GMDC MOCK 2 34 ALL THE BEST THANK YOU Quiz 1 / 40 A child with severe haemophilia A would have an abnormal Blood film morphology Platelet count Prothrombin time All of the above None of the above 2 / 40 In determining the Apgar score of a newborn, the following would be assessed except Response to stimulation Muscle tone Oxygen saturation Respiratory effort Skin colour 3 / 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 Fetal assessment techniques can predict abruption with good precision The chance of repeated abruption is not different 4 / 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 Ergot Hysterectomy Oxytocin infusion Bimanual uterine massage 5 / 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 Evacuation of the uterus by a specialist Hysteroscopy Methotrexate and folic acid and iron supplement Methotrexate and leukovorin 6 / 40 An innocent murmur is likely to be Loudest at the left sternal border Associated with a thrill Non-radiating Persistent into early adulthood Diastolic 7 / 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% 8 / 40 Low birth weight is defined as None of the above Below the average weight for the age and parity of the mother Below -2 z-score for gestational age Below the 10th percentile for gestational age Below 2500g 9 / 40 ECG changes associated with hypokalemia include Shortened PR interval ST segment elevation Upright T wave Right axis deviation Appearance of a U wave 10 / 40 Clinical features of childhood acute lymphoblastic leukaemia include Bone pain Dental anarchy Proptosis Gum hyperplasia Chloromas 11 / 40 A child born in Ghana in 2016 will routinely receive the following vaccinations except Pneumococcus Meningococcus Rubella Rotavirus Mumps 12 / 40 The risk of acute bilirubin encephalopathy in a newborn is increased with the use of Ceftriaxone Ampicillin Gentamycin Phenobarbitone Phenytoin 13 / 40 Which of the following drugs IS NOT used to inhibit premature labour? Magnesium sulfate. Phenobarbital. Indomethacin. Nifedipine. Ritodrine 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? Diazepam Phenobarbital MgSO4 Labetalol IV Phenytoin 15 / 40 Contraindication to medical therapy (Methotrexate) in tubal pregnancy is Desire for future fertility. Absence of active bleeding. Size of the ectopic gestational sac is 3cm for less. No fetal heart motion on ultrasound. History of active hepatic and renal disease. 16 / 40 The following are characteristics of simple febrile seizures Commonly caused by cerebral malaria Initially focal with secondary generalization Rate of epilepsy is higher than in the general population Last for thirty minutes or less Occur only once or twice in a twenty-four-hour period 17 / 40 A 9-month-old girl may Know the names of items in a picture book Build a tower of four or more blocks Have temper tantrums Stand on tiptoe Be afraid of strangers 18 / 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 Immediate intraosseous access for rehydration Intravenous Ringer's lactate Intravenous Dextrose saline Stat dose of broad spectrum intravenous antibiotics 19 / 40 In Preeclampsia all are correct EXCEPT: Is more common with women with a first degree relative who has preeclampsia. It is a significant cause of maternal mortality. Development of epigastric pain is a serious sign. Regular full blood count are helpful in monitoring the progress of the condition. The condition is more common in women who smoke cigarettes. 20 / 40 Which of the following diseases is caused by a virus? Histoplasmosis Lassa fever Diphtheria Amyloidosis Pneumocystis jirovecii pneumonia 21 / 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. Marginal sinus bleed. Placenta praevia. Vaginitis. Abruptio placenta. 22 / 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 Muluscum - analgesics and steroids Prolapse of the urethra - topical estrogen Skene gland abscess - antibiotic and evacuation Bartholin's gland abscess - gland excision 23 / 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 Tranexamic acid to control bleeding Termination of pregnancy Observation 24 / 40 The following are features of prematurity in a neonate except Flat areola No creases on sole Abundant lanugo Empty scrotum Thick ear cartilage 25 / 40 What is wrong about vaginal hematoma after delivery? An incision on the site if pain is severe and hematoma enlarges Pressure dressing should be applied on the hematoma bed for 12-24 hours Mattress suturing the bed of hematoma Observation if hematoma is small Vulvar hematoma can occur after improper episiotomy repair 26 / 40 The following diseases are associated with the Epstein Barr virus except Post-transplant lymphoproliferative disease Nasopharyngeal carcinoma Burkitt's lymhpoma Hodgkin's lymphoma Wilm's tumour 27 / 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 too expensive. Are ineffective Are associated with lactic acidosis. Produce marked hypertension. 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? Tubal obstruction Anovulation Endometriosis Intrauterine synechiae Male factor 29 / 40 The most likely finding in the initial stages of septic shock is Hyperpnoea Tachypnoea Abnormally low blood pressure Absent femoral pulses Delayed capillary refill 30 / 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 Leiomyomata uteri Pregnancy Anovulatory bleeding Endometritis 31 / 40 Which is not among pathophysiological changes of preeclampsia? DIC Increased thromboxane A2 Increased resistance to angiotensin Reduction in prostacyclin Platelet dysfunction 32 / 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 Multiple myeloma Tuberculosis of the bone Fracture of the left femur 33 / 40 A low weight for height in a three-year-old child indicates Underweight Wasting Stunting Kwashiorkor Marasmus 34 / 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 urine Reduced placental perfusion Reduced fetal renal blood perfusion Severe preeclampsia may be a cause 35 / 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 Administration of antibiotic Curettage should be completed and patient should remain under observation Curettage should be continued by a specialist only Laparotomy 36 / 40 In the diagnosis of minimal change nephrotic syndrome, the following tests would be useful except Doppler ultrasound of the lower limbs Urinalysis Serum complement levels Fasting lipid profile Liver function tests 37 / 40 This is false about diabetic ketoacidosis 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 deep sighing respiration is present 38 / 40 In the fetal circulation, the INCORRECT statement is: 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. 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. 39 / 40 Acetaminophen-induced toxicity most commonly affects the Kidneys Heart Liver Bone marrow Lungs 40 / 40 Haemorrhagic cystitis is a recognized complication of Methotrexate Adriamycin Cyclophosphamide VIncristine Cisplatin Your score is The average score is 63% LinkedIn Facebook Twitter 0%