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