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