MEDICINE

1. The following statements about peptic ulcer disease are true except
a. Duodenal ulcers are more common than gastric ulcers
b. Duodenal ulcers do not become malignant
c. Gastric ulceration usually occurs with normal or low acid
d. Gastric ulcers are associated with blood group A
e. spicy food may play a role in the aetiology

2. Causes of erythema nodosum include all except

a. Sarcoid
b. Streptococcal sore throat
c. Sulphonamides
d. Trauma
e. Tuberculosis

3. Which of the following may be detected by urine dip stick

a. Bence Jones proteins
b. Hyaline cast
c. Microalbuminuria
d. Nitrite
e. Red cell cast

4. The following are possible causes of goitre except

a. Carbimazole
b. Exogenous iodine
c. Graves disease
d. Pregnancy
e. Puberty

5. Syncope is a recognized feature of

a. Fanconi syndrome
b. Malaria
c. Meniere’s disease
d. Otitis media
e. Thyrotoxicosis

6. Glycosuria may be found in

 a. Acromegaly - GH inhbits several functions of insulin
b. Addisons disease
c. Diabetes insipidus
d. Psychogenic polydipsia
e. Urinary tract infection
7. Recognized causes of diarrhoea include all the following except:
a. carcinoid syndrome
b. chronic pancreatitis
c. diabetes Mellitus
d. Hyperparathyroidism-causes hypercalcemia and causes constipation
e. thyrotoxicosis

8. Hypercalcaemia can occur in

a. acute pancreatitis
b. hypermagnesaemia
c. pseudohypoparathyroidism
d. pseudopseudohypoparathyroidism
e. sarcoid

9. Which of the following statements about the normal chest x ray is

correct?
a. The heart appears larger on a PA film
b. The horizontal fissure is normally visible to the left
c. The left hemidiaphragm is lower than the right
d. The left hilum is lower than the right
e. The trachea is slightly shifted to the left of the midline

10. Causes of papilloedema include all the following except:

a. Benign intracranial hypertension
b. Hyperparathyroidism
c. Hypertension
d. Parasagittal meningioma
e. Type II respiratory failure - normal pao2 and increased paCO2

11. Pulmonary embolism often produces the following:

a. Cardiomegaly
b. ECG pattern of S1Q3T3
c. Loud P2
d. Pleuritic chest pain
 e. Tachypnoea, bradycardia and hypoxia

12. Dysphagia occurs in these conditions except

a. Anxiety
b. Chagas disease- american trypanosomiasis
c. Iron deficiency
d. Myasthenia gravis
e. Pyloric stenosis- space between stomach and duodenum becomes
narrow

13. Acromegaly causes all of these except:

a. Blindness
b. Cardiomyopathy
c. Glycosuria
d. Hepatomegaly
e. Hypertension

14. The risk of osteoporosis is decreased in

a. Heparin treatment
b. Premature menopause
c. Regular exercise
d. Steroid therapy
e. Thyrotoxicosis

15. Ocular complications of diabetes mellitus include:

a. Glaucoma
b. Isolated sixth nerve palsy- abducence
c. Optic neuritis
d. Retinitis pigmentosa
e. Trichiasis

16. The usual clinical features of primaries hyperaldosteronism include the

following except:
a. Hypernatraemia
b. Hypokalaemia
 c. Hypotension - hypertension instead
d. hypertension
e. Mass in the suprarenal region

17. The following statements about type 1 diabetes are true

a. Diabetic nephropathy affects about 4%of all subjects
b. Insulin dosage must be decreased when illness prevents eating and
drinking.
c. Nephropathy is more common than retinopathy
d. Retinopathy is less common than with type II diabetes mellitus
e. There is increased frequency of HLA DR3

18. Nephrotic syndrome may be caused by:

a. Retinal vein thrombosis
b. Streptococcal sore throat
c. Severe gastroenteritis
d. Syatemic lupus erythematosis
e. Interstitial nephritis

