GMDC MOCK 2 34 ALL THE BEST THANK YOU Quiz 1 / 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 Oxytocin infusion Ergot Speculum examination Hysterectomy 2 / 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. 3 / 40 Which of the following drugs IS NOT used to inhibit premature labour? Nifedipine. Phenobarbital. Magnesium sulfate. Indomethacin. Ritodrine 4 / 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 Dextrose saline Stat dose of broad spectrum intravenous antibiotics Oral rehydration solution if the child can drink Intravenous Ringer's lactate 5 / 40 In the diagnosis of minimal change nephrotic syndrome, the following tests would be useful except Fasting lipid profile Doppler ultrasound of the lower limbs Serum complement levels Liver function tests Urinalysis 6 / 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. 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. 7 / 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? Evacuation of the uterus by a specialist Laparotomy and salpingectomy and follow up Methotrexate and leukovorin Methotrexate and folic acid and iron supplement Hysteroscopy 8 / 40 An innocent murmur is likely to be Associated with a thrill Loudest at the left sternal border Non-radiating Persistent into early adulthood Diastolic 9 / 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 Tubal obstruction Endometriosis Anovulation Male factor 10 / 40 Clinical features of childhood acute lymphoblastic leukaemia include Gum hyperplasia Bone pain Dental anarchy Proptosis Chloromas 11 / 40 Haemorrhagic cystitis is a recognized complication of VIncristine Adriamycin Cyclophosphamide Cisplatin Methotrexate 12 / 40 Which is true about placental abruption? The chance of repeated abruption is twice 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 13 / 40 The risk of acute bilirubin encephalopathy in a newborn is increased with the use of Ceftriaxone Phenobarbitone Gentamycin Ampicillin Phenytoin 14 / 40 During a sharp curettage of an incomplete abortion, the uterine was perforated. What is the first step of management? Curettage should be completed and patient should remain under observation 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 Laparotomy 15 / 40 Which is not among pathophysiological changes of preeclampsia? Reduction in prostacyclin Platelet dysfunction Increased resistance to angiotensin Increased thromboxane A2 DIC 16 / 40 The following are characteristics of simple febrile seizures Rate of epilepsy is higher than in the general population Commonly caused by cerebral malaria Occur only once or twice in a twenty-four-hour period Last for thirty minutes or less Initially focal with secondary generalization 17 / 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. Regular full blood count are helpful in monitoring the progress of the condition. Development of epigastric pain is a serious sign. 18 / 40 Non-steroidal anti-inflammatory drugs are not generally used for long term tocolysis because they: Are ineffective Are too expensive. May cause premature closure of fetal ductus arteriosus. Are associated with lactic acidosis. Produce marked hypertension. 19 / 40 A child born in Ghana in 2016 will routinely receive the following vaccinations except Rotavirus Meningococcus Mumps Rubella Pneumococcus 20 / 40 ECG changes associated with hypokalemia include Upright T wave Shortened PR interval Appearance of a U wave ST segment elevation Right axis deviation 21 / 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 Tuberculosis of the bone None of the above Septic arthritis of the left hip joint Multiple myeloma Fracture of the left femur 22 / 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 Diazepam Phenobarbital Labetalol IV Phenytoin 23 / 40 Which of the following diseases is caused by a virus? Pneumocystis jirovecii pneumonia Lassa fever Histoplasmosis Diphtheria Amyloidosis 24 / 40 The following diseases are associated with the Epstein Barr virus except Burkitt's lymhpoma Nasopharyngeal carcinoma Hodgkin's lymphoma Wilm's tumour Post-transplant lymphoproliferative disease 25 / 40 A 20-year-old primigravida, 32 weeks gestation, presents with profuse vaginal bleeding with pain and tenderness per abdomen. The most probable diagnosis: Abruptio placenta. Vaginitis. Placenta praevia. Uterine rupture. Marginal sinus bleed. 26 / 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 Tranexamic acid to control bleeding Observation Blood transfusion is a must Discharge home 27 / 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? Anovulatory bleeding Pregnancy Endometrial polyps Endometritis Leiomyomata uteri 28 / 40 In determining the Apgar score of a newborn, the following would be assessed except Respiratory effort Skin colour Oxygen saturation Muscle tone Response to stimulation 29 / 40 A child with severe haemophilia A would have an abnormal Prothrombin time Blood film morphology None of the above Platelet count All of the above 30 / 40 A low weight for height in a three-year-old child indicates Kwashiorkor Wasting Stunting Underweight Marasmus 31 / 40 Low birth weight is defined as None of the above Below 2500g 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 32 / 40 The following are features of prematurity in a neonate except Thick ear cartilage Abundant lanugo Empty scrotum No creases on sole Flat areola 33 / 40 This is false about diabetic ketoacidosis ketonemia and ketonuria are characteristic blood glucose is usually greater than 11.0 mmol/l blood ph is less than 7.3 deep sighing respiration is present serum bicarbonate level is more than 18mEq/l 34 / 40 The most likely finding in the initial stages of septic shock is Abnormally low blood pressure Hyperpnoea Absent femoral pulses Tachypnoea Delayed capillary refill 35 / 40 What is wrong about vaginal hematoma after delivery? 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 Observation if hematoma is small Mattress suturing the bed of hematoma Vulvar hematoma can occur after improper episiotomy repair 36 / 40 Acetaminophen-induced toxicity most commonly affects the Liver Heart Lungs Kidneys Bone marrow 37 / 40 A 9-month-old girl may Know the names of items in a picture book Be afraid of strangers Have temper tantrums Stand on tiptoe Build a tower of four or more blocks 38 / 40 What is not a reason of oligohydramnios in a woman at gestational age of 35W2D with IUGR in pregnancy? Reduced placental perfusion Reduced fetal renal blood perfusion Reduced fetal urine Increased swallowing of the fetus due to asphyxia Severe preeclampsia may be a cause 39 / 40 What is the diagnosis and treatment of a non-tender mass near the urethral opening in a 4 year old girl? Prolapse of the urethra - topical estrogen Bartholin's gland abscess - gland excision Skene gland abscess - antibiotic and evacuation Muluscum - analgesics and steroids Condylomata acuminate - TCA acid 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 are 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 cannot be ruled out Your score is The average score is 63% LinkedIn Facebook Twitter 0%