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