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