GMDC MOCK 2 34 ALL THE BEST THANK YOU Quiz 1 / 40 A child with severe haemophilia A would have an abnormal None of the above Prothrombin time Platelet count Blood film morphology All of the above 2 / 40 Which is not among pathophysiological changes of preeclampsia? Increased resistance to angiotensin Increased thromboxane A2 DIC Platelet dysfunction Reduction in prostacyclin 3 / 40 A low weight for height in a three-year-old child indicates Wasting Marasmus Kwashiorkor Stunting Underweight 4 / 40 This is false about diabetic ketoacidosis ketonemia and ketonuria are characteristic blood glucose is usually greater than 11.0 mmol/l blood ph is less than 7.3 deep sighing respiration is present serum bicarbonate level is more than 18mEq/l 5 / 40 Contraindication to medical therapy (Methotrexate) in tubal pregnancy is Absence of active bleeding. Desire for future fertility. History of active hepatic and renal disease. No fetal heart motion on ultrasound. Size of the ectopic gestational sac is 3cm for less. 6 / 40 What is wrong about vaginal hematoma after delivery? Mattress suturing the bed of hematoma Vulvar hematoma can occur after improper episiotomy repair Pressure dressing should be applied on the hematoma bed for 12-24 hours Observation if hematoma is small An incision on the site if pain is severe and hematoma enlarges 7 / 40 In determining the Apgar score of a newborn, the following would be assessed except Response to stimulation Muscle tone Respiratory effort Oxygen saturation Skin colour 8 / 40 A 9-month-old girl may Know the names of items in a picture book Be afraid of strangers Stand on tiptoe Have temper tantrums Build a tower of four or more blocks 9 / 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 Blood transfusion is a must Discharge home Tranexamic acid to control bleeding Termination of pregnancy 10 / 40 In the fetal circulation, the INCORRECT statement is: 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. The ductus venous connects the umbilical vein with inferior vena cava. 11 / 40 ECG changes associated with hypokalemia include Shortened PR interval Appearance of a U wave Right axis deviation ST segment elevation Upright T wave 12 / 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 Evacuation of the uterus by a specialist Laparotomy and salpingectomy and follow up Methotrexate and folic acid and iron supplement Methotrexate and leukovorin 13 / 40 Acetaminophen-induced toxicity most commonly affects the Bone marrow Liver Kidneys Lungs Heart 14 / 40 In Preeclampsia all are correct EXCEPT: Development of epigastric pain is a serious sign. Regular full blood count are helpful in monitoring the progress of the condition. The condition is more common in women who smoke cigarettes. It is a significant cause of maternal mortality. Is more common with women with a first degree relative who has preeclampsia. 15 / 40 Haemorrhagic cystitis is a recognized complication of Cyclophosphamide VIncristine Methotrexate Adriamycin Cisplatin 16 / 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 Ergot Oxytocin infusion Speculum examination Bimanual uterine massage 17 / 40 Which of the following diseases is caused by a virus? Diphtheria Pneumocystis jirovecii pneumonia Amyloidosis Histoplasmosis Lassa fever 18 / 40 Which of the following drugs IS NOT used to inhibit premature labour? Phenobarbital. Magnesium sulfate. Indomethacin. Nifedipine. Ritodrine 19 / 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 Curettage should be continued by a specialist only Administration of antibiotic If there is no hemorrhage in the first 24 hours after operation, the patient can be discharged 20 / 40 An innocent murmur is likely to be Loudest at the left sternal border Associated with a thrill Persistent into early adulthood Diastolic Non-radiating 21 / 40 Non-steroidal anti-inflammatory drugs are not generally used for long term tocolysis because they: Are ineffective Produce marked hypertension. Are associated with lactic acidosis. Are too expensive. May cause premature closure of fetal ductus arteriosus. 22 / 40 Which is true about placental abruption? Abruption occurs after placental delivery There is no means to predict abruption Fetal assessment techniques can predict abruption with good precision The chance of repeated abruption is twice The chance of repeated abruption is not different 23 / 40 The following are features of prematurity in a neonate except Abundant lanugo Flat areola Empty scrotum No creases on sole Thick ear cartilage 24 / 40 The following are characteristics of simple febrile seizures Rate of epilepsy is higher than in the general population Last for thirty minutes or less Initially focal with secondary generalization Commonly caused by cerebral malaria Occur only once or twice in a twenty-four-hour period 25 / 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 Phenobarbital MgSO4 Diazepam 26 / 40 What is not a reason of oligohydramnios in a woman at gestational age of 35W2D with IUGR in pregnancy? Increased swallowing of the fetus due to asphyxia Reduced fetal renal blood perfusion Reduced fetal urine Severe preeclampsia may be a cause Reduced placental perfusion 27 / 40 Clinical features of childhood acute lymphoblastic leukaemia include Gum hyperplasia Chloromas Dental anarchy Proptosis Bone pain 28 / 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 Fracture of the left femur None of the above Multiple myeloma Tuberculosis of the bone 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 is ruled out Ectopic pregnancy and intrauterine pregnancy cannot be ruled out Ectopic pregnancy risk is about 90% Ectopic pregnancy and intrauterine pregnancy are ruled out 30 / 40 The risk of acute bilirubin encephalopathy in a newborn is increased with the use of Ampicillin Phenytoin Ceftriaxone Phenobarbitone Gentamycin 31 / 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 Endometritis Endometrial polyps Anovulatory bleeding Pregnancy 32 / 40 The following diseases are associated with the Epstein Barr virus except Hodgkin's lymphoma Burkitt's lymhpoma Nasopharyngeal carcinoma Wilm's tumour Post-transplant lymphoproliferative disease 33 / 40 A child born in Ghana in 2016 will routinely receive the following vaccinations except Mumps Rotavirus Rubella Pneumococcus Meningococcus 34 / 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 Tubal obstruction Endometriosis 35 / 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 Oral rehydration solution if the child can drink Intravenous Ringer's lactate Stat dose of broad spectrum intravenous antibiotics Intravenous Dextrose saline 36 / 40 The most likely finding in the initial stages of septic shock is Hyperpnoea Tachypnoea Abnormally low blood pressure Absent femoral pulses Delayed capillary refill 37 / 40 Low birth weight is defined as Below -2 z-score for gestational age None of the above Below the 10th percentile for gestational age Below 2500g Below the average weight for the age and parity of the mother 38 / 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 Condylomata acuminate - TCA acid Skene gland abscess - antibiotic and evacuation Prolapse of the urethra - topical estrogen Bartholin's gland abscess - gland excision 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: Uterine rupture. Placenta praevia. Marginal sinus bleed. Vaginitis. Abruptio placenta. 40 / 40 In the diagnosis of minimal change nephrotic syndrome, the following tests would be useful except Serum complement levels Liver function tests Urinalysis Fasting lipid profile Doppler ultrasound of the lower limbs Your score is The average score is 63% LinkedIn Facebook Twitter 0%