GMDC MOCK 2 34 ALL THE BEST THANK YOU Quiz 1 / 40 Contraindication to medical therapy (Methotrexate) in tubal pregnancy is Size of the ectopic gestational sac is 3cm for less. No fetal heart motion on ultrasound. Absence of active bleeding. History of active hepatic and renal disease. Desire for future fertility. 2 / 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 Endometritis Endometrial polyps Leiomyomata uteri Anovulatory bleeding 3 / 40 The following are features of prematurity in a neonate except Abundant lanugo Empty scrotum Thick ear cartilage No creases on sole Flat areola 4 / 40 ECG changes associated with hypokalemia include Right axis deviation Upright T wave ST segment elevation Appearance of a U wave Shortened PR interval 5 / 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 Phenytoin Diazepam Labetalol IV Phenobarbital 6 / 40 Acetaminophen-induced toxicity most commonly affects the Bone marrow Lungs Liver Kidneys Heart 7 / 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 Speculum examination Ergot Bimanual uterine massage Oxytocin infusion 8 / 40 In determining the Apgar score of a newborn, the following would be assessed except Muscle tone Oxygen saturation Respiratory effort Response to stimulation Skin colour 9 / 40 Which is not among pathophysiological changes of preeclampsia? Increased thromboxane A2 Reduction in prostacyclin DIC Increased resistance to angiotensin Platelet dysfunction 10 / 40 An innocent murmur is likely to be Persistent into early adulthood Diastolic Non-radiating Loudest at the left sternal border Associated with a thrill 11 / 40 During a sharp curettage of an incomplete abortion, the uterine was perforated. What is the first step of management? Laparotomy 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 12 / 40 Clinical features of childhood acute lymphoblastic leukaemia include Dental anarchy Gum hyperplasia Bone pain Chloromas Proptosis 13 / 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 Skene gland abscess - antibiotic and evacuation Prolapse of the urethra - topical estrogen Bartholin's gland abscess - gland excision Muluscum - analgesics and steroids 14 / 40 Non-steroidal anti-inflammatory drugs are not generally used for long term tocolysis because they: Are too expensive. Produce marked hypertension. May cause premature closure of fetal ductus arteriosus. Are associated with lactic acidosis. Are ineffective 15 / 40 Haemorrhagic cystitis is a recognized complication of Adriamycin Methotrexate VIncristine Cisplatin Cyclophosphamide 16 / 40 What is not a reason of oligohydramnios in a woman at gestational age of 35W2D with IUGR in pregnancy? Reduced fetal renal blood perfusion Reduced fetal urine Increased swallowing of the fetus due to asphyxia Reduced placental perfusion Severe preeclampsia may be a cause 17 / 40 A low weight for height in a three-year-old child indicates Marasmus Wasting Kwashiorkor Stunting Underweight 18 / 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 Mattress suturing the bed of hematoma An incision on the site if pain is severe and hematoma enlarges Observation if hematoma is small 19 / 40 Low birth weight is defined as Below -2 z-score for gestational age Below 2500g Below the 10th percentile for gestational age Below the average weight for the age and parity of the mother None of the above 20 / 40 Which of the following diseases is caused by a virus? Amyloidosis Diphtheria Histoplasmosis Pneumocystis jirovecii pneumonia Lassa fever 21 / 40 Which of the following drugs IS NOT used to inhibit premature labour? Phenobarbital. Nifedipine. Indomethacin. Magnesium sulfate. Ritodrine 22 / 40 In the fetal circulation, the INCORRECT statement is: The inferior vena cava contains both oxygenated and deoxygenated blood. 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. Prostaglandins maintain patency of ductus arteriosus. There are two umbilical veins and one umbilical artery. 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? Termination of pregnancy Observation Blood transfusion is a must Tranexamic acid to control bleeding Discharge home 24 / 40 The following are characteristics of simple febrile seizures 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 Commonly caused by cerebral malaria Last for thirty minutes or less 25 / 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. Is more common with women with a first degree relative who has preeclampsia. Development of epigastric pain is a serious sign. Regular full blood count are helpful in monitoring the progress of the condition. 26 / 40 The risk of acute bilirubin encephalopathy in a newborn is increased with the use of Ceftriaxone Phenytoin Phenobarbitone Gentamycin Ampicillin 27 / 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 Liver function tests Urinalysis Fasting lipid profile 28 / 40 The most likely finding in the initial stages of septic shock is Delayed capillary refill Tachypnoea Abnormally low blood pressure Hyperpnoea Absent femoral pulses 29 / 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 Intravenous Ringer's lactate Intravenous Dextrose saline Immediate intraosseous access for rehydration Stat dose of broad spectrum intravenous antibiotics 30 / 40 A child born in Ghana in 2016 will routinely receive the following vaccinations except Rubella Pneumococcus Meningococcus Rotavirus Mumps 31 / 40 This is false about diabetic ketoacidosis deep sighing respiration is present serum bicarbonate level is more than 18mEq/l blood glucose is usually greater than 11.0 mmol/l ketonemia and ketonuria are characteristic blood ph is less than 7.3 32 / 40 The following diseases are associated with the Epstein Barr virus except Nasopharyngeal carcinoma Burkitt's lymhpoma Hodgkin's lymphoma Wilm's tumour Post-transplant lymphoproliferative disease 33 / 40 A child with severe haemophilia A would have an abnormal Platelet count Blood film morphology Prothrombin time All of the above None of the above 34 / 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. Abruptio placenta. Uterine rupture. 35 / 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 Fracture of the left femur Tuberculosis of the bone Septic arthritis of the left hip joint None of the above Multiple myeloma 36 / 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 37 / 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 Male factor Endometriosis Intrauterine synechiae 38 / 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 folic acid and iron supplement Laparotomy and salpingectomy and follow up Methotrexate and leukovorin Hysteroscopy Evacuation of the uterus by a specialist 39 / 40 Which is true about placental abruption? The chance of repeated abruption is twice 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 40 / 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 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 Your score isThe average score is 63% LinkedIn Facebook VKontakte 0%