Transcript Dr.E.Boateng +233-249856723 Attachment @the 37 Mil Hosp.&KTH

Guidelines for foreign trained doctors sitting for the Ghana Medical &Dental Council Pre-Registration Examination.
Do not hesitate to contact if you have any question (do not send sms )..
Good luck.
2008
INTRODUCTION
 Please note that this material is not from the Ghana Medical and Dental
Council. One has no right to contact the council in case a question arises with
respect in using this material.
 This material is compiled up after careful and thorough investigations as far as
our environment and the need to pass the pre-registration exam is concerned.
 The content of this material is liable to change without prior notice hence it is
to your own interest to contact the above doctor from time to time for up dates.
 To pass this exam is not only about what you know. Is all about following
instructions, exhibiting your ability to stand pressure ,think and link ideas
diversely and frustrations etc.
 “What you need to know before sitting for the exam, how to answer the
questions, what the professors are expecting from you etc”, feel free to contact :
 Dr.Boateng
Dr.E.Boateng,2008
Materials
 Standard treatment and guidelines. Remember to ask for the
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latest edition. You have to chew this book. A copy can be obtain
at the Human resource opposite tema station. Or ask from
MDC
A hand book for medical emergencies: a hand book for house
officers by korlebu teaching hospital medical dept.
Protocol for house officers in surgery produce by Mr. Adufulconsultant surgeon -4th floor ,Korlebu TH.
A hand book for house officers in paediatrics
A handbook for obs & gynae by kwame Aryee,or Ten teachers
A short text book of public health for the tropics
Oxford handbook of clinical medicine, surgery.
 Dr.E.Boateng,2008
Problem solving
 This carry 110 marks out of 200 and it takes the greatest score.
 If you failed in the problem solving automatically you have failed
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the exam. The other way is said to be true
You have to pay particular attention to investigations.
Questions on management do NOT necessary require you to
provide specific drug dosages such as tab paracetamol 20mg,but
in broad terms such as = Analgesics .However if you know the
specifics you can provide them in the exam but Remember it will
go against you should you get it wrong.
Look very fast than never before during the exams.
Answer all questions-PARTICULARLY the short cases section.
 Dr.E.Boateng,2008
VIVA
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Don’t let fear rub you off all that you have toiled for. This part of the exam can frustrate you but grit
your teeth and be a man once for a life time.
Be confident and boost yourself up before you enter the room. It’s not the place to ask questions or
make friends. Never crack jokes. They will laugh to let you feel bad if you dare say something wrong,
so the simple rule is:
Do not attempt to answer a question you are not clear with . If you don’t know ask them to change the
question for you. Don’t ponder over questions. It will go against you.
You try and slow the rate at which you answer your questions to beat time and avoid more questions.
i.e. if you know the answer
Remember most of the questions in the viva are to insult your intelligence and test your IQ .
**Remember to read referral letters and notes first: to take history ,next examine patient and order for
investigations. Then seek review by senior colleague. *****
Always advocate the examiner. Let them feel they know all that medicine is about even if they are
wrong.
You will have 18 min to face the panel. 3 min for each subject. Don’t panic when the bell is rang. Talk
and talk till the bell is gone for a change over.
Don’t explain anything if you are not asked to do so. Define,state,list etc.
Listen carefully to the examiner to make a rightful judgment. The answers can be deduced from the
scenario they give .
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Dr. E.Boateng,2008
Past questions
 Remember to read over and over again what your
“forefathers” left behind. Another powerful instrument
as long as passing this exam is concerned.
 Is now your turn to leave something behind for
someone else. Don’t be a curse “forefather”.
 GOOD LUCK!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Dr.E.Boateng,2008
Preclinical topics
 Please contact for solutions to some of the questions/topics outlined below:
 ANATOMY:
- Inguinal canal: boundries,content in males & females
- femoral canal
- cervical canal
GENETICS:
Pay attention to :
-trisomes – 21=down syndrome
13= Edward syndrome
18= paten syndrome
Their features, characteristics
- Turner’s syndrome
- Kleifelter’s syndrome
EMBRYOLOGY
 Pay attention to :
 Birth Defects
- Neural tube defects:
spina bifida, microanenchaphaly, anenchaphaly (+ their
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intrauterine/pre-natal diagnosis) = do amniocenteses
**elevated levels of alpha feto protein in amniotic fluid.**
Down syndrome –prenatal diagnosis = low level of alpha
feto protein in maternal blood
Respiratory Distress – in neonates & premature babies
- causes + role of surfactant deficiency:
Dr .E.Boateng,2008
surfactant deficiency
 Diagnosis of lung maturation prenatally=
Ans: Amniotic fluid examination for splingomyelin ratio i.e. leathin/
splingomyelin ratio > 2 = adequate amount of surfactant, hence
adequate lung maturation.
