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