19. All the following are causes of ptosis except:

a. Brain tumour
b. Damage to the sympathetic nervous system
c. Dystrophia myotonica
d. Facial nerve palsy
e. Myasthenia gravis

20. The following are features of bell’s palsy

a. Deafness
b. Hyperacusis- hearing disorder
c. Miosis
d. Ptosis
e. Upper motor neurone type of lesion
 INDEX NO.:…………………………………

PAEDIATRICS

21. Which of the following is a true statement about performing the

newborn examination?
a. Babies born at home should be excluded from a newborn
examination
b. Newborn examinations must be done by a doctor
c. The examination can be performed at any time provided the baby
has been fed, is warm and is not unwell
 d. A ‘systems-based’ approach is better than a ‘head to toe’ approach
e. Only speak to the parents and document findings if something is
abnormal.

22. Which of the following statements is true of the newborn skull?

a. The skull is made of three separate bones separated by sutures
b. The anterior fontanelle usually closes before the posterior fontanelle
c. The normal occipito-frontal circumference (OFC) for a full-term
baby is 28–30 cm
d. Plagiocephaly is more common in babies who sleep in the supine
position
e. A cephalhaematoma can cross several suture lines.

23. In Ghana, the following vaccinations are given routinely in the first 6
months of life, except:
a. Polio
b. Measles
c. Rotavirus
d. Hepatitis B
e. BCG

24. An 18-month-old toddler should be able to do which of the following:

a. Build a tower of 3 or 4 blocks
b. Use 2-3 word sentences
c. Copy a circle
d. Go up stairs 1-foot per step
e. Ride a tricycle

25. Which one of the following statements is FALSE with regard to the
composition of human milk versus cows' milk?
a. Human milk contains more unsaturated fat
b. Human milk contains more vitamins A, C and E
c. Human milk contains more calcium
d. Human milk contains more lactoferrin
e. Human milk contains more IgA
26. Which of the following mid upper arm circumference (MUAC)
measurements is the cut-off for severe acute malnutrition in a child less
than 5 years of age?
a. <115mm
 b. <120mm
c. <125mm
d. <130mm
e. <135mm
27. Using the new Ballard score, the following physical characteristics are
used to determine the gestational age of a newborn, except:
a. Skin
b. Posture
c. Lanugo
d. Plantar surface
e. Ear
28. The following anomalies are present in Tetralogy of Fallot:
a. Left ventricular hypertrophy
b. Stenosis of the tricuspid valve
c. Atrial septal defect
d. Overriding aorta
e. All of the above
29. You are in the Special Care Babies’ Unit. A 32-week gestation preterm
baby weighing 1600g has a loud, continuous heart murmur at the left
upper chest. Which one of the following is an appropriate further
action?
a. Stop all enteral feeding and keep baby nil per os
b. Examine the peripheral pulses and measure the blood pressure
c. Immediately administer oxygen via facemask
d. Prescribe intravenous antibiotics to decrease the risk of infective
endocarditis
e. Request for an urgent cardiac angiogram
30. Which of the following supports a diagnosis of iron deficiency anaemia?
a. Decreased red cell distribution width
b. Elevated serum ferritin
c. Increased percent transferrin saturation
d. Increased total iron binding capacity
e. Decreased HbA2 levels
31. A child would be classified as having clinical stage 4 HIV infection if
which of the following is present:
a. Recurrent oral ulcers
 b. Oesophageal candidiasis
c. Pulmonary tuberculosis
d. Herpes zoster
e. Persistent, generalized lymphadenopathy
32. The Epstein-Barr virus is often associated with all of the following
conditions, except:
a. Infectious mononucleosis
b. Burkitt’s Lymphoma
c. Rhabdomyosarcoma
d. Hodgkin’s Lymphoma
e. Oral hairy leukoplakia

