1. Dr.E.Boateng 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

2. 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

3. Materials
Standard treatment and guidelines. Remember to ask for the 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. Aduful-consultant 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

4. 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 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

5. VIVA
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 .
Dr. E.Boateng,2008

6. 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

7. 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

8. EMBRYOLOGY Pay attention to : Birth Defects Neural tube defects:
spina bifida, microanenchaphaly, anenchaphaly (+ their 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

9. 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

10. PHARMACOLOGY Definition of pharmacology, pharmacokinetics;
pharmacodynamic;
clinical trials
General pharmacological principles
Receptor mechanisms
Dr .E.Boateng,2008

11. 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

12. MICROBIOLOGY Definitions of: -immunological principles:
Primary immunity
secondary immunity
acquired immunity
innate immunity
active immunity
passive immunity
gram + & gram –ve organisms
vaccination
Dr .E.Boateng,2008

13. 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

14. PATHOLOGY 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

15. clinical PUBLIC HEALTH/PRIMARY HEALTH CARE & DELIVERY:
Public health features *very importantly* in the entire examination.
Biostatistics:
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

16. VITAL STATISTICS Birth rate Infant mortality rate
Neonatal mortality rate
Maternal mortality rate
Under five mortality rate
Incidence – occurrence of new cases
Incidence rate= incidence /tot risk X 1000
Prevalence = number of existing cases at a given point in time in a given population
Dr.E.Boateng,2008

17. 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

18. PREVENTIONS(primary,2ndary,tertiary):
Primary prevention:
health education
health promotion
prophylaxis

19. - prompt /adequate treatment
Secondary prevention
2ndary prevention:
- early diagnosis
- prompt /adequate treatment

20. 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

21. 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

22. Define and give examples
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
Onchocerciases
Filarial worms
Dr. Boateng,2008

23. quizzzzzzzzz 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

24. 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:
spontaneous;
-threaten
- incomplete
-complete
-inevitable
- missed
induced;
- therapeutic
-criminal
Dr. Boateng,2008

25. Obs + gynae APH= antepartum haemorrhage PPH=post partum haemorrhage
PIH = pregnancy induce hypertension
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

26. Obs + gynae 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

27. 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

28. 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!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Dr.Boateng,2008

29. 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

30. paediatrics - vitamins 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

31. Breast feeding Advantages of breast milk =
-mother child bond is assured
-contraceptive effect
-prevent breast cancer
-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 !!!!!
Dr. Boateng ,2008

32. Respiratory distress syndrome(RDS)
RDS :causes ,signs, symptoms
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
Dr. Boateng , 2008

33. 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

34. Sickle cell disease Signs + symptoms Crisis :
1. VOC= vaso oclusive crisis(pain + mild jaundice)
Haemolytic crisis( 1 + anaemia+severe jaundice)
Aplastic crisis( severe anaemia)
Sequestration crisis( hepatosplenomegaly )
Complications:
sc dactylitis, osteomyelitis,swelling of the hand + feet, priapism, spleenic infarction, brain infarction-stroke, 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

35. 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

36. 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

37. GMDC , Feb 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

38. GMDC , Feb 2008. paediatrics Ans:
A child 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.
**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

39. Surgery
Fluid & electrolyte balance = daily fluid requirements in the tropics. Check this up 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

40. Surgery 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

41. Gmdc ,Feb 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

42. Medicine 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

43. Medicine Anaphylactic reactions and shock
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.

44. Gmdc feb.2008.medicine Dr.Boateng, 2008
Compare and contrast malaria and Typhoid fever. Which one will you Rx first based on incubation period. Write your regime.
In a tabular form compare CCF, nephritic, liver, adult malnutrition oedema
TB + management (it’s preamble and you have to deduce it.)
CCF. managent. (it’s preamble and you have to deduce it.)
Dr.Boateng, 2008

45. how to answer the questions
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.
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.
Dr. Boateng, 2008

46. 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.
Dr. Boateng, 2008

47. VIVA prominent questions
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
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
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.

49. PAST QUESTIONS
1.A Whiteman presented with Haematuria. He had swam in lake 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

50. 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 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

51. PAST QUESTIONS 27. indications for blood transfusion
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

52. PAST QUESTIONS
43. Monteux test negative. Give 3 conditions to show negativity?
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.

53. 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
doc_
Stay blessed.

54. Solutions to the past questions