GMDC MOCK 2 34 ALL THE BEST THANK YOU Quiz 1 / 40 In Preeclampsia all are correct EXCEPT: Development of epigastric pain is a serious sign. It is a significant cause of maternal mortality. Regular full blood count are helpful in monitoring the progress of the condition. Is more common with women with a first degree relative who has preeclampsia. The condition is more common in women who smoke cigarettes. 2 / 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? Hysterectomy Bimanual uterine massage Oxytocin infusion Ergot Speculum examination 3 / 40 A child with severe haemophilia A would have an abnormal Platelet count None of the above All of the above Prothrombin time Blood film morphology 4 / 40 A low weight for height in a three-year-old child indicates Underweight Kwashiorkor Stunting Wasting Marasmus 5 / 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 Ringer's lactate Intravenous Dextrose saline Oral rehydration solution if the child can drink Stat dose of broad spectrum intravenous antibiotics Immediate intraosseous access for rehydration 6 / 40 A 9-month-old girl may Be afraid of strangers Build a tower of four or more blocks Have temper tantrums Stand on tiptoe Know the names of items in a picture book 7 / 40 ECG changes associated with hypokalemia include Right axis deviation Upright T wave Shortened PR interval ST segment elevation Appearance of a U wave 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 risk is about 90% Ectopic pregnancy is ruled out Ectopic pregnancy and intrauterine pregnancy are ruled out Ectopic pregnancy and intrauterine pregnancy cannot be ruled out 9 / 40 In determining the Apgar score of a newborn, the following would be assessed except Oxygen saturation Skin colour Respiratory effort Muscle tone Response to stimulation 10 / 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 Leiomyomata uteri Endometritis Anovulatory bleeding Endometrial polyps 11 / 40 What is not a reason of oligohydramnios in a woman at gestational age of 35W2D with IUGR in pregnancy? Reduced fetal urine Reduced placental perfusion Reduced fetal renal blood perfusion Severe preeclampsia may be a cause Increased swallowing of the fetus due to asphyxia 12 / 40 Which is not among pathophysiological changes of preeclampsia? Increased resistance to angiotensin Reduction in prostacyclin Platelet dysfunction Increased thromboxane A2 DIC 13 / 40 Acetaminophen-induced toxicity most commonly affects the Kidneys Heart Lungs Liver Bone marrow 14 / 40 Which of the following diseases is caused by a virus? Diphtheria Pneumocystis jirovecii pneumonia Lassa fever Histoplasmosis Amyloidosis 15 / 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 Hysteroscopy Methotrexate and folic acid and iron supplement Laparotomy and salpingectomy and follow up Evacuation of the uterus by a specialist 16 / 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 Fracture of the left femur Multiple myeloma Tuberculosis of the bone 17 / 40 The risk of acute bilirubin encephalopathy in a newborn is increased with the use of Phenobarbitone Gentamycin Ceftriaxone Phenytoin Ampicillin 18 / 40 A child born in Ghana in 2016 will routinely receive the following vaccinations except Rotavirus Pneumococcus Mumps Rubella Meningococcus 19 / 40 This is false about diabetic ketoacidosis ketonemia and ketonuria are characteristic blood ph is less than 7.3 blood glucose is usually greater than 11.0 mmol/l serum bicarbonate level is more than 18mEq/l deep sighing respiration is present 20 / 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 Rate of epilepsy is higher than in the general population Initially focal with secondary generalization 21 / 40 In the fetal circulation, the INCORRECT statement is: 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. Prostaglandins maintain patency of ductus arteriosus. The ductus venous connects the umbilical vein with inferior vena cava. 22 / 40 Which of the following drugs IS NOT used to inhibit premature labour? Indomethacin. Phenobarbital. Nifedipine. Magnesium sulfate. Ritodrine 23 / 40 Non-steroidal anti-inflammatory drugs are not generally used for long term tocolysis because they: Are associated with lactic acidosis. May cause premature closure of fetal ductus arteriosus. Produce marked hypertension. Are too expensive. Are ineffective 24 / 40 Contraindication to medical therapy (Methotrexate) in tubal pregnancy is History of active hepatic and renal disease. Absence of active bleeding. No fetal heart motion on ultrasound. Size of the ectopic gestational sac is 3cm for less. Desire for future fertility. 25 / 40 The most likely finding in the initial stages of septic shock is Absent femoral pulses Hyperpnoea Tachypnoea Abnormally low blood pressure Delayed capillary refill 26 / 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 Labetalol IV Diazepam Phenobarbital MgSO4 27 / 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? Tranexamic acid to control bleeding Blood transfusion is a must Discharge home Observation Termination of pregnancy 28 / 40 In the diagnosis of minimal change nephrotic syndrome, the following tests would be useful except Urinalysis Fasting lipid profile Liver function tests Serum complement levels Doppler ultrasound of the lower limbs 29 / 40 The following are features of prematurity in a neonate except Empty scrotum Flat areola No creases on sole Abundant lanugo Thick ear cartilage 30 / 40 Haemorrhagic cystitis is a recognized complication of Methotrexate VIncristine Cisplatin Adriamycin Cyclophosphamide 31 / 40 What is wrong about vaginal hematoma after delivery? An incision on the site if pain is severe and hematoma enlarges Vulvar hematoma can occur after improper episiotomy repair Mattress suturing the bed of hematoma Observation if hematoma is small Pressure dressing should be applied on the hematoma bed for 12-24 hours 32 / 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 Male factor Endometriosis Intrauterine synechiae Tubal obstruction 33 / 40 Low birth weight is defined as Below -2 z-score for gestational age Below 2500g Below the 10th percentile for gestational age None of the above Below the average weight for the age and parity of the mother 34 / 40 The following diseases are associated with the Epstein Barr virus except Post-transplant lymphoproliferative disease Burkitt's lymhpoma Nasopharyngeal carcinoma Hodgkin's lymphoma Wilm's tumour 35 / 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. Placenta praevia. Vaginitis. Uterine rupture. Abruptio placenta. 36 / 40 What is the diagnosis and treatment of a non-tender mass near the urethral opening in a 4 year old girl? Muluscum - analgesics and steroids Prolapse of the urethra - topical estrogen Condylomata acuminate - TCA acid Bartholin's gland abscess - gland excision Skene gland abscess - antibiotic and evacuation 37 / 40 Which is true about placental abruption? Fetal assessment techniques can predict abruption with good precision There is no means to predict abruption The chance of repeated abruption is not different Abruption occurs after placental delivery The chance of repeated abruption is twice 38 / 40 An innocent murmur is likely to be Non-radiating Associated with a thrill Loudest at the left sternal border Persistent into early adulthood Diastolic 39 / 40 Clinical features of childhood acute lymphoblastic leukaemia include Bone pain Chloromas Gum hyperplasia Proptosis Dental anarchy 40 / 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 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 Your score is The average score is 63% LinkedIn Facebook Twitter 0%