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