33. In the neonatal period, an infant with Hb S disease:

a. Has a negative sickle solubility test
b. Often presents with hand-foot syndrome
c. Requires routine folic acid supplementation
d. Should be examined for splenomegaly
e. Should be evaluated with transcranial doppler studies to determine
stroke risk

34. Complications of blood transfusions include all of the following, except:

a. Haemolysis
b. Hyperviscosity
c. Alloimmunization
d. Iron deficiency
e. Cytomegalovirus Infection (CMV)

35. The most common cause of primary idiopathic nephrotic syndrome is:
a. Focal segmental glomerular sclerosis
b. Membranoproliferative glomerulonephritis
c. Membranous glomerulopathy
d. Minimal change disease
e. IgA nephropathy

36. Which of the following is an X-linked recessive disorder?

a. Duchenne muscular dystrophy
b. Von Willebrand disease
c. Tuberous sclerosis
d. Gardner’s syndrome
e. Tay Sachs disease
37. Features of rickets in children include all the following, except:
a. Frontal bossing
b. Kyphosis
c. Scaphoid abdomen
d. Marfan sign
e. Harrison groove

38. The most common cause of viral meningoencephalitis in children is:

a. Measles
b. Arbovirus
c. Enteroviruses
d. Herpes simplex virus
e. Cytomegalovirus

39. Complications of phenytoin may include all of the following, except:

a. Ataxia
b. Gingival atrophy
c. Aplastic anaemia
d. Hirsutism
e. Stevens-Johnson syndrome

40. Tumour lysis syndrome is associated with:

a. Hypocalcemia
b. Hypokalemia
c. Hyporuricemia
d. Hypophosphatemia
e. Hypoglycemia
 INDEX NO.:…………………………………

COMMUNITY HEALTH

41. The following applies to Descriptive Epidemiology:

a. It is used to develop hypothesis
b. It is used to test hypothesis
c. It is used to prove the cause of a disease
d. It requires matching of the study population
e. It requires a control group

42. Which of the following diseases has been earmarked for eradication?
a. Poliomyelitis
b. Leprosy
c. Lymphatic filariasis
d. Trachoma
e. Neonatal tetanus

43. Indicate which pair of words is incorrectly matched:

a. Plague……………Rat
b. Anthrax…………..Cattle
c. Yellow fever……..Aedes aegypti
d. Yaws……………..Gangosa
e. Dracontiasis………Cercaria

44. This helminth uses the skin as its mode of entry into the host
a. Ascaris lumbricoides
b. Necatur americanus
c. Dracunculus medinensis
d. Taenia saginata
e. Enterobius vermicularis

45. Colostrum, the first breast milk is said to contain antibodies and
protects the young baby against diseases. This immunity is
a. Acquired, passive, natural
b. Acquired, passive, artificial
c. Acquired, active, natural
d. Acquired, active, artificial
e. None of the above
46. The main measure for averting enteric fever epidemics in Ghana is;
a. Use of residual insecticides
b. Sanitary disposal of excreta
c. Prophylactic chemotherapy
d. Immunization of contacts
e. Periodic medical examination of food handlers
47. Incubation period is the time interval between exposure to an infectious
agent and the
a. Time the first symptom of disease develops
b. Time the first sign of disease develops
c. Time the first sign and symptom develop
d. Time the first sign or symptom develops
e. None of the above

48. Measures being used in Ghana to decrease maternal mortality include

the following except:
a. Increase in service coverage
b. Female education
c. Improved referral avenues for complications
d. Provision of maternity waiting homes
e. Family planning
49. A 26 year old lactating mother, with a baby aged less than 6 months,
who has not started menstruating, is counselled not to use this
contraceptive method:
a. Lactation Amenorrhoea Method
b. Combined oral pill
c. Implant
d. IUD
e. Condom

