GMDC MOCK 2 34 ALL THE BEST THANK YOU Quiz 1 / 40 The risk of acute bilirubin encephalopathy in a newborn is increased with the use of Phenytoin Gentamycin Ampicillin Phenobarbitone Ceftriaxone 2 / 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 Condylomata acuminate - TCA acid Bartholin's gland abscess - gland excision Muluscum - analgesics and steroids Prolapse of the urethra - topical estrogen 3 / 40 What is not a reason of oligohydramnios in a woman at gestational age of 35W2D with IUGR in pregnancy? Increased swallowing of the fetus due to asphyxia Reduced placental perfusion Severe preeclampsia may be a cause Reduced fetal renal blood perfusion Reduced fetal urine 4 / 40 The following are features of prematurity in a neonate except No creases on sole Flat areola Empty scrotum Abundant lanugo Thick ear cartilage 5 / 40 Which of the following diseases is caused by a virus? Amyloidosis Diphtheria Pneumocystis jirovecii pneumonia Histoplasmosis Lassa fever 6 / 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 Septic arthritis of the left hip joint Tuberculosis of the bone Fracture of the left femur Multiple myeloma None of the above 7 / 40 This is false about diabetic ketoacidosis blood ph is less than 7.3 deep sighing respiration is present serum bicarbonate level is more than 18mEq/l blood glucose is usually greater than 11.0 mmol/l ketonemia and ketonuria are characteristic 8 / 40 A child born in Ghana in 2016 will routinely receive the following vaccinations except Rotavirus Pneumococcus Rubella Meningococcus Mumps 9 / 40 In the fetal circulation, the INCORRECT statement is: The ductus venous connects the umbilical vein with inferior vena cava. There are two umbilical veins and one umbilical artery. Prostaglandins maintain patency of ductus arteriosus. The inferior vena cava contains both oxygenated and deoxygenated blood. The blood is shifted from the right atrium to the left atrium via the foramen ovale. 10 / 40 A 9-month-old girl may Be afraid of strangers Stand on tiptoe Build a tower of four or more blocks Know the names of items in a picture book Have temper tantrums 11 / 40 Acetaminophen-induced toxicity most commonly affects the Heart Kidneys Liver Bone marrow Lungs 12 / 40 A low weight for height in a three-year-old child indicates Wasting Stunting Kwashiorkor Marasmus Underweight 13 / 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 and intrauterine pregnancy cannot be ruled out 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 14 / 40 The following are characteristics of simple febrile seizures Rate of epilepsy is higher than in the general population Occur only once or twice in a twenty-four-hour period Initially focal with secondary generalization Commonly caused by cerebral malaria Last for thirty minutes or less 15 / 40 Non-steroidal anti-inflammatory drugs are not generally used for long term tocolysis because they: Are ineffective Produce marked hypertension. Are too expensive. May cause premature closure of fetal ductus arteriosus. Are associated with lactic acidosis. 16 / 40 What is wrong about vaginal hematoma after delivery? Pressure dressing should be applied on the hematoma bed for 12-24 hours Vulvar hematoma can occur after improper episiotomy repair An incision on the site if pain is severe and hematoma enlarges Mattress suturing the bed of hematoma Observation if hematoma is small 17 / 40 Low birth weight is defined as Below 2500g Below the average weight for the age and parity of the mother Below the 10th percentile for gestational age None of the above Below -2 z-score for gestational age 18 / 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 leukovorin Evacuation of the uterus by a specialist Laparotomy and salpingectomy and follow up Hysteroscopy Methotrexate and folic acid and iron supplement 19 / 40 In the diagnosis of minimal change nephrotic syndrome, the following tests would be useful except Liver function tests Doppler ultrasound of the lower limbs Serum complement levels Fasting lipid profile Urinalysis 20 / 40 Clinical features of childhood acute lymphoblastic leukaemia include Gum hyperplasia Dental anarchy Chloromas Proptosis Bone pain 21 / 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 Dextrose saline Stat dose of broad spectrum intravenous antibiotics Intravenous Ringer's lactate Oral rehydration solution if the child can drink Immediate intraosseous access for rehydration 22 / 40 An innocent murmur is likely to be Associated with a thrill Persistent into early adulthood Non-radiating Diastolic Loudest at the left sternal border 23 / 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. Marginal sinus bleed. Uterine rupture. Placenta praevia. Abruptio placenta. 24 / 40 In Preeclampsia all are correct EXCEPT: Regular full blood count are helpful in monitoring the progress of the condition. Is more common with women with a first degree relative who has preeclampsia. Development of epigastric pain is a serious sign. The condition is more common in women who smoke cigarettes. It is a significant cause of maternal mortality. 25 / 40 Haemorrhagic cystitis is a recognized complication of Cisplatin Adriamycin Methotrexate VIncristine Cyclophosphamide 26 / 40 The most likely finding in the initial stages of septic shock is Hyperpnoea Abnormally low blood pressure Absent femoral pulses Delayed capillary refill Tachypnoea 27 / 40 A child with severe haemophilia A would have an abnormal Platelet count Blood film morphology Prothrombin time All of the above None of the above 28 / 40 Which is true about placental abruption? Abruption occurs after placental delivery The chance of repeated abruption is not different The chance of repeated abruption is twice There is no means to predict abruption Fetal assessment techniques can predict abruption with good precision 29 / 40 ECG changes associated with hypokalemia include Shortened PR interval Appearance of a U wave Upright T wave ST segment elevation Right axis deviation 30 / 40 The following diseases are associated with the Epstein Barr virus except Wilm's tumour Post-transplant lymphoproliferative disease Hodgkin's lymphoma Nasopharyngeal carcinoma Burkitt's lymhpoma 31 / 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? Termination of pregnancy Observation Blood transfusion is a must Tranexamic acid to control bleeding Discharge home 32 / 40 During a sharp curettage of an incomplete abortion, the uterine was perforated. What is the first step of management? Laparotomy Curettage should be completed and patient should remain under observation Curettage should be continued by a specialist only If there is no hemorrhage in the first 24 hours after operation, the patient can be discharged Administration of antibiotic 33 / 40 Which is not among pathophysiological changes of preeclampsia? Platelet dysfunction Increased thromboxane A2 DIC Reduction in prostacyclin Increased resistance to angiotensin 34 / 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? Pregnancy Endometritis Leiomyomata uteri Anovulatory bleeding Endometrial polyps 35 / 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? Tubal obstruction Intrauterine synechiae Endometriosis Male factor Anovulation 36 / 40 Contraindication to medical therapy (Methotrexate) in tubal pregnancy is No fetal heart motion on ultrasound. Absence of active bleeding. Size of the ectopic gestational sac is 3cm for less. History of active hepatic and renal disease. Desire for future fertility. 37 / 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? Bimanual uterine massage Oxytocin infusion Speculum examination Hysterectomy Ergot 38 / 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? Phenobarbital MgSO4 Diazepam Labetalol IV Phenytoin 39 / 40 In determining the Apgar score of a newborn, the following would be assessed except Oxygen saturation Skin colour Respiratory effort Muscle tone Response to stimulation 40 / 40 Which of the following drugs IS NOT used to inhibit premature labour? Ritodrine Magnesium sulfate. Indomethacin. Phenobarbital. Nifedipine. Your score is The average score is 63% LinkedIn Facebook Twitter 0%