FETAL BLOOD CIRCULATION & HEMODYNAMIC CHANGES
THAT OCCURS AFTER BIRTH & STRUCTURAL CHANGES eg:
Ductus arteriosus
Foramen ovale=fossa ovale
Umbilical vessels
Patent ductus arteriosus,early conservative management
=INDOMETHACIN.
Dr .E.Boateng,2008
PHARMACOLOGY
 Definition of pharmacology,
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pharmacokinetics;
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pharmacodynamic;
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clinical trials
 General pharmacological principles
 Receptor mechanisms
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Dr .E.Boateng,2008
CONGENITAL HEART DISEASE
 -VSD, ASD,TOF
 Read all you can about this topic.
 PHYSIOLOGY=general physiological principles
-osmosis
-diffusion, perfusion
permeability
- Shock
Dr .E.Boateng,2008
MICROBIOLOGY
 Definitions of:
 -immunological principles:
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Primary immunity
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secondary immunity
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acquired immunity
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innate immunity
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active immunity
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passive immunity
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gram + & gram –ve organisms
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vaccination
Dr .E.Boateng,2008
VACCINATION
 Pay attention to terminology in this section
 Vaccination schedules –pay attention to this - very very
important
 HIV/AIDS:WHO classifications or stages. Test
,Medications.
Dr .E.Boateng,2008
PATHOLOGY
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General pathological principles
inflammation-features;
-pain, redness, oedema, heat, hyperemia,
Necrosis(types)= coagulation, colliquative
- ***based on my own observation, it’s found out that
the preclinical topics cut across the MCQs**
Dr .E.Boateng,2008
clinical
 PUBLIC HEALTH/PRIMARY HEALTH CARE &
DELIVERY:
 Public health features *very importantly* in the entire
examination.
 Biostatistics:
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i. SENSITIVITY- of a test is its ability to identify
individuals with the disease or condition.
S= true positive(TP)/TP + False Negative(FN)
ii. SPECIFICITY - of a test is defined as its ability to defined those who
do not have the disease.
SP=FN/FN +TP
VITAL STATISTICS
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Birth rate
Infant mortality rate
Neonatal mortality rate
Maternal mortality rate
Under five mortality rate
Incidence – occurrence of new cases
Incidence rate= incidence /tot pop @ risk X 1000
Prevalence = number of existing cases at a given point in time in a given
population
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Dr.E.Boateng,2008
VITAL STATISTICS
 Epidemiology + its method( cohort or prospective study, case control study or
retrospective)
Epidemiology= study of human population with respect to size, density, distribution and
structure.
Methods:
i. cohort study
ii.case control study
Read about the methods**
Endemic = the constant presence of a disease within a given geographical area.
Epidemic = occurrence of disease in excess of normal expectancy
Accuracy = t he degree of veracity
Reliability= consistency and repeatability of a set of measurement
PREVENTIONS(primary,2ndary,tertiary):
Primary
prevention:
health
education
prophylaxis
health promotion
Secondary prevention
2ndary
prevention:
- early
diagnosis
- prompt
/adequate
treatment
Tertiary prevention
 Involves rehabilitation.
 **1.prevention of susceptible host,
2.elimination of vectors
3.interruption of route of transmission
1,2,3 conforms to the levels of preventions discussed
above respectively.
Dr. Boateng,2008
quiz
 In an outbreak of cholera what will you do as a
doctor??
Very high yield important question!!!!
Ans: think around the level of prevention we just discussed and answer it yourself.
If fumbling you can contact for help. Don’t pass by this question. you will regret.
Define:
- Notifiable disease
- Infectious disease
- Communicable disease
- Contagious diseases
Dr. Boateng,2008
Define and give examples
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Zoo noses
Ornithoses
Very high yield – obligatory topic to learn thoroughly:
-life cycle of malaria parasite
-life cycle of schistosomiasis
ankylostoma & others
- Helminthes
- Note clearly – the group of worms that inhabit the lungs as part of their life cycle
- Group of worm that pass through the liver in their life cycle
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Onchocerciases
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Filarial worms
Dr. Boateng,2008
quizzzzzzzzz
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Cold chain
Malnutrition
Guinea worm
Refuse disposal
KVIP & pit latrine
Birds
Immigration & types
Can road traffic accident(RTA) be considered as EPIDEMIC?
