GMDC MOCK 2 34 ALL THE BEST THANK YOU Quiz 1 / 40 A child born in Ghana in 2016 will routinely receive the following vaccinations except Rubella Mumps Pneumococcus Meningococcus Rotavirus 2 / 40 What is your management of a 32 years old woman G1P0, GA of 6 weeks with an empty gestational sac, no heart beat and empty uterus on Ultrasound? Methotrexate and folic acid and iron supplement Evacuation of the uterus by a specialist Hysteroscopy Methotrexate and leukovorin Laparotomy and salpingectomy and follow up 3 / 40 In the diagnosis of minimal change nephrotic syndrome, the following tests would be useful except Doppler ultrasound of the lower limbs Serum complement levels Urinalysis Fasting lipid profile Liver function tests 4 / 40 A 19 year old woman is hospitalized for abdominal pain. Serum progesterone is 15ng/mL. Which is a true statement about her illness? Ectopic pregnancy risk is about 90% Ectopic pregnancy is ruled out Ectopic pregnancy and intrauterine pregnancy are ruled out Ectopic can be ruled out by careful physical examination Ectopic pregnancy and intrauterine pregnancy cannot be ruled out 5 / 40 What is the diagnosis and treatment of a non-tender mass near the urethral opening in a 4 year old girl? Skene gland abscess - antibiotic and evacuation Bartholin's gland abscess - gland excision Muluscum - analgesics and steroids Condylomata acuminate - TCA acid Prolapse of the urethra - topical estrogen 6 / 40 Which of the following drugs IS NOT used to inhibit premature labour? Nifedipine. Magnesium sulfate. Phenobarbital. Ritodrine Indomethacin. 7 / 40 A 42-year-old woman comes to the physician because of increasingly heavy menstrual periods during the past 2 years. Menses occur at regular intervals and last 8 days with heavy flow during the first 3 days. She takes no medications. She is sexually active with one partner and uses a diaphragm consistently. Pelvic examination shows a uterus consistent in size with a 14- week gestation. Examination of an endometrial biopsy specimen obtained 5 days before her last menstrual period shows secretory endometrium. Which of the following is the most likely diagnosis? Leiomyomata uteri Anovulatory bleeding Pregnancy Endometrial polyps Endometritis 8 / 40 A low weight for height in a three-year-old child indicates Wasting Kwashiorkor Underweight Marasmus Stunting 9 / 40 Contraindication to medical therapy (Methotrexate) in tubal pregnancy is Size of the ectopic gestational sac is 3cm for less. Desire for future fertility. History of active hepatic and renal disease. Absence of active bleeding. No fetal heart motion on ultrasound. 10 / 40 Acetaminophen-induced toxicity most commonly affects the Liver Kidneys Bone marrow Lungs Heart 11 / 40 A 9-month-old girl may Be afraid of strangers Build a tower of four or more blocks Stand on tiptoe Have temper tantrums Know the names of items in a picture book 12 / 40 Which is not among pathophysiological changes of preeclampsia? Reduction in prostacyclin Increased resistance to angiotensin Increased thromboxane A2 Platelet dysfunction DIC 13 / 40 The risk of acute bilirubin encephalopathy in a newborn is increased with the use of Gentamycin Phenytoin Ceftriaxone Ampicillin Phenobarbitone 14 / 40 Low birth weight is defined as Below the average weight for the age and parity of the mother Below -2 z-score for gestational age Below the 10th percentile for gestational age None of the above Below 2500g 15 / 40 In determining the Apgar score of a newborn, the following would be assessed except Muscle tone Respiratory effort Response to stimulation Oxygen saturation Skin colour 16 / 40 A child with severe haemophilia A would have an abnormal Prothrombin time Blood film morphology All of the above None of the above Platelet count 17 / 40 ECG changes associated with hypokalemia include ST segment elevation Shortened PR interval Upright T wave Appearance of a U wave Right axis deviation 18 / 40 What is not a reason of oligohydramnios in a woman at gestational age of 35W2D with IUGR in pregnancy? Reduced fetal urine Reduced fetal renal blood perfusion Severe preeclampsia may be a cause Reduced placental perfusion Increased swallowing of the fetus due to asphyxia 19 / 40 A 33-year-old nulligravid woman with primary infertility comes for a follow-up examination. She has been unable to conceive for 5 years; analysis of her husband's semen showed normal sperm counts. Menses occur at regular 28-day intervals and last 5 to 6 days. She is asymptomatic except for severe dysmenorrhea. An endometrial biopsy specimen 5 days before menses shows secretory endometrium. Hysterosalpingography 6 months ago showed normal findings. Pelvic examination shows a normal vagina and cervix. Bimanual examination shows a normal-sized uterus and no palpable adnexal masses. Rectal examination is unremarkable. Which of the following is the most likely diagnosis? Endometriosis Anovulation Tubal obstruction Male factor Intrauterine synechiae 20 / 40 Non-steroidal anti-inflammatory drugs are not generally used for long term tocolysis because they: Are associated with lactic acidosis. Are ineffective May cause premature closure of fetal ductus arteriosus. Produce marked hypertension. Are too expensive. 