GMDC MOCK 2 34 ALL THE BEST THANK YOU Quiz 1 / 40 The most likely finding in the initial stages of septic shock is Tachypnoea Abnormally low blood pressure Hyperpnoea Delayed capillary refill Absent femoral pulses 2 / 40 Acetaminophen-induced toxicity most commonly affects the Lungs Liver Heart Bone marrow Kidneys 3 / 40 The following diseases are associated with the Epstein Barr virus except Burkitt's lymhpoma Wilm's tumour Hodgkin's lymphoma Nasopharyngeal carcinoma Post-transplant lymphoproliferative disease 4 / 40 A child born in Ghana in 2016 will routinely receive the following vaccinations except Meningococcus Rubella Pneumococcus Mumps Rotavirus 5 / 40 Low birth weight is defined as Below the 10th percentile for gestational age Below the average weight for the age and parity of the mother Below 2500g None of the above Below -2 z-score for gestational age 6 / 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? Anovulation Tubal obstruction Male factor Intrauterine synechiae Endometriosis 7 / 40 Non-steroidal anti-inflammatory drugs are not generally used for long term tocolysis because they: Are ineffective Produce marked hypertension. May cause premature closure of fetal ductus arteriosus. Are associated with lactic acidosis. Are too expensive. 8 / 40 Clinical features of childhood acute lymphoblastic leukaemia include Chloromas Proptosis Dental anarchy Gum hyperplasia Bone pain 9 / 40 Which of the following drugs IS NOT used to inhibit premature labour? Magnesium sulfate. Ritodrine Nifedipine. Phenobarbital. Indomethacin. 10 / 40 In the fetal circulation, the INCORRECT statement is: The ductus venous connects the umbilical vein with inferior vena cava. Prostaglandins maintain patency of ductus arteriosus. 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. The inferior vena cava contains both oxygenated and deoxygenated blood. 11 / 40 The following are characteristics of simple febrile seizures Rate of epilepsy is higher than in the general population Last for thirty minutes or less Initially focal with secondary generalization Occur only once or twice in a twenty-four-hour period Commonly caused by cerebral malaria 12 / 40 The risk of acute bilirubin encephalopathy in a newborn is increased with the use of Gentamycin Phenytoin Ceftriaxone Ampicillin Phenobarbitone 13 / 40 Haemorrhagic cystitis is a recognized complication of Adriamycin VIncristine Cisplatin Methotrexate Cyclophosphamide 14 / 40 A 20-year-old primigravida, 32 weeks gestation, presents with profuse vaginal bleeding with pain and tenderness per abdomen. The most probable diagnosis: Marginal sinus bleed. Vaginitis. Placenta praevia. Uterine rupture. Abruptio placenta. 15 / 40 A low weight for height in a three-year-old child indicates Stunting Underweight Kwashiorkor Marasmus Wasting 16 / 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 Bimanual uterine massage Speculum examination Oxytocin infusion Ergot 17 / 40 An innocent murmur is likely to be Persistent into early adulthood Diastolic Non-radiating Loudest at the left sternal border Associated with a thrill 18 / 40 The following are features of prematurity in a neonate except Abundant lanugo No creases on sole Flat areola Empty scrotum Thick ear cartilage 19 / 40 A 9-month-old girl may Be afraid of strangers Stand on tiptoe Have temper tantrums Know the names of items in a picture book Build a tower of four or more blocks 20 / 40 In determining the Apgar score of a newborn, the following would be assessed except Oxygen saturation Response to stimulation Muscle tone Respiratory effort Skin colour 21 / 40 A child with severe haemophilia A would have an abnormal Prothrombin time Blood film morphology Platelet count All of the above None of the above 22 / 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 Laparotomy and salpingectomy and follow up Evacuation of the uterus by a specialist Hysteroscopy Methotrexate and folic acid and iron supplement 23 / 40 ECG changes associated with hypokalemia include ST segment elevation Right axis deviation Upright T wave Shortened PR interval Appearance of a U wave 24 / 40 Which of the following diseases is caused by a virus? Histoplasmosis Lassa fever Amyloidosis Diphtheria Pneumocystis jirovecii pneumonia 25 / 40 What is wrong about vaginal hematoma after delivery? 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 An incision on the site if pain is severe and hematoma enlarges Mattress suturing the bed of hematoma 26 / 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 Diazepam Phenytoin Labetalol IV MgSO4 27 / 40 In the diagnosis of minimal change nephrotic syndrome, the following tests would be useful except Liver function tests Fasting lipid profile Urinalysis Serum complement levels Doppler ultrasound of the lower limbs 28 / 40 This is false about diabetic ketoacidosis deep sighing respiration is present blood ph is less than 7.3 ketonemia and ketonuria are characteristic blood glucose is usually greater than 11.0 mmol/l serum bicarbonate level is more than 18mEq/l 29 / 40 Which is not among pathophysiological changes of preeclampsia? Reduction in prostacyclin DIC Increased resistance to angiotensin Platelet dysfunction Increased thromboxane A2 30 / 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 Tranexamic acid to control bleeding Observation Discharge home Termination of pregnancy 31 / 40 In Preeclampsia all are correct EXCEPT: It is a significant cause of maternal mortality. Regular full blood count are helpful in monitoring the progress of the condition. Development of epigastric pain is a serious sign. Is more common with women with a first degree relative who has preeclampsia. The condition is more common in women who smoke cigarettes. 32 / 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 None of the above Multiple myeloma 33 / 40 Contraindication to medical therapy (Methotrexate) in tubal pregnancy is No fetal heart motion on ultrasound. Size of the ectopic gestational sac is 3cm for less. Desire for future fertility. Absence of active bleeding. History of active hepatic and renal disease. 34 / 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 is ruled out Ectopic pregnancy and intrauterine pregnancy cannot be ruled out Ectopic pregnancy risk is about 90% Ectopic pregnancy and intrauterine pregnancy are ruled out Ectopic can be ruled out by careful physical examination 35 / 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 Endometrial polyps Anovulatory bleeding 36 / 40 Which of the following would be most appropriate in the immediate management of a 10-month-old infant with diarrhea and severe dehydration Stat dose of broad spectrum intravenous antibiotics Immediate intraosseous access for rehydration Intravenous Dextrose saline Intravenous Ringer's lactate Oral rehydration solution if the child can drink 37 / 40 What is the diagnosis and treatment of a non-tender mass near the urethral opening in a 4 year old girl? Muluscum - analgesics and steroids Condylomata acuminate - TCA acid Prolapse of the urethra - topical estrogen Skene gland abscess - antibiotic and evacuation Bartholin's gland abscess - gland excision 38 / 40 Which is true about placental abruption? 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 Abruption occurs after placental delivery 39 / 40 What is not a reason of oligohydramnios in a woman at gestational age of 35W2D with IUGR in pregnancy? Reduced fetal urine Increased swallowing of the fetus due to asphyxia Reduced placental perfusion Severe preeclampsia may be a cause Reduced fetal renal blood perfusion 40 / 40 During a sharp curettage of an incomplete abortion, the uterine was perforated. What is the first step of management? If there is no hemorrhage in the first 24 hours after operation, the patient can be discharged Laparotomy Curettage should be completed and patient should remain under observation Administration of antibiotic Curettage should be continued by a specialist only Your score is The average score is 63% LinkedIn Facebook Twitter 0%