The Ans is YES. You should be able to explain based on the definition
given previously.
 Dr. E.Boateng,2008
Obstetrics + Gynaecology
 Antenatal care
 Signs and symptoms of pregnancy
 Abortion definition +types:
expulsion of the fetus before the 28th week of pregnancy is termed as abortion.
types:
1. spontaneous;
-threaten
- incomplete
-complete
-inevitable
- missed
2. induced;
- therapeutic
-criminal
Dr. Boateng,2008
Obs + gynae
 APH= antepartum haemorrhage
 PPH=post partum haemorrhage
 PIH = pregnancy induce hypertension
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i.e. pre – eclampsia= high BP+ proteinuria + oedema
eclampsia= pre eclampsia + fit
Contraception
Emergency contraception + indications
Rh –incompatibility
Anaemia in pregnancy
Multiple pregnancies
Polyhydramnios
Oligohydramnios
Dr Boateng, 2008
Obs + gynae
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Ectopic pregnancies
Cervical cerclage in cervical incompetence
Placental insufficiency
Birth injuries:
-caput succedaneum
-cephalhaematoma
-Erb’s palsy(involves C5-C6)
-Klumpke’s palsy(involves C7-C8 +Th1)
Menstarl cycle- physiology, phases, hormones involved, the axes= hypothalamo –
pituitary –ovarian axis
quiz
 How would you diagnose pregnancy?
 Ans:
 A. clinically
- symptoms=morning sickness,amenorrhia,breast
engorgement etc
-signs= linear nigra,bluish discoloration of the vulva +
vagina, FHS etc
 B . By investigation:
UPT,USG,Beta HCG etc
Dr. E.Boateng,2008
quiz
 Fibroid = definition,causes,management.
 Do you know Ghana is the country that started the treatment of
eclampsia with magnesium sulphate and one of the best countries
when it comes to the management of hypertension?
 Pre eclampsia, eclampsia. Signs, symptoms ,diagnosis, management.
 Compare and contrast abruptio placenta ,placenta praevia and vasa
praevia.
 Dysmenorrheal .definition, types and treatment.
 A pregnant woman in your office .What tests will you do and why?
GOOD LUCK!!!!!!!!!!!!!!!!!!!!!!!!!!!!
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Dr.Boateng,2008
MDC feb ,2008. obs+gynae
 50 year old female presented with abdominal
distension. Give 6 causes
 A 25 yr old hypertensive pregnant woman bleeding per
vagina at 30 week .10 causes. Diagnose
 Unconscious after successful delivery.10 causes?
 A 29 yr old female has just missed her period and
started bleeding p/v. Causes. How will you manage
her?
For answers feel free to contact
Dr. Boateng, 2008
paediatrics
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Neonatology :
- breast feeding.*read all you can about this topic*
-formation of breast milk
Types of breast milk=
1. colostrums
2.mature breast milk
Breast milk composition i.e.=
- carbohydrate 6.7
- protein 1.25 (casein,lactoglobulin,lactalbumin)
- lipid 3.5
- water 87
-mineral (Na, ca, K,Cl)
- vitamins
Dr. E. Boateng,2008
Breast feeding
 Advantages of breast milk =
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-mother child bond is assured
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-contraceptive effect
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-prevent breast cancer
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-antiviral/bacterial effect etc
 Weaning- programme or schedule
 Cow milk( formula feeds)
- advantages
- Disadvantages
- Their composition i.e. constituents as above.
- !!!this topic features quite prominently !!!!!
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Dr. Boateng ,2008
Respiratory distress syndrome(RDS)
:causes ,signs, symptoms
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RDS
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Neonatal jaundice
Neonatal sepsis
Neonatal tetanus
Failure to thrive
Congenital heart disease
Otitis media
Cerebral palsy
Malaria + complication
Pharyngitis
Tonsillitis
Anaemia
Diarrhea + complication
Meningitis diagnosis = lumbar puncture. Note CSF changes
Signs of meningitis = neck stiffness, kerning's +ve,brudzenski +ve and others
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Dr. Boateng , 2008
Febrile convulsion
 Definition + causes
 What would you do at the emergency dept. when a child is brought in convulsing??
