GMDC MOCK 2 34 ALL THE BEST THANK YOU Quiz 1 / 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 2 / 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. Marginal sinus bleed. Uterine rupture. Vaginitis. Abruptio placenta. 3 / 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 leukovorin Laparotomy and salpingectomy and follow up Hysteroscopy Evacuation of the uterus by a specialist Methotrexate and folic acid and iron supplement 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? Bimanual uterine massage Speculum examination Oxytocin infusion Ergot Hysterectomy 5 / 40 This is false about diabetic ketoacidosis blood ph is less than 7.3 serum bicarbonate level is more than 18mEq/l deep sighing respiration is present ketonemia and ketonuria are characteristic blood glucose is usually greater than 11.0 mmol/l 6 / 40 Clinical features of childhood acute lymphoblastic leukaemia include Dental anarchy Gum hyperplasia Proptosis Chloromas Bone pain 7 / 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 Endometritis Anovulatory bleeding 8 / 40 Haemorrhagic cystitis is a recognized complication of Cyclophosphamide VIncristine Methotrexate Adriamycin Cisplatin 9 / 40 An innocent murmur is likely to be Loudest at the left sternal border Non-radiating Persistent into early adulthood Diastolic Associated with a thrill 10 / 40 In the diagnosis of minimal change nephrotic syndrome, the following tests would be useful except Liver function tests Fasting lipid profile Urinalysis Serum complement levels Doppler ultrasound of the lower limbs 11 / 40 A 9-month-old girl may Build a tower of four or more blocks Be afraid of strangers Stand on tiptoe Know the names of items in a picture book Have temper tantrums 12 / 40 Which is not among pathophysiological changes of preeclampsia? Platelet dysfunction Reduction in prostacyclin Increased thromboxane A2 Increased resistance to angiotensin DIC 13 / 40 In determining the Apgar score of a newborn, the following would be assessed except Oxygen saturation Response to stimulation Skin colour Muscle tone Respiratory effort 14 / 40 The risk of acute bilirubin encephalopathy in a newborn is increased with the use of Ampicillin Phenobarbitone Ceftriaxone Gentamycin Phenytoin 15 / 40 The most likely finding in the initial stages of septic shock is Delayed capillary refill Hyperpnoea Abnormally low blood pressure Tachypnoea Absent femoral pulses 16 / 40 During a sharp curettage of an incomplete abortion, the uterine was perforated. What is the first step of management? 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 Administration of antibiotic Curettage should be completed and patient should remain under observation Laparotomy 17 / 40 What is wrong about vaginal hematoma after delivery? Vulvar hematoma can occur after improper episiotomy repair 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 18 / 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 cannot be ruled out Ectopic pregnancy and intrauterine pregnancy are ruled out Ectopic pregnancy risk is about 90% Ectopic pregnancy is ruled out 19 / 40 The following are characteristics of simple febrile seizures Commonly caused by cerebral malaria Last for thirty minutes or less Occur only once or twice in a twenty-four-hour period Initially focal with secondary generalization Rate of epilepsy is higher than in the general population 20 / 40 ECG changes associated with hypokalemia include ST segment elevation Appearance of a U wave Shortened PR interval Upright T wave Right axis deviation 21 / 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? Male factor Intrauterine synechiae Anovulation Endometriosis Tubal obstruction 22 / 40 Non-steroidal anti-inflammatory drugs are not generally used for long term tocolysis because they: Are ineffective Are associated with lactic acidosis. May cause premature closure of fetal ductus arteriosus. Are too expensive. Produce marked hypertension. 23 / 40 Acetaminophen-induced toxicity most commonly affects the Bone marrow Lungs Heart Kidneys Liver 24 / 40 Which of the following drugs IS NOT used to inhibit premature labour? Indomethacin. Magnesium sulfate. Ritodrine Phenobarbital. Nifedipine. 25 / 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 Severe preeclampsia may be a cause Reduced placental perfusion Reduced fetal renal blood perfusion 26 / 40 A low weight for height in a three-year-old child indicates Stunting Marasmus Underweight Wasting Kwashiorkor 27 / 40 Contraindication to medical therapy (Methotrexate) in tubal pregnancy is Size of the ectopic gestational sac is 3cm for less. Desire for future fertility. No fetal heart motion on ultrasound. History of active hepatic and renal disease. Absence of active bleeding. 28 / 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 Tranexamic acid to control bleeding Blood transfusion is a must Termination of pregnancy Observation 29 / 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 Phenobarbital Diazepam Labetalol IV Phenytoin 30 / 40 The following diseases are associated with the Epstein Barr virus except Hodgkin's lymphoma Wilm's tumour Nasopharyngeal carcinoma Burkitt's lymhpoma Post-transplant lymphoproliferative disease 31 / 40 Low birth weight is defined as Below -2 z-score for gestational age Below 2500g None of the above Below the 10th percentile for gestational age Below the average weight for the age and parity of the mother 32 / 40 Which of the following diseases is caused by a virus? Diphtheria Histoplasmosis Pneumocystis jirovecii pneumonia Lassa fever Amyloidosis 33 / 40 What is the diagnosis and treatment of a non-tender mass near the urethral opening in a 4 year old girl? Bartholin's gland abscess - gland excision Skene gland abscess - antibiotic and evacuation Muluscum - analgesics and steroids Prolapse of the urethra - topical estrogen Condylomata acuminate - TCA acid 34 / 40 In the fetal circulation, the INCORRECT statement is: 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. Prostaglandins maintain patency of ductus arteriosus. 35 / 40 A child with severe haemophilia A would have an abnormal Prothrombin time None of the above All of the above Blood film morphology Platelet count 36 / 40 A child born in Ghana in 2016 will routinely receive the following vaccinations except Pneumococcus Rubella Rotavirus Mumps Meningococcus 37 / 40 In Preeclampsia all are correct EXCEPT: Is more common with women with a first degree relative who has preeclampsia. Development of epigastric pain is a serious sign. The condition is more common in women who smoke cigarettes. It is a significant cause of maternal mortality. Regular full blood count are helpful in monitoring the progress of the condition. 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 Intravenous Dextrose saline Oral rehydration solution if the child can drink Immediate intraosseous access for rehydration Stat dose of broad spectrum intravenous antibiotics Intravenous Ringer's lactate 39 / 40 Which is true about placental abruption? There is no means to predict abruption Fetal assessment techniques can predict abruption with good precision The chance of repeated abruption is twice Abruption occurs after placental delivery The chance of repeated abruption is not different 40 / 40 The following are features of prematurity in a neonate except Flat areola Abundant lanugo Thick ear cartilage Empty scrotum No creases on sole Your score isThe average score is 63% LinkedIn Facebook VKontakte 0%