GMDC MOCK 2 34 ALL THE BEST THANK YOU Quiz 1 / 40 A child born in Ghana in 2016 will routinely receive the following vaccinations except Rotavirus Mumps Rubella Meningococcus Pneumococcus 2 / 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 Multiple myeloma None of the above Fracture of the left femur Tuberculosis of the bone Septic arthritis of the left hip joint 3 / 40 The risk of acute bilirubin encephalopathy in a newborn is increased with the use of Gentamycin Phenobarbitone Ampicillin Phenytoin Ceftriaxone 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? Hysteroscopy Evacuation of the uterus by a specialist Methotrexate and folic acid and iron supplement Methotrexate and leukovorin Laparotomy and salpingectomy and follow up 5 / 40 Which of the following diseases is caused by a virus? Diphtheria Pneumocystis jirovecii pneumonia Amyloidosis Histoplasmosis Lassa fever 6 / 40 In the diagnosis of minimal change nephrotic syndrome, the following tests would be useful except Liver function tests Fasting lipid profile Urinalysis Doppler ultrasound of the lower limbs Serum complement levels 7 / 40 A 9-month-old girl may Know the names of items in a picture book Build a tower of four or more blocks Be afraid of strangers Have temper tantrums Stand on tiptoe 8 / 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 is ruled out Ectopic pregnancy and intrauterine pregnancy cannot be ruled out Ectopic pregnancy and intrauterine pregnancy are ruled out Ectopic pregnancy risk is about 90% 9 / 40 A low weight for height in a three-year-old child indicates Marasmus Kwashiorkor Wasting Underweight Stunting 10 / 40 This is false about diabetic ketoacidosis ketonemia and ketonuria are characteristic 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 11 / 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 Observation Termination of pregnancy Tranexamic acid to control bleeding 12 / 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 Curettage should be continued by a specialist only Laparotomy 13 / 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 Endometrial polyps Leiomyomata uteri Pregnancy Endometritis 14 / 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 Hysterectomy Oxytocin infusion Speculum examination Bimanual uterine massage 15 / 40 Clinical features of childhood acute lymphoblastic leukaemia include Bone pain Gum hyperplasia Dental anarchy Chloromas Proptosis 16 / 40 In the fetal circulation, the INCORRECT statement is: 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. The ductus venous connects the umbilical vein with inferior vena cava. Prostaglandins maintain patency of ductus arteriosus. There are two umbilical veins and one umbilical artery. 17 / 40 The following are characteristics of simple febrile seizures Rate of epilepsy is higher than in the general population Initially focal with secondary generalization Occur only once or twice in a twenty-four-hour period Commonly caused by cerebral malaria Last for thirty minutes or less 18 / 40 In Preeclampsia all are correct EXCEPT: Regular full blood count are helpful in monitoring the progress of the condition. The condition is more common in women who smoke cigarettes. Development of epigastric pain is a serious sign. Is more common with women with a first degree relative who has preeclampsia. It is a significant cause of maternal mortality. 19 / 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 20 / 40 An innocent murmur is likely to be Persistent into early adulthood Non-radiating Diastolic Loudest at the left sternal border Associated with a thrill 21 / 40 Which of the following drugs IS NOT used to inhibit premature labour? Indomethacin. Phenobarbital. Magnesium sulfate. Nifedipine. Ritodrine 22 / 40 What is wrong about vaginal hematoma after delivery? Mattress suturing the bed of hematoma An incision on the site if pain is severe and hematoma enlarges Vulvar hematoma can occur after improper episiotomy repair Pressure dressing should be applied on the hematoma bed for 12-24 hours Observation if hematoma is small 23 / 40 Contraindication to medical therapy (Methotrexate) in tubal pregnancy is Desire for future fertility. Absence of active bleeding. No fetal heart motion on ultrasound. Size of the ectopic gestational sac is 3cm for less. History of active hepatic and renal disease. 24 / 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 Intrauterine synechiae Male factor Endometriosis 25 / 40 A child with severe haemophilia A would have an abnormal All of the above Blood film morphology Platelet count Prothrombin time None of the above 26 / 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 Bartholin's gland abscess - gland excision Muluscum - analgesics and steroids Skene gland abscess - antibiotic and evacuation 27 / 40 In determining the Apgar score of a newborn, the following would be assessed except Muscle tone Respiratory effort Oxygen saturation Skin colour Response to stimulation 28 / 40 Acetaminophen-induced toxicity most commonly affects the Liver Lungs Bone marrow Heart Kidneys 29 / 40 The following diseases are associated with the Epstein Barr virus except Wilm's tumour Hodgkin's lymphoma Nasopharyngeal carcinoma Post-transplant lymphoproliferative disease Burkitt's lymhpoma 30 / 40 Which is not among pathophysiological changes of preeclampsia? Increased resistance to angiotensin Increased thromboxane A2 Reduction in prostacyclin DIC Platelet dysfunction 31 / 40 Low birth weight is defined as Below the 10th percentile for gestational age Below -2 z-score for gestational age Below the average weight for the age and parity of the mother None of the above Below 2500g 32 / 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 Phenytoin Diazepam Labetalol IV MgSO4 33 / 40 ECG changes associated with hypokalemia include Upright T wave Right axis deviation Shortened PR interval Appearance of a U wave ST segment elevation 34 / 40 The following are features of prematurity in a neonate except Flat areola No creases on sole Thick ear cartilage Empty scrotum Abundant lanugo 35 / 40 Non-steroidal anti-inflammatory drugs are not generally used for long term tocolysis because they: May cause premature closure of fetal ductus arteriosus. Are ineffective Produce marked hypertension. Are too expensive. Are associated with lactic acidosis. 36 / 40 Which is true about placental abruption? There is no means to predict abruption The chance of repeated abruption is twice Fetal assessment techniques can predict abruption with good precision The chance of repeated abruption is not different Abruption occurs after placental delivery 37 / 40 Haemorrhagic cystitis is a recognized complication of Cyclophosphamide Cisplatin Methotrexate Adriamycin VIncristine 38 / 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. Abruptio placenta. Vaginitis. Placenta praevia. Uterine rupture. 39 / 40 The most likely finding in the initial stages of septic shock is Hyperpnoea Delayed capillary refill Absent femoral pulses Abnormally low blood pressure Tachypnoea 40 / 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 fetal renal blood perfusion Severe preeclampsia may be a cause Reduced placental perfusion Reduced fetal urine Your score is The average score is 63% LinkedIn Facebook Twitter 0%