GMDC MOCK 2 34 ALL THE BEST THANK YOU Quiz 1 / 40 Which is not among pathophysiological changes of preeclampsia? Platelet dysfunction Increased resistance to angiotensin Increased thromboxane A2 Reduction in prostacyclin DIC 2 / 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? Phenobarbital Phenytoin Labetalol IV Diazepam MgSO4 3 / 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. 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. 4 / 40 What is wrong about vaginal hematoma after delivery? Observation if hematoma is small An incision on the site if pain is severe and hematoma enlarges Mattress suturing the bed of hematoma Pressure dressing should be applied on the hematoma bed for 12-24 hours Vulvar hematoma can occur after improper episiotomy repair 5 / 40 A child with severe haemophilia A would have an abnormal Platelet count All of the above Blood film morphology Prothrombin time None of the above 6 / 40 In determining the Apgar score of a newborn, the following would be assessed except Muscle tone Respiratory effort Skin colour Oxygen saturation Response to stimulation 7 / 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 Endometriosis Tubal obstruction Anovulation Male factor 8 / 40 A 9-month-old girl may Be afraid of strangers Have temper tantrums Know the names of items in a picture book Build a tower of four or more blocks Stand on tiptoe 9 / 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 pregnancy risk is about 90% Ectopic can be ruled out by careful physical examination Ectopic pregnancy and intrauterine pregnancy are ruled out 10 / 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. Placenta praevia. Marginal sinus bleed. Vaginitis. Uterine rupture. 11 / 40 A child born in Ghana in 2016 will routinely receive the following vaccinations except Meningococcus Rotavirus Mumps Pneumococcus Rubella 12 / 40 Clinical features of childhood acute lymphoblastic leukaemia include Chloromas Dental anarchy Proptosis Gum hyperplasia Bone pain 13 / 40 The following diseases are associated with the Epstein Barr virus except Wilm's tumour Nasopharyngeal carcinoma Hodgkin's lymphoma Post-transplant lymphoproliferative disease Burkitt's lymhpoma 14 / 40 In Preeclampsia all are correct EXCEPT: It is a significant cause of maternal mortality. Regular full blood count are helpful in monitoring the progress of the condition. 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. 15 / 40 In the diagnosis of minimal change nephrotic syndrome, the following tests would be useful except Serum complement levels Urinalysis Doppler ultrasound of the lower limbs Liver function tests Fasting lipid profile 16 / 40 This is false about diabetic ketoacidosis serum bicarbonate level is more than 18mEq/l ketonemia and ketonuria are characteristic deep sighing respiration is present blood glucose is usually greater than 11.0 mmol/l blood ph is less than 7.3 17 / 40 Haemorrhagic cystitis is a recognized complication of Adriamycin VIncristine Methotrexate Cisplatin Cyclophosphamide 18 / 40 Which is true about placental abruption? The chance of repeated abruption is twice Abruption occurs after placental delivery There is no means to predict abruption The chance of repeated abruption is not different Fetal assessment techniques can predict abruption with good precision 19 / 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? Leiomyomata uteri Pregnancy Endometritis Endometrial polyps Anovulatory bleeding 20 / 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 21 / 40 A low weight for height in a three-year-old child indicates Stunting Underweight Kwashiorkor Wasting Marasmus 22 / 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? Observation Tranexamic acid to control bleeding Termination of pregnancy Blood transfusion is a must Discharge home 23 / 40 ECG changes associated with hypokalemia include Appearance of a U wave ST segment elevation Shortened PR interval Right axis deviation Upright T wave 24 / 40 The most likely finding in the initial stages of septic shock is Hyperpnoea Absent femoral pulses Abnormally low blood pressure Delayed capillary refill Tachypnoea 25 / 40 The risk of acute bilirubin encephalopathy in a newborn is increased with the use of Gentamycin Ceftriaxone Phenobarbitone Phenytoin Ampicillin 26 / 40 Which of the following diseases is caused by a virus? Pneumocystis jirovecii pneumonia Diphtheria Amyloidosis Histoplasmosis Lassa fever 27 / 40 The following are features of prematurity in a neonate except No creases on sole Flat areola Thick ear cartilage Empty scrotum Abundant lanugo 28 / 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 29 / 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 Multiple myeloma Septic arthritis of the left hip joint None of the above 30 / 40 Non-steroidal anti-inflammatory drugs are not generally used for long term tocolysis because they: May cause premature closure of fetal ductus arteriosus. Are too expensive. Produce marked hypertension. Are ineffective Are associated with lactic acidosis. 31 / 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 Laparotomy Curettage should be completed and patient should remain under observation 32 / 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 Oral rehydration solution if the child can drink Immediate intraosseous access for rehydration Intravenous Dextrose saline Stat dose of broad spectrum intravenous antibiotics 33 / 40 Low birth weight is defined as Below 2500g None of the above Below the average weight for the age and parity of the mother Below the 10th percentile for gestational age Below -2 z-score for gestational age 34 / 40 Acetaminophen-induced toxicity most commonly affects the Kidneys Heart Lungs Bone marrow Liver 35 / 40 What is not a reason of oligohydramnios in a woman at gestational age of 35W2D with IUGR in pregnancy? Reduced placental perfusion Increased swallowing of the fetus due to asphyxia Reduced fetal urine Reduced fetal renal blood perfusion Severe preeclampsia may be a cause 36 / 40 Which of the following drugs IS NOT used to inhibit premature labour? Ritodrine Nifedipine. Indomethacin. Magnesium sulfate. Phenobarbital. 37 / 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 Condylomata acuminate - TCA acid Skene gland abscess - antibiotic and evacuation Muluscum - analgesics and steroids Bartholin's gland abscess - gland excision 38 / 40 Contraindication to medical therapy (Methotrexate) in tubal pregnancy is No fetal heart motion on ultrasound. Absence of active bleeding. History of active hepatic and renal disease. Size of the ectopic gestational sac is 3cm for less. Desire for future fertility. 39 / 40 An innocent murmur is likely to be Loudest at the left sternal border Associated with a thrill Persistent into early adulthood Non-radiating Diastolic 40 / 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 Evacuation of the uterus by a specialist Hysteroscopy Laparotomy and salpingectomy and follow up Methotrexate and folic acid and iron supplement Your score is The average score is 63% LinkedIn Facebook Twitter 0%