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