GMDC MOCK 2 34 ALL THE BEST THANK YOU Quiz 1 / 40 A 20-year-old primigravida, 32 weeks gestation, presents with profuse vaginal bleeding with pain and tenderness per abdomen. The most probable diagnosis: Vaginitis. Uterine rupture. Abruptio placenta. Marginal sinus bleed. Placenta praevia. 2 / 40 Low birth weight is defined as None of the above Below 2500g Below the average weight for the age and parity of the mother Below the 10th percentile for gestational age Below -2 z-score for gestational age 3 / 40 What is wrong about vaginal hematoma after delivery? Pressure dressing should be applied on the hematoma bed for 12-24 hours Observation if hematoma is small Vulvar hematoma can occur after improper episiotomy repair Mattress suturing the bed of hematoma An incision on the site if pain is severe and hematoma enlarges 4 / 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 Immediate intraosseous access for rehydration Intravenous Dextrose saline Intravenous Ringer's lactate 5 / 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 Oxytocin infusion Ergot Bimanual uterine massage Speculum examination 6 / 40 Acetaminophen-induced toxicity most commonly affects the Lungs Liver Bone marrow Kidneys Heart 7 / 40 Contraindication to medical therapy (Methotrexate) in tubal pregnancy is Desire for future fertility. Size of the ectopic gestational sac is 3cm for less. No fetal heart motion on ultrasound. Absence of active bleeding. History of active hepatic and renal disease. 8 / 40 Which is true about placental abruption? Fetal assessment techniques can predict abruption with good precision The chance of repeated abruption is not different There is no means to predict abruption Abruption occurs after placental delivery The chance of repeated abruption is twice 9 / 40 Which of the following drugs IS NOT used to inhibit premature labour? Indomethacin. Magnesium sulfate. Ritodrine Nifedipine. Phenobarbital. 10 / 40 In Preeclampsia all are correct EXCEPT: Development of epigastric pain is a serious sign. It is a significant cause of maternal mortality. The condition is more common in women who smoke cigarettes. Regular full blood count are helpful in monitoring the progress of the condition. Is more common with women with a first degree relative who has preeclampsia. 11 / 40 Which of the following diseases is caused by a virus? Pneumocystis jirovecii pneumonia Lassa fever Diphtheria Amyloidosis Histoplasmosis 12 / 40 In determining the Apgar score of a newborn, the following would be assessed except Muscle tone Response to stimulation Respiratory effort Skin colour Oxygen saturation 13 / 40 A 9-month-old girl may Know the names of items in a picture book Be afraid of strangers Have temper tantrums Stand on tiptoe Build a tower of four or more blocks 14 / 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 Curettage should be completed and patient should remain under observation Laparotomy Curettage should be continued by a specialist only Administration of antibiotic 15 / 40 A child with severe haemophilia A would have an abnormal None of the above Blood film morphology Prothrombin time Platelet count All of the above 16 / 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 17 / 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 Condylomata acuminate - TCA acid Muluscum - analgesics and steroids Bartholin's gland abscess - gland excision Skene gland abscess - antibiotic and evacuation 18 / 40 ECG changes associated with hypokalemia include Appearance of a U wave Shortened PR interval ST segment elevation Right axis deviation Upright T wave 19 / 40 Clinical features of childhood acute lymphoblastic leukaemia include Chloromas Dental anarchy Proptosis Gum hyperplasia Bone pain 20 / 40 The following are characteristics of simple febrile seizures Initially focal with secondary generalization Commonly caused by cerebral malaria Last for thirty minutes or less Rate of epilepsy is higher than in the general population Occur only once or twice in a twenty-four-hour period 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? Phenytoin Diazepam Phenobarbital MgSO4 Labetalol IV 22 / 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 folic acid and iron supplement Methotrexate and leukovorin Hysteroscopy Evacuation of the uterus by a specialist 23 / 40 An innocent murmur is likely to be Associated with a thrill Loudest at the left sternal border Non-radiating Persistent into early adulthood Diastolic 24 / 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 25 / 40 The risk of acute bilirubin encephalopathy in a newborn is increased with the use of Phenytoin Ampicillin Phenobarbitone Ceftriaxone Gentamycin 26 / 40 In the fetal circulation, the INCORRECT statement is: 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. 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. 27 / 40 The following diseases are associated with the Epstein Barr virus except Wilm's tumour Hodgkin's lymphoma Burkitt's lymhpoma Nasopharyngeal carcinoma Post-transplant lymphoproliferative disease 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? Blood transfusion is a must Termination of pregnancy Observation Tranexamic acid to control bleeding Discharge home 29 / 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 can be ruled out by careful physical examination Ectopic pregnancy risk is about 90% Ectopic pregnancy and intrauterine pregnancy are ruled out Ectopic pregnancy and intrauterine pregnancy cannot be ruled out Ectopic pregnancy is ruled out 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? Pregnancy Endometritis Anovulatory bleeding Endometrial polyps Leiomyomata uteri 31 / 40 A low weight for height in a three-year-old child indicates Stunting Marasmus Underweight Kwashiorkor Wasting 32 / 40 Haemorrhagic cystitis is a recognized complication of Methotrexate Cisplatin VIncristine Adriamycin Cyclophosphamide 33 / 40 In the diagnosis of minimal change nephrotic syndrome, the following tests would be useful except Urinalysis Doppler ultrasound of the lower limbs Fasting lipid profile Liver function tests Serum complement levels 34 / 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 Tuberculosis of the bone None of the above Septic arthritis of the left hip joint 35 / 40 The following are features of prematurity in a neonate except Thick ear cartilage Empty scrotum No creases on sole Flat areola Abundant lanugo 36 / 40 The most likely finding in the initial stages of septic shock is Delayed capillary refill Absent femoral pulses Tachypnoea Hyperpnoea Abnormally low blood pressure 37 / 40 Which is not among pathophysiological changes of preeclampsia? Increased resistance to angiotensin Reduction in prostacyclin Platelet dysfunction Increased thromboxane A2 DIC 38 / 40 Non-steroidal anti-inflammatory drugs are not generally used for long term tocolysis because they: Are too expensive. Are associated with lactic acidosis. Produce marked hypertension. Are ineffective May cause premature closure of fetal ductus arteriosus. 39 / 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 Tubal obstruction Intrauterine synechiae Male factor 40 / 40 A child born in Ghana in 2016 will routinely receive the following vaccinations except Rubella Rotavirus Mumps Meningococcus Pneumococcus Your score is The average score is 63% LinkedIn Facebook Twitter 0%