Ans:
- 1st take RBS=random blood sugar
-next tipped with water if temperature is high
-if unconscious evaluate the level of consciousness with Blantyre coma scale
- Next of paramouncy is =control of convulsion with anticonvulsants and the drug of
choice is DIAZEPAM per rectum/ IV
- Take history from mother,
- Examine the child thoroughly
- Order for investigation
- Seek review by senior colleague as and when necessary.
- Dr. Boateng,2008
Sickle cell disease
 Signs + symptoms
 Crisis :
1. VOC= vaso oclusive crisis(pain + mild jaundice)
2. Haemolytic crisis( 1 + anaemia+severe jaundice)
3. Aplastic crisis( severe anaemia)
4. Sequestration crisis( hepatosplenomegaly )
Complications:
sc dactylitis, osteomyelitis,swelling of the hand + feet, priapism, spleenic infarction, brain infarctionstroke, heart failure etc
Management:
- relief Pain with analgesics
- rehydrate with IVF
-Blood transfusion if indicated
- oxygen if hypoxic
- cover infection = antimalaria or Rx for precipitants
Dr. Boateng ,2008
Ca
 Burkits lymphoma – the most common malignancy in children in the tropics
 Hodgkin's lymphoma
 Typhoid fever(enteric fever):drug of choice in Ghana now is ciprofloxacin
according to sensitivity. Chloramphenicol is used at regions where salmonella
is sensitive to it
GMDC , Feb 2008.paediatrics
 Neonatal jaudice.Causes,2 most important test to do, treatment.
-causes:
-physiological if >1d old but <6d old
-neonatal sepsis
-blood, Rh incompatibility
-hypothyroidism
Obstructive jaundice
-galactosaemia etc
Investigation:
-SBR,comb test of child
-blood group of mother and child, blood culture etc
write as many as you can
Treatment :
-phototherapy
- exchange transfusion.
Dr. Boateng, 2008
GMDC , Feb 2008. paediatrics
 A mother presented with asthmatic child. What will you
ask the mother? Immediate management of this child?
Ans:
-diurnal variation in PEF
-Exercise tolerance
-sleep disturbances
-other atopic diseases
-the home(esp. bed rooms, sitting room etc)
-medication etc
Treatment:
-give humidified oxygen
-nebulized salbutamol
-IVF if necessary.
Dr. Boateng,2008
GMDC , Feb 2008. paediatrics
looks dull as compare to his friends during sports activities and squat during family walks. Diagnosis. What
other signs will you find?
Ans:
Diagnose: congenital heart disease( Tetralogy of fallot)
Other signs: pansystolic murmur, cyanosis, failure to thrive etc.
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A child
**do well and read about all the topics discussed above. Your viva ,mcq, problem solving will be from these topics**
Red typed means answer /s to the asked question but you are encouraged to read more about the said topics. The answers
were provided to guide you as to how to answer the questions.
Never write notes/essay!!!!!!!
Dr. Boateng,2008
Surgery
 Fluid & electrolyte balance = daily fluid requirements in the tropics. Check this up
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from Archampong & Jaja’s Book on surgery
Blood transfusion & transfusion reactions
The acute abdomen
Acute appendicitis
Acute cholecystitis
Pancreatitis
Intestinal obstruction: causes:
hernia(*strangulated)
adhesion and band
vulvulus
intussusceptions
constipation/ faecal compaction
intestinal worms
malignancy
PUD( peptic ulcer disease)
Typhoid perforation **HIGH YIELD** note differential from appendicitis .Pay attention to the history of preceding
fever.
Upper & lower GI bleeding. Causes ,management.
Hernia- classification
Surgical jaundice
Haemorrhoids
Surgery
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Wound +wound healing. Classification
Urinary retention . Note causes + management
Haematuria . Note cause and management
Haematemesis . Note causes and management. Refer to GI bleeding.
Burns classification(the rule of 9’s)
Buruli ulcer
Postoperative care
Dr. Boateng , 2008
Gmdc ,Feb. 2008.surgery
 Haematuria. Cause? How would you manage any 1 of the causes?
 A boy presented at the emergency dept. with swollen elbow after a fall on hand
outstretched. Diagnose , management, give 4 early and late complications.
 Fracture of the tibia and fibular. Give 4 early and late complications. How
would you manage it?
 A 70 yr old woman unable to stand after a fall. Her right leg is shorten.
Diagnose? How would you manage her. Give 6 early and late complications.
