GMDC MOCK 2 34 ALL THE BEST THANK YOU Quiz 1 / 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 Labetalol IV Phenytoin Diazepam MgSO4 2 / 40 Which is true about placental abruption? Fetal assessment techniques can predict abruption with good precision 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 3 / 40 The risk of acute bilirubin encephalopathy in a newborn is increased with the use of Gentamycin Phenobarbitone Ceftriaxone Ampicillin Phenytoin 4 / 40 In the fetal circulation, the INCORRECT statement is: The ductus venous connects the umbilical vein with inferior vena cava. There are two umbilical veins and one umbilical artery. Prostaglandins maintain patency of ductus arteriosus. The inferior vena cava contains both oxygenated and deoxygenated blood. The blood is shifted from the right atrium to the left atrium via the foramen ovale. 5 / 40 What is wrong about vaginal hematoma after delivery? 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 Mattress suturing the bed of hematoma Observation if hematoma is small Vulvar hematoma can occur after improper episiotomy repair 6 / 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 associated with lactic acidosis. Are ineffective Are too expensive. Produce marked hypertension. 7 / 40 The most likely finding in the initial stages of septic shock is Tachypnoea Delayed capillary refill Absent femoral pulses Abnormally low blood pressure Hyperpnoea 8 / 40 The following diseases are associated with the Epstein Barr virus except Post-transplant lymphoproliferative disease Hodgkin's lymphoma Nasopharyngeal carcinoma Wilm's tumour Burkitt's lymhpoma 9 / 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 Anovulation Male factor Endometriosis Tubal obstruction 10 / 40 A child born in Ghana in 2016 will routinely receive the following vaccinations except Meningococcus Mumps Rotavirus Rubella Pneumococcus 11 / 40 Which is not among pathophysiological changes of preeclampsia? Increased thromboxane A2 DIC Increased resistance to angiotensin Reduction in prostacyclin Platelet dysfunction 12 / 40 Which of the following diseases is caused by a virus? Pneumocystis jirovecii pneumonia Lassa fever Histoplasmosis Amyloidosis Diphtheria 13 / 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 Termination of pregnancy Observation 14 / 40 ECG changes associated with hypokalemia include Appearance of a U wave ST segment elevation Shortened PR interval Upright T wave Right axis deviation 15 / 40 Which of the following drugs IS NOT used to inhibit premature labour? Indomethacin. Magnesium sulfate. Phenobarbital. Ritodrine Nifedipine. 16 / 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 17 / 40 A 9-month-old girl may Be afraid of strangers Build a tower of four or more blocks Stand on tiptoe Have temper tantrums Know the names of items in a picture book 18 / 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 continued by a specialist only 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 19 / 40 Low birth weight is defined as Below -2 z-score for gestational age Below the average weight for the age and parity of the mother Below the 10th percentile for gestational age None of the above Below 2500g 20 / 40 Clinical features of childhood acute lymphoblastic leukaemia include Proptosis Chloromas Bone pain Gum hyperplasia Dental anarchy 21 / 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 None of the above Septic arthritis of the left hip joint Tuberculosis of the bone Multiple myeloma Fracture of the left femur 22 / 40 What is not a reason of oligohydramnios in a woman at gestational age of 35W2D with IUGR in pregnancy? Reduced fetal urine Severe preeclampsia may be a cause Increased swallowing of the fetus due to asphyxia Reduced placental perfusion Reduced fetal renal blood perfusion 23 / 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 24 / 40 Contraindication to medical therapy (Methotrexate) in tubal pregnancy is Size of the ectopic gestational sac is 3cm for less. History of active hepatic and renal disease. Desire for future fertility. No fetal heart motion on ultrasound. Absence of active bleeding. 25 / 40 An innocent murmur is likely to be Loudest at the left sternal border Persistent into early adulthood Non-radiating Diastolic Associated with a thrill 26 / 40 A low weight for height in a three-year-old child indicates Marasmus Stunting Underweight Kwashiorkor Wasting 27 / 40 A child with severe haemophilia A would have an abnormal Blood film morphology None of the above All of the above Platelet count Prothrombin time 28 / 40 In the diagnosis of minimal change nephrotic syndrome, the following tests would be useful except Doppler ultrasound of the lower limbs Fasting lipid profile Serum complement levels Urinalysis Liver function tests 29 / 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. Placenta praevia. Abruptio placenta. Marginal sinus bleed. Vaginitis. 30 / 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 Skene gland abscess - antibiotic and evacuation Bartholin's gland abscess - gland excision Muluscum - analgesics and steroids 31 / 40 Haemorrhagic cystitis is a recognized complication of Cisplatin VIncristine Adriamycin Cyclophosphamide Methotrexate 32 / 40 The following are characteristics of simple febrile seizures Occur only once or twice in a twenty-four-hour period Last for thirty minutes or less Initially focal with secondary generalization Rate of epilepsy is higher than in the general population Commonly caused by cerebral malaria 33 / 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? Oxytocin infusion Speculum examination Bimanual uterine massage Hysterectomy Ergot 34 / 40 Acetaminophen-induced toxicity most commonly affects the Liver Bone marrow Lungs Kidneys Heart 35 / 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 cannot be ruled out Ectopic pregnancy is ruled out Ectopic can be ruled out by careful physical examination Ectopic pregnancy and intrauterine pregnancy are ruled out Ectopic pregnancy risk is about 90% 36 / 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? Evacuation of the uterus by a specialist Methotrexate and folic acid and iron supplement Methotrexate and leukovorin Hysteroscopy Laparotomy and salpingectomy and follow up 37 / 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. It is a significant cause of maternal mortality. Is more common with women with a first degree relative who has preeclampsia. 38 / 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 Oral rehydration solution if the child can drink Stat dose of broad spectrum intravenous antibiotics Intravenous Dextrose saline 39 / 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 Pregnancy Anovulatory bleeding Leiomyomata uteri Endometritis 40 / 40 The following are features of prematurity in a neonate except Empty scrotum No creases on sole Flat areola Thick ear cartilage Abundant lanugo Your score isThe average score is 63% LinkedIn Facebook VKontakte 0%