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