Dr. Boateng, 2008
Medicine
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Heart failure
Congestive heart failure
Oedema( chf, nephrotic, liver, malnutrition)
Bacterial endocarditis
ACE inhibitors – side effect
Hypertension
Cardiac murmurs
Malaria + its complications such as cerebral malaria
DVT/PE
Cellulitis
DKA
Shock
TB
Pneumonia
Aphasia
Addisonian crisis
Acute renal failure
Poisoning and intoxication
Bites and stings
Dr. Boateng, 2008
Medicine
 Anaphylactic reactions and shock
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Brown – Sequad syndrome: Partial cord lesion. Features:
- loss of pain and temperature below specific dermatome levels
- loss of proprioception and discrimination to touch
- limb weakness
 Causes of hepatosplenomegaly
 Sickle cell crisis
 Status asthmaticus
 Status epilepticus
 Pneumothorax
 Consolidation
 Pleural effusion
Dr. Boateng, 2008.
Gmdc feb.2008.medicine
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Compare and contrast malaria and Typhoid fever. Which one will you Rx first based on incubation
period. Write your regime
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In a tabular form compare CCF, nephritic, liver, adult malnutrition oedema
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TB + management (it’s preamble and you have to deduce it.)
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CCF. managent. (it’s preamble and you have to deduce it.)
Dr.Boateng, 2008
how to answer the questions
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The questions in this exams are set or asked vaguely in the viva and in the problem solving. Understanding the
principles in answering such questions is the key.
We take example 1. You enter the room , sit before the panel and you are asked
‘ACUTE ABDOMEN’.
it looks simple, Right? I tell you just a single word you’ll say can fail you but knowing the single word to say will pass you.
In such vague questions the single word is DIFFERENCIALS/causes of acute abdomen in order of importance.
The answer is differential diagnosis. Just list them. Then after commence on management if time permits you to do so.
Which will include:
Resuscitation - Analgesics half strength(to avoid diminishing of the pain before the review by resident or consultant) ,
IVF,
History, examination
Order for investigation
Seek review by consultant or resident. And Go according to their instructions.
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QUESTN:
1. Kidney and Splenic mass
2. pleural effusion
**answer 1= clinical signs to differentiate between the two.
*Answer 2= clinical signs** look for them.
These are some of the questions I had in the viva.
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Dr. Boateng, 2008
Example 2
 Unconscious patient?
Your approach in such cases is ‘causes/differentials. You can use the mnemonics below (hide
seeds)list them. don’t explain :
H - hypogycaemia
I - infections
D - diabetic + its complications
E- epilepsy
S - stroke
E - encephalitis
E – electrolytes disturbance
D- drugs
s –subarachnoid bleed/ space occupying lesion
Your next step is management / resuscitation:
-check ABC( airway, breathing and circulation)
Next ‘check RBS (random blood sugar) very important and correct deficits
Secure IV access ,infuse/transfuse or give oxygen as and when needed
Access level of consciousness with GCS( Glasgow coma scale)
Monitor urine output by catheterization
Take history, examination, order for investigation
Seek review by resident / consultant./rule out possible cause and treat.
The above is a question I had in the viva. You may be the next.
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Dr. Boateng, 2008
VIVA
prominent questions. have these on your finger tips & you’ll be 80% via the exam
medicine
OBS/ GYNAE
surgery
paediatrics
Public health
1.Diabetic + comp eg DKA
2.DVT
3.Cellulitis
4.Pneumonia
5. TB
6.GI bleeding
7.Hypertension
8.PUD
9.Splen & kidney mass
10.Unconscious patient
11.stroke/ CVA
12.Status epilepticus
13.Dehydration + signs
14. CCF
15.CHD
16.Oedema
17.Malnutrition
18. Malaria
19. Typhoid
20. Dyspnea
21.Astma
22.Endocarditis
23.Pericarditis
24.STD’s
25.Upper/lower motor
neuron lesion
26.hypo/hyperthyroidism
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
1.Fractures
2.Acute abdomen
3.Haematuria
4.BPH
5.Urinary retention
6.Appendicitis
7.Goo(gastric outlet
obstruction)
8.Hernia
9.DVT
10. Cellulitis
11.Tetanus
12.Gasgan grene
13.Jaundice pt
14.Haemorrhoids
15.Fissura in ani
16 .intestinal obstruction
17.GI bleeding
18.Rectal prolapse
19.colle’s fracture
20 orthopaedics
21 .RIF mass(right iliac
fossa mass)
1.Neonatal jaundice
2. Convulsion
3.Meningitis
4.Dehydration +signs
5.SCD
6.CHD
7.Pneumonia
8.Immunization +
schedule
9.Otitis media
10.Cerebral palsy
11.Neonatal sepsis
12.malaria/cerebral
malaria
13.RDS
14.Measles
15.Chicken pox
16.Malnutrition
Read the ‘juju ‘+ the
already discussed
questions.