50. Neonatal mortalities in Ghana

a. Account for the majority of infant mortalities
b. Include deaths due to malaria
c. Are largely due to domestic accidents
d. Are a direct result of poor environmental conditions
e. Are not influenced by the quality of obstetric care
51. The current additions to the routine childhood immunization schedule
 in Ghana includes immunization against;
a. Tetanus
b. Diarrhoeal diseases
c. Tuberculosis
d. Rubella
e. Haemophilus influenza

52. The following food items are rich in vitamin A except:

a. Liver
b. Carrots
c. Milk
d. Whole grain cereals
e. Dark green leafy vegetables

53. Permanent nerve deafness may occur in one of the following group of
workers:
a. Drivers
b. Deep sea divers
c. Weavers in a textile factory
d. Workers in a paint factory
e. Sewage workers

54. A 30 year old man with Asthma and bronchitis, applying for a job in a
textile industry requires the following except:
a. A routine pre-placement medical examination
b. Chest Xray
c. Antibiotic chemopropylaxis
d. Lung function tests
e. Periodic medical examination

55. Choose the correct answer: A Health Education programme can be

considered successful if:
a. Majority of the people hear about the programme
b. Majority of the people become health conscious
c. Majority of the people change their attitude
d. Majority of the people change their behaviour
e. Majority of the people like the programme

56. Which of these statements is incorrect? In environmental health,

a. Water from a spring may be protected with a Henderson’s box
 b. Cholera and infective hepatitis are water-borne diseases
c. Composting comprises the breakdown of organic matter by both
anaerobic and aerobic micro-organisms
d. Super-chlorination of water is used in cholera epidemics
e. Infrared rays are sometimes used for the sterilization of air

57. Choose the correct answer: In water purification

a. A presumptive coliform count of 10/1000 mls of water is normal
b. The Biological Oxygen Demand is the excess oxygen in aeration of
water
c. Fluoride levels of .5mg-1mg/litre predispose to dental and skeletal
fluorosis
d. Free residual chlorine is the main disinfecting chemical
e. Filtration gets rid of viruses

58. The natural increase in population in an area is determined by:

a. Births and deaths
b. Deaths and migration
c. Births and migration
d. Births, deaths and net migration
e. Deaths and net migration
59. As used in statistics, the range of a series of observations is the:
a. Sum total of the values divided by the number of observations
b. Centre value when the observations are in order from highest to
lowest
c. Value occurring most often
d. Distance between the highest and lowest values
e. Variance

60. A polyclinic should have the following facilities except:

a. An Xray unit
b. A laboratory
c. A social welfare unit
d. d A pharmacy
e. A blood bank
 INDEX NO.:…………………………………

SURGERY

61. Horner`s syndrome is caused by damage to the cervical sympathetic

trunk. It’s features include all of the following except:
a. Absence of sweating
b. Drooping of the lower eye lid
c. Drooping of the upper eyelid
d. Contraction of the pupil
e. None of the above

62. The carotid sheath contains

a. External carotid artery
b. Internal jagular vein
c. Phrenic nerve
d. External jagular vein
e. Sympathetic trunk

63. The tenth cranial nerve is

a. Accessory
b. Vagus
c. Hypoglossal
d. Lingual
e. Phrenic

64. Passive immunization against Tetanus is achieved with

a. Tetanus toxoid
b. Penicillin
c. Human tetanus immunoglobulin
d. Botulin toxoid
e. Clostridia tetani

65. Tuberculosis of the spine destroys

a. Bone only
b. Intervetebral disc only
c. Both the bone and vertebral disc
d. None of the above
e. The spinal cord only
66. Crohn’s disease commonly affects the
a. mouth
b. duodenum
c. sigmoid colon
d. rectum
e. none of the above
67. Malignant melanoma can be staged using all of the following except
a. Sex
b. Age
c. Anatomical site
d. Type oftumour
e. Breslows thickness

68. patient with a blunt abdominal injury is likely to have diaphragmatic

hernia if the following is present
a. Tactile vocal fremitus is increased
b. Percussion note is resonant on the affected side
c. Breath sounds are increased
d. Chest expansion is increased
e. Chest pain is more on the right side

