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