12.
13.
14.
15.
16.
17.
18.
PPH
APH
Abruptio placenta
Placenta Praevia
Vasa praevia
Post partum pyrexia
Abortion
Ectopic pregnancy
PIH
PID
Diagnosis of
pregnancy
Labour
PROM
Infertility
Fibroids
Shoulder dystosia
Ca cervix
Anaemia in
pregnancy
PAST QUESTIONS
 1.A Whiteman presented with Haematuria. He had swam in lake
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bosomtwe 4 months ago & lake volta.What is your diagnose? in which
lake did he acquire the disease & your treatment.
2.PUD
3. A child presents with Hb of 4 g/dl. Looks pale & feverish. What is the
most important thing to do?
4.A child presents with abdominal pain. Differential diagnose?
5.Signs of dehydration
6.Typhoid fever
7.Acute epiglottitis
8. Meningitis: causes , signs and symptoms, management
9. the unconscious child : causes, general management
10. contraindication of lumbar puncture
11.subphrenic abscess, management
PAST QUESTIONS
 12. complication of pregnancy with IUCD in sito
 13.A woman come to you with IUCD in sito and want to keep her pregnancy ,what would you
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do?
14. after 24hrs gastrectomy a patient comes with difficulty in breathing.Diagnose,Treatment.
15. menopause, climacteric: signs & symptoms. Treatment.
16. A farmer presented with tremor & spasm of muscles after receiving a minor injury. What
would be your diagnose and management?
17. signs of meningeal irritation
18. Maternal care
19. shoulder dystocia & management
20. uterovaginal prolapse
21. distribution of iron in pregnancy
22.Diagnose of pregnancy
23. Antenatal care
24. Anaemia : signs & symptoms
25. lower & upper motor neuron lesions
26. posterior motor neuron lesions & cerebella syndrome
PAST QUESTIONS
 27. indications for blood transfusion
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28. complications of sickle cell disease
29.cardiomyopathy
30. Ectopic pregnancy
31. septic abortion ,management
32. dysmenorrheal: signs & symptoms
33.post partum pyrexia
34. an elderly person complains of headaches ,dizziness and unable to stand on the feet. On
examination BP is high .What is the diagnosis and where will the lesion be? What other signs
will you find in in the physical examination?
35.differentiate b/n peripheral and central motor neuron lesion
36. treatment of TB
37. causes of PPH
38.A girl presented with bone pain. The sister was recently transfused .Diagnose and
treatment?
39.Burns: classifications, signs n symptoms
40. Pneumothorax, pleural effusion,empyema, lobar consolidation in pneumonia
41. gas gangrene, management
42. Anaemia in Pregnancy
PAST QUESTIONS
 43. Monteux test negative. Give 3 conditions to show negativity?
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44.Goo:causes, problems ,Treatment
45.Mention 10 characteristics of febrile convulsion
46. differential diagnosis of a mass in the LIF
47.Demography
48.a Patient started experiencing numbness & tickling of the arm after subtotal thyroidectomy.What is the possible cause and
management?
49. differential diagnosis of a mass in the RIF
50. Acute abdomen
51.New born: screening, Average
52.complications of radiotherapy in Cervix Ca. Treatment
51. hyperemesis Gravidium
52.major cause of maternal mortality in Ghana
53. A pregnant woman undergoing radiotherapy. Which organ of the fetus would be affected.
54.Emergency contraceptive + types
55.Ectopic pregnancy
56.what is your diagnosis & management of a woman who delivered 2 days ago & presented with fever, general weakness and
offensive vaginal discharge
57.Painless ulcer on the penis: diagnose & treatment
58. painful ulcer on the penis
59.clinical features of chronic renal failure
60.A child comes with painful limb. Give differential diagnose
61.Failure to thrive. Give causes
62.pre operation preparation of the jaundiced patient.
Addendum
 Wishing you the best of luck!!!!
 Contact me for answers and further explanations to
some of the problems outlined here. 90% of the
questions will come from the cases discussed above. Be
prudent.
 Dr.E.Boateng
 +233-249856723
 doc_ [email protected]
 Stay blessed.
Solutions to the past questions