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