GMDC MOCK 2 34 ALL THE BEST THANK YOU Quiz 1 / 40 In the fetal circulation, the INCORRECT statement is: 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. There are two umbilical veins and one umbilical artery. Prostaglandins maintain patency of ductus arteriosus. The ductus venous connects the umbilical vein with inferior vena cava. 2 / 40 This is false about diabetic ketoacidosis deep sighing respiration is present blood glucose is usually greater than 11.0 mmol/l blood ph is less than 7.3 serum bicarbonate level is more than 18mEq/l ketonemia and ketonuria are characteristic 3 / 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? Evacuation of the uterus by a specialist Methotrexate and folic acid and iron supplement Methotrexate and leukovorin Hysteroscopy Laparotomy and salpingectomy and follow up 4 / 40 Low birth weight is defined as Below -2 z-score for gestational age Below 2500g Below the average weight for the age and parity of the mother None of the above Below the 10th percentile for gestational age 5 / 40 In the diagnosis of minimal change nephrotic syndrome, the following tests would be useful except Doppler ultrasound of the lower limbs Fasting lipid profile Liver function tests Urinalysis Serum complement levels 6 / 40 The following diseases are associated with the Epstein Barr virus except Post-transplant lymphoproliferative disease Burkitt's lymhpoma Nasopharyngeal carcinoma Wilm's tumour Hodgkin's lymphoma 7 / 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 Endometriosis Anovulation Intrauterine synechiae Male factor 8 / 40 Haemorrhagic cystitis is a recognized complication of Cyclophosphamide Methotrexate VIncristine Adriamycin Cisplatin 9 / 40 Which of the following diseases is caused by a virus? Histoplasmosis Amyloidosis Diphtheria Lassa fever Pneumocystis jirovecii pneumonia 10 / 40 During a sharp curettage of an incomplete abortion, the uterine was perforated. What is the first step of management? Administration of antibiotic 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 11 / 40 Which of the following would be most appropriate in the immediate management of a 10-month-old infant with diarrhea and severe dehydration Oral rehydration solution if the child can drink Intravenous Ringer's lactate Stat dose of broad spectrum intravenous antibiotics Immediate intraosseous access for rehydration Intravenous Dextrose saline 12 / 40 In determining the Apgar score of a newborn, the following would be assessed except Skin colour Response to stimulation Respiratory effort Oxygen saturation Muscle tone 13 / 40 What is wrong about vaginal hematoma after delivery? Observation if hematoma is small 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 Pressure dressing should be applied on the hematoma bed for 12-24 hours 14 / 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 Endometrial polyps Leiomyomata uteri Anovulatory bleeding Endometritis 15 / 40 A 20-year-old primigravida, 32 weeks gestation, presents with profuse vaginal bleeding with pain and tenderness per abdomen. The most probable diagnosis: Abruptio placenta. Vaginitis. Uterine rupture. Marginal sinus bleed. Placenta praevia. 16 / 40 Which is not among pathophysiological changes of preeclampsia? DIC Increased thromboxane A2 Platelet dysfunction Reduction in prostacyclin Increased resistance to angiotensin 17 / 40 A 9-month-old girl may Be afraid of strangers Know the names of items in a picture book Stand on tiptoe Build a tower of four or more blocks Have temper tantrums 18 / 40 Contraindication to medical therapy (Methotrexate) in tubal pregnancy is Absence of active bleeding. History of active hepatic and renal disease. Desire for future fertility. Size of the ectopic gestational sac is 3cm for less. No fetal heart motion on ultrasound. 19 / 40 The following are features of prematurity in a neonate except Thick ear cartilage Flat areola Abundant lanugo Empty scrotum No creases on sole 20 / 40 A child born in Ghana in 2016 will routinely receive the following vaccinations except Rotavirus Pneumococcus Mumps Meningococcus Rubella 21 / 40 Clinical features of childhood acute lymphoblastic leukaemia include Bone pain Proptosis Dental anarchy Chloromas Gum hyperplasia 22 / 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. Are too expensive. Produce marked hypertension. 23 / 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? Hysterectomy Oxytocin infusion Speculum examination Bimanual uterine massage Ergot 24 / 40 An innocent murmur is likely to be Non-radiating Loudest at the left sternal border Persistent into early adulthood Associated with a thrill Diastolic 25 / 40 Which of the following drugs IS NOT used to inhibit premature labour? Magnesium sulfate. Phenobarbital. Nifedipine. Indomethacin. Ritodrine 26 / 40 Which is true about placental abruption? Abruption occurs after placental delivery There is no means to predict abruption Fetal assessment techniques can predict abruption with good precision The chance of repeated abruption is twice The chance of repeated abruption is not different 27 / 40 The most likely finding in the initial stages of septic shock is Hyperpnoea Tachypnoea Absent femoral pulses Delayed capillary refill Abnormally low blood pressure 28 / 40 In Preeclampsia all are correct EXCEPT: The condition is more common in women who smoke cigarettes. Is more common with women with a first degree relative who has preeclampsia. Regular full blood count are helpful in monitoring the progress of the condition. Development of epigastric pain is a serious sign. It is a significant cause of maternal mortality. 29 / 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 can be ruled out by careful physical examination Ectopic pregnancy risk is about 90% Ectopic pregnancy and intrauterine pregnancy cannot be ruled out Ectopic pregnancy is ruled out Ectopic pregnancy and intrauterine pregnancy are ruled out 30 / 40 The following are characteristics of simple febrile seizures Initially focal with secondary generalization Commonly caused by cerebral malaria Last for thirty minutes or less Occur only once or twice in a twenty-four-hour period Rate of epilepsy is higher than in the general population 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? Discharge home Tranexamic acid to control bleeding Observation Termination of pregnancy Blood transfusion is a must 32 / 40 What is the diagnosis and treatment of a non-tender mass near the urethral opening in a 4 year old girl? Condylomata acuminate - TCA acid Prolapse of the urethra - topical estrogen Muluscum - analgesics and steroids Skene gland abscess - antibiotic and evacuation Bartholin's gland abscess - gland excision 33 / 40 The risk of acute bilirubin encephalopathy in a newborn is increased with the use of Phenytoin Ceftriaxone Gentamycin Ampicillin Phenobarbitone 34 / 40 A child with severe haemophilia A would have an abnormal Platelet count None of the above Prothrombin time All of the above Blood film morphology 35 / 40 A low weight for height in a three-year-old child indicates Kwashiorkor Marasmus Wasting Stunting Underweight 36 / 40 ECG changes associated with hypokalemia include ST segment elevation Right axis deviation Appearance of a U wave Upright T wave Shortened PR interval 37 / 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 Fracture of the left femur Septic arthritis of the left hip joint Multiple myeloma Tuberculosis of the bone None of the above 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? Labetalol IV Diazepam Phenobarbital Phenytoin MgSO4 39 / 40 Acetaminophen-induced toxicity most commonly affects the Kidneys Bone marrow Heart Liver Lungs 40 / 40 What is not a reason of oligohydramnios in a woman at gestational age of 35W2D with IUGR in pregnancy? Reduced placental perfusion Severe preeclampsia may be a cause Increased swallowing of the fetus due to asphyxia Reduced fetal renal blood perfusion Reduced fetal urine Your score isThe average score is 63% LinkedIn Facebook VKontakte 0%