69. Congenital diaphragmatic thoracic hernias are commoner on

a. left side
b. Right side
c. Bilaterally
d. Midline
e. Retroperitoneal

70. Concerning gall bladder stones,

a. They occur equally in both sexes
b. Fatty foods relieve the biliary colic
c. It is uncommon in Africa
d. Diagnosis is by abdominal x-ray
e. Can be asymptomatic

71. A young adult male had a linear laceration on the face that required
 suturing. In order to achieve an optimum outcome, the following are
useful considerations
a. Pollygaltic suture is a non-absorbable suture
b. Interrupted sutures are preferable
c. Wound length : Suture length of 1 is ideal
d. Healing is often by primary intention
e. Healing is by secondary intention

72. A young adult female who had hysterectomy and developed symptoms
and signs of mechanical intestinal obstruction a week after surgery. The
most likely cause of the obstruction will be
a. Fibrous adhesions
b. Foreign body
c. Fibrinous adhesions
d. Hypokalemia
e. Tumour

73. An adult male involved in a road traffic accident was brought to the
emergency room an hour later with difficulty in breathing. Initial chest
x-rays showed patchy infiltrates in both lung fields otherwise
unremarkable. The most appropriate management for this patient will
be
a. Intravenous heparinisation as a case of pulmonary embolism
b. I.V furosemide as a case of fluid overload
c. Intranasal oxygen and possible ventilation as a case of pulmonary
contusion
d. Antikochs therapy for military TB
e. None of the above

74. A patient who had a human bite on the volar aspect of his hand is likely
to develop all of these complications except
a. Necrotising fasciitis
b. Compartment syndrome
c. Palmar Abscess
d. Cellulitis
e. Mondors disease

75. Concerning compartment syndrome, the following are all true except:
a. Occurs more commonly in the anterior compartment
 b. Can occur in an open wound of the leg
c. Can occur without external injury
d. Abdominal compartment syndrome may occur during laparoscopy
e. Urine output is increased in abdominal compartment syndrome

76. Causes of nipple discharge includes all except:

a. infection
b. cancer
c. trauma
d. skin diseases
e. lactation

77. A 105-year-old male has an inguinal hernia. Which of the following

statements is applicable to this case?
a. At this age an indirect hernia is more common than a direct
b. The hernia is liable to descend to the lower scrotum
c. The neck of the hernia sac lies medial to the inferior epigastric artery
d. The hernia begins between the lateral margin of the conjoint tendon
and the internal ring
e. Strangulation is likely to occur
78. Acute appendicitis is the commonest acute abdominal emergency. With
regard to the appendix,
a. It does not have any lymphatic tissue
b. The position at the base is relatively inconstant
c. It opens into first 2.5cm (1 in) of the ascending colon
d. It averages 15cm (6 in) in length
e. The tip lies most commonly in the retrocecal position.

79. A young medical officer carrying out his/her first hernia operation is
confused by the contents of the inguinal canal. He/she should expect to
encounter all these structures except:
a. The dartos muscle
b. The vas deferens
c. A persistent processus vaginalis
d. The genital branch of the genitofemoral nerve
e. The cremasteric muscle/fascia

80. Acid from a leaking gastric ulcer irritates the peritoneum covering the
undersurface of the central tendon of the diaphragm, and may produce
pain referred to the
a. Inner side of the left forearm
b. Umbilical region
c. Ear
d. Shoulder
e. Sternal region
 INDEX NO.:…………………………………

OBSTETRIC AND GYNAECOLOGY

81. A manoeuvre employed when there is shoulder dystocia that involves

hyperextending the legs at the hip onto the abdomen is known as
a. McLenaghans manoeuvre
b. McRoberts manoeuvre
c. McDonalds manoeuvre
d. McKinsey Manoeuve
e. McCanns manoeuvre

