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