21 / 40 A 30year old woman G3P2, gestational age of 35 weeks and BP of 190/110 is in seizure. What is the best way to control her seizure? Phenytoin MgSO4 Diazepam Phenobarbital Labetalol IV 22 / 40 This is false about diabetic ketoacidosis serum bicarbonate level is more than 18mEq/l ketonemia and ketonuria are characteristic blood ph is less than 7.3 blood glucose is usually greater than 11.0 mmol/l deep sighing respiration is present 23 / 40 Haemorrhagic cystitis is a recognized complication of Adriamycin Methotrexate Cisplatin Cyclophosphamide VIncristine 24 / 40 Which is true about placental abruption? The chance of repeated abruption is not different There is no means to predict abruption Abruption occurs after placental delivery Fetal assessment techniques can predict abruption with good precision The chance of repeated abruption is twice 25 / 40 An innocent murmur is likely to be Non-radiating Persistent into early adulthood Loudest at the left sternal border Diastolic Associated with a thrill 26 / 40 During a sharp curettage of an incomplete abortion, the uterine was perforated. What is the first step of management? Curettage should be completed and patient should remain under observation If there is no hemorrhage in the first 24 hours after operation, the patient can be discharged Laparotomy Curettage should be continued by a specialist only Administration of antibiotic 27 / 40 A pregnant woman G2P1, GA of 39 weeks has the chief complaint of vaginal spotting. There is no sign of abruption or previa by ultrasound. What is the best management? Blood transfusion is a must Termination of pregnancy Discharge home Observation Tranexamic acid to control bleeding 28 / 40 The following diseases are associated with the Epstein Barr virus except Post-transplant lymphoproliferative disease Burkitt's lymhpoma Hodgkin's lymphoma Nasopharyngeal carcinoma Wilm's tumour 29 / 40 A 20-year-old primigravida, 32 weeks gestation, presents with profuse vaginal bleeding with pain and tenderness per abdomen. The most probable diagnosis: Vaginitis. Abruptio placenta. Marginal sinus bleed. Uterine rupture. Placenta praevia. 30 / 40 Clinical features of childhood acute lymphoblastic leukaemia include Bone pain Chloromas Dental anarchy Gum hyperplasia Proptosis 31 / 40 A 34-year-old G4P4 woman is immediately postpartum from delivery of a 4.0kg baby girl at 39 weeks' gestation. Time elapsed from the onset of labor to delivery of the placenta was 6 hours. Delivery was complicated by a second-degree perineal tear. Postpartum vital signs are within normal limits when the patient begins to hemorrhage vaginally. Estimated blood loss is 300 mL so far. Bimanual examination reveals a soft, enlarged, "boggy" uterus. Which of the following is the most appropriate first step in treatment? Speculum examination Bimanual uterine massage Hysterectomy Ergot Oxytocin infusion 32 / 40 In the fetal circulation, the INCORRECT statement is: Prostaglandins maintain patency of ductus arteriosus. There are two umbilical veins and one umbilical artery. The inferior vena cava contains both oxygenated and deoxygenated blood. The ductus venous connects the umbilical vein with inferior vena cava. The blood is shifted from the right atrium to the left atrium via the foramen ovale. 33 / 40 The following are characteristics of simple febrile seizures Occur only once or twice in a twenty-four-hour period Commonly caused by cerebral malaria Rate of epilepsy is higher than in the general population Last for thirty minutes or less Initially focal with secondary generalization 34 / 40 What is wrong about vaginal hematoma after delivery? Mattress suturing the bed of hematoma An incision on the site if pain is severe and hematoma enlarges Pressure dressing should be applied on the hematoma bed for 12-24 hours Observation if hematoma is small Vulvar hematoma can occur after improper episiotomy repair 35 / 40 In Preeclampsia all are correct EXCEPT: It is a significant cause of maternal mortality. Is more common with women with a first degree relative who has preeclampsia. The condition is more common in women who smoke cigarettes. Development of epigastric pain is a serious sign. Regular full blood count are helpful in monitoring the progress of the condition. 36 / 40 A 2-year-old presents with a three day history of refusal to bear weight on the left leg. The temperature on admission is 39°C. Initial blood work shows Haemoglobin 9.6g/dl, WBC 15 x 109/l, platelets 470 x 109/L and ESR 60mm/hr. The most likely diagnosis is Multiple myeloma Fracture of the left femur None of the above Septic arthritis of the left hip joint Tuberculosis of the bone 37 / 40 Which of the following diseases is caused by a virus? Amyloidosis Pneumocystis jirovecii pneumonia Histoplasmosis Diphtheria Lassa fever 38 / 40 The following are features of prematurity in a neonate except Flat areola Empty scrotum Thick ear cartilage No creases on sole Abundant lanugo 39 / 40 The most likely finding in the initial stages of septic shock is Absent femoral pulses Abnormally low blood pressure Delayed capillary refill Hyperpnoea Tachypnoea 40 / 40 Which of the following would be most appropriate in the immediate management of a 10-month-old infant with diarrhea and severe dehydration Intravenous Ringer's lactate Immediate intraosseous access for rehydration Intravenous Dextrose saline Oral rehydration solution if the child can drink Stat dose of broad spectrum intravenous antibiotics Your score is The average score is 63% LinkedIn Facebook Twitter 0%