82. During a delivery involving shoulder dystocia, excessive traction on the

neck can damage the brachial plexus, resulting in
a. Elland’s palsy
b. Ellington’s palsy
c. Earl’s palsy
d. Erb’s plasy
e. Eel’s palsy

83. When liquor enters the maternal circulation, causing sudden dyspnoea,
hypoxia and hypotension, often accompanied by seizures, it is referred
to as
a. Cord prolapse
b. Amniotic fluid embolus
c. Fundal dystocia
d. Uterine rupure
e. FFP

84. Twins usually grow at the same rate as singletons until about ___ weeks
a. 28
b. 24
c. 20
d. 30
e. 18

85. When part, or all of the placenta separates before delivery of the foetus
it is termed
 a. Placental abruption
b. Placental deciduous
c. Placenta praevia
d. Placenta hyperchomnion
e. Placenta accrete

86. Which of the following is NOT a risk factor for pre-eclampsia?

a. multiparity
b. diabetes
c. chronic hypertension
d. obesity
e. twin pregnancies

87. Which of the drugs below is used to promote foetal pulmonary maturity
if the gestation is <34 weeks
a. methyldopa
b. steroids
c. Magnesium sulphate
d. oral nifedipine
e. Atenolol

88. Eclampsia is the ...

a. complete closure of the external os
b. occurence of epileptiform seizures
c. fixation of the placenta
d. fall in foetal blood pressure
e. obstruction of the umbilical cord

89. Which of the following is NOT a complication of diabetes?

a. Preterm labour
b. Birth trauma
c. Sudden foetal death
d. Oligohydramnios
e. Congenital abnormalities

90. Ideal glucose levels in pregnancy are between

 a. 4-6 mmol/L
b. 6-8 mmol/L
c. 1-2 mmol/L
d. 8-10 mmol/L
e. 2-4 mmol/L

91. Blood formation in the embryo first occurs in the

a. liver
b. spleen
c. bone marrow
d. lymph nodes
e. heart

92. A true statement regarding fertilization is:

a. Sperm capacitation occurs in the vas deferens.
b. Fertilization usually occurs in the ampulla of the fallopian tube.
c. Most fertilized ova complete cleavage.
d. Teratogens present during fertilization cause limb defects.
e. Monozygotic twinning occurs after the formation of the blastula.

93. Which of the following is the most important factor contributing to the
development of a specific anomaly by a known teratogen:
a. dose of the teratogen
b. timing of the exposure to the teratogen
c. genetic makeup of the embryo
d. presence of other environmental factors
e. duration of action of the teratogen

94. A Pap smear is likely to identify all the following except:

a. cervical squamous cell carcinoma
b. trichomoniasis
c. human papilloma virus
d. inflammatory changes
e. gonorrhea

95. Side effects of Norplant include:

a. breast atrophy
b. lower mean hemoglobin levels in long-term users
c. irregular uterine bleeding
 d. weight loss
e. hair loss

96. Women with ectopic pregnancies should receive Rh(D) immunoglobulin

if they are
a. Rh negative, antibody negative
b. Rh negative, antibody positive
c. Rh positive, antibody negative
d. Rh positive, antibody positive
e. Du positive, antibody negative

97. The chemotherapeutic agent used for the medical treatment of an

ectopic pregnancy is
a. doxorubicin
b. RU486
c. cyclophosphamide
d. methotrexate
e. chlorambucil

98. Medical treatment of myomata is best accomplished with

a. danazol
b. Depo-Provera (medroxyprogesterone)
c. GnRH analogues
d. Estrogens
e. Testosterone

99. In a 25-year-old with pelvic pain, endometriosis is best confirmed by

a. the initial history
b. a repeat pelvic examination on the first day of menstrual flow
c. laparoscopic visualization and biopsy
d. speculum visualization
e. hysterosalpingogram

100. A defect in pelvic anatomy that can be correctly termed a true hernia is
a?
a. cystocele
b. enterocele
c. rectocele
d. urethrocele
e. ureterocele