenital talipes equinovarus is most likely to be the result of

1 point

A. Maternal trauma in the first trimester

B. Maternal ingestion of an abortificient in the first trimester

C. Mendelian inheritance

D. A cytogenetic abnormality

E. Multi-factorial inheritance

Clear selection

Osteomyelitis in sickle cell disease

1 point

A. Usually starts in the metaphysis

B. Has a less stormy course than in the HBAA patient

C. Is most frequently produced by staph pyogenes

D. Is frequently complicated by septicaemia

E. Amputation is commonly done to prevent septicaemia

Clear selection

The bone changes of sickle cell disease are particularly encountered in all except

1 point

A. Pelvis

B. Skull

C. Vertebral bodies

D. Metacarpals

E. Radius

Clear selection

One of these is not a common malignant bone tumour in the younger age group:

1 point

A. Clasic Osteosarcoma

B. Secondary Osteosarcoma [occurs in the older age group]

C. Ewing’s sarcoma

D. Paricosteal Osteosarcoma

E. None of the above

Clear selection

Rickets

1 point

A. Is seen in children and adolescents

B. Is in all patients caused by inadequate vitamin D intake

C. Results in failure of calcification of osteoid to osseous bone

D. The serum alkaline phosphatase is normal

E. Is now rare in the world because of routine administration of vitamin D to children

Clear selection

Among the causes of varus angular deformity of the knee, one of these is predominant in West African sub-region:

1 point

A. Rickets

B. Osteomyelitis

C. Blount’s disease

D. Poliomyelitis

E. Septic arthritis

Clear selection

Talipes equino-varus

1 point

A. Abducted, inverted and plantarly flexed foot

B. It may be congenital or acquired on top of paralysis of common peroneal nerve

C. Congenital deformity can be corrected while acquired ones cannot

D. Acquired deformity is bilateral while congenital is unilateral

E. In the acquired type, the sole of the foot is full of corrugation

Clear selection

Talipes equino-varus is characterized by all except:

1 point

A. Plantar flexion of the foot

B. Inversion of the foot

C. Adduction of forefoot

D. Abduction of the hind foot

E. Is primarily a subluxation of the mid tarsal joint

Clear selection

Tragal tenderness is a sign of?

1 point

A. Otitis media

B. Otitis externa

C. Labyrinthitis

D. Mastoiditis

E. Otitis externa et media

Clear selection

Nasal obstruction and mouth breathing in children under four years is most likely due to?

1 point

A. Rhinitis medicamentosa

B. Bilateral choanal atresia

C. Acute tonsillitis et pharyngitis

D. Adenoid hypertrophy

E. Foreign body in the nose

Clear selection

A 3 year old child with nasal obstruction, rhinolalia clausa, rhinorrhoea, snoring and sleep apnea disturbance may be suffering from

1 point

A. Le forte fracture type 1

B. Foreign body in the right nasal cavity

C. Foreign body in the left nasal cavity

D. Obstructive adenoid hypertrophy

E. Obstructive tonsil hypertrophy

Clear selection

Unilateral nasal discharge in a child is suggestive off?

1 point

A. Paranasal sinus mucocele

B. Vasomotor rhinitis

C. impacted foreign body

D. Nasal polyp

E. Allergic rhinosinusitis

Clear selection

Which of these systems is used for neonatal anesthesia?

1 point

A. Bain system

B. Mapleson D system

C. Margil system

D. Ayres T piece (aka Mapleson E)

E. Lack system

Clear selection

Which of the following childhood tumours has been associated with aniridia?

1 point

A. Neuroblastoma

B. Hodgkin’s lymphoma

C. Medulloblastoma

D. Nephroblastoma

E. Hepatoblastoma

Clear selection

Some cases of congenital anomalies result from the effects of teratogen. At what period during gestation is the embryo/fetus most susceptible?

1 point

A. 0-8 weeks

B. 12-16 weeks

C. 18-24 weeks

D. 28-34 weeks

E. 36-40 weeks

Clear selection

Which of the following conditions is associated with low level of maternal alpha fetoproteins?

1 point

A. Omphalocele

B. Gastroschisis

C. Down’s syndrome

D. Meningocele

E. Sacrococcygeal teratoma

Clear selection

Syndactyly could be associated with which of the following anomalies?

1 point

A. Tuberous sclerosis

B. Sturge-Weber syndrome

C. Arnold-Chiari type 2

D. Poland syndrome

E. EMG syndrome

Clear selection

Which is not true about cerebral palsy?

1 point

A. Mental retardation is sometimes the main problem

B. Musculoskeletal disorder are sometimes main problem

C. Speech, hearing and visual defects can occur

D. Brain lesion occur in perinatal age

E. It is caused by a progressive brain lesion

Clear selection

Which of the following is not a treatment modality for hydrocephalus?

1 point

A. Use of carbonic anhydrase inhibitor

B. Ventriculo-peritoneal shunt CSF diversion

C. Endoscopic third ventriculostomy

D. Aquedeuctoplasty

E. None of the above

Clear selection

Which of the following is not a cutaneous stroma of an underlying spinal dysraphism?

1 point

A. Dermal naevus

B. Dermal sinus

C. Lipoma

D. Implantation dermoid

E. None of the above

Clear selection

A newborn with trisomy 21 develops bilious emesis on the first day of life. An abdominal x-ray reveals a “double bubble sign.” Which of the following is the most likely diagnosis?

1 point

(A) annular pancreas

(B) duodenal atresia

(D) pyloric stenosis

(E) Hirschsprung disease

Clear selection

An 8-day-old infant develops inflammatory papules and pustules on the forehead, nose, and malar areas of the face. The child is otherwise well, and the remainder of the physical examination is normal. Which of the following is the most likely diagnosis?

1 point

(A) congenital syphilis

(B) impetigo

(D) staphylococcal pustulosis

(E) tuberous sclerosis

Clear selection

A full-term, ill appearing, infant presents with vesicles and large bullae shortly at birth. Which of the following is most likely?

1 point

(A) herpes simplex virus

(B) gram-negative infection

(D) Staphylococcus aureus

(E) maternal diabetes

Clear selection

A mother with hyperparathyroidism just delivered a term infant who appears healthy. Which of the following problems is likely to develop in her infant?

1 point

(A) hypercalcemia

(B) hypocalcemia

(D) hyperthyroidism

(E) hyperparathyroidism

Clear selection

You are evaluating an infant born at 39 weeks gestation weighing 2000 g. Which of the following would be the appropriate classification of this infant?

1 point

(A) low birth weight

(B) premature

(D) low birth weight and small for gestational age

(E) premature and small for gestational age

Clear selection

Which of the following statements is true concerning childhood brain tumors?

1 point

A. Most are infra-tentorial in location

B. Most are Supratentorial in location

C. Most are primary tumors

D. Most are secondaries from systemic cancer

E. And C above

Clear selection

Which of the following is not a cause of congenital hydrocephalus?

1 point

A. Dandy walker malformation

B. Arnold-Chiari malformation

C .Aqueductal stenosis

D. May be familial

E. Hydrocephalus exvacuo

Clear selection

Meningocele, all are true except?

1 point

A. Is the commonest variety of spina bifida

B. Is associated with hydrocephalus

C. May rarely contain lipomatous tissue

D. Should be excised the dura repaired

E. has an excellent prognosis

Clear selection

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