GMDC MOCK 2 34 ALL THE BEST THANK YOU Quiz 1 / 40 What is not a reason of oligohydramnios in a woman at gestational age of 35W2D with IUGR in pregnancy? Severe preeclampsia may be a cause Increased swallowing of the fetus due to asphyxia Reduced fetal urine Reduced placental perfusion Reduced fetal renal blood perfusion 2 / 40 What is wrong about vaginal hematoma after delivery? Observation if hematoma is small Pressure dressing should be applied on the hematoma bed for 12-24 hours Mattress suturing the bed of hematoma Vulvar hematoma can occur after improper episiotomy repair An incision on the site if pain is severe and hematoma enlarges 3 / 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 can be ruled out by careful physical examination Ectopic pregnancy and intrauterine pregnancy cannot be ruled out Ectopic pregnancy risk is about 90% Ectopic pregnancy is ruled out 4 / 40 An innocent murmur is likely to be Persistent into early adulthood Associated with a thrill Non-radiating Loudest at the left sternal border Diastolic 5 / 40 Which of the following diseases is caused by a virus? Histoplasmosis Pneumocystis jirovecii pneumonia Lassa fever Amyloidosis Diphtheria 6 / 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 Fetal assessment techniques can predict abruption with good precision The chance of repeated abruption is not different 7 / 40 A 20-year-old primigravida, 32 weeks gestation, presents with profuse vaginal bleeding with pain and tenderness per abdomen. The most probable diagnosis: Abruptio placenta. Placenta praevia. Vaginitis. Uterine rupture. Marginal sinus bleed. 8 / 40 The risk of acute bilirubin encephalopathy in a newborn is increased with the use of Phenobarbitone Gentamycin Phenytoin Ampicillin Ceftriaxone 9 / 40 ECG changes associated with hypokalemia include Upright T wave Right axis deviation ST segment elevation Shortened PR interval Appearance of a U wave 10 / 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 Tranexamic acid to control bleeding Termination of pregnancy Blood transfusion is a must Observation 11 / 40 Contraindication to medical therapy (Methotrexate) in tubal pregnancy is No fetal heart motion on ultrasound. History of active hepatic and renal disease. Desire for future fertility. Absence of active bleeding. Size of the ectopic gestational sac is 3cm for less. 12 / 40 A child born in Ghana in 2016 will routinely receive the following vaccinations except Rubella Mumps Rotavirus Meningococcus Pneumococcus 13 / 40 The most likely finding in the initial stages of septic shock is Abnormally low blood pressure Hyperpnoea Absent femoral pulses Delayed capillary refill Tachypnoea 14 / 40 A low weight for height in a three-year-old child indicates Wasting Stunting Underweight Marasmus Kwashiorkor 15 / 40 Acetaminophen-induced toxicity most commonly affects the Kidneys Bone marrow Heart Liver Lungs 16 / 40 This is false about diabetic ketoacidosis serum bicarbonate level is more than 18mEq/l deep sighing respiration is present ketonemia and ketonuria are characteristic blood glucose is usually greater than 11.0 mmol/l blood ph is less than 7.3 17 / 40 The following are features of prematurity in a neonate except Thick ear cartilage Empty scrotum Flat areola No creases on sole Abundant lanugo 18 / 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 Laparotomy and salpingectomy and follow up Methotrexate and leukovorin Hysteroscopy Methotrexate and folic acid and iron supplement 19 / 40 A child with severe haemophilia A would have an abnormal All of the above None of the above Blood film morphology Platelet count Prothrombin time 20 / 40 The following are characteristics of simple febrile seizures Occur only once or twice in a twenty-four-hour period Last for thirty minutes or less Initially focal with secondary generalization Commonly caused by cerebral malaria Rate of epilepsy is higher than in the general population 21 / 40 In Preeclampsia all are correct EXCEPT: It is a significant cause of maternal mortality. Regular full blood count are helpful in monitoring the progress of the condition. Development of epigastric pain is a serious sign. The condition is more common in women who smoke cigarettes. Is more common with women with a first degree relative who has preeclampsia. 22 / 40 A 9-month-old girl may Be afraid of strangers Stand on tiptoe Build a tower of four or more blocks Know the names of items in a picture book Have temper tantrums 23 / 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 Tubal obstruction Anovulation Intrauterine synechiae Male factor 24 / 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 Urinalysis Liver function tests Fasting lipid profile 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? Diazepam Labetalol IV Phenytoin Phenobarbital MgSO4 26 / 40 Haemorrhagic cystitis is a recognized complication of Methotrexate Cisplatin Cyclophosphamide Adriamycin VIncristine 27 / 40 Non-steroidal anti-inflammatory drugs are not generally used for long term tocolysis because they: Are too expensive. Are ineffective May cause premature closure of fetal ductus arteriosus. Are associated with lactic acidosis. Produce marked hypertension. 28 / 40 Which of the following drugs IS NOT used to inhibit premature labour? Ritodrine Magnesium sulfate. Indomethacin. Phenobarbital. Nifedipine. 29 / 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. 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. The inferior vena cava contains both oxygenated and deoxygenated blood. 30 / 40 Which is not among pathophysiological changes of preeclampsia? Platelet dysfunction DIC Increased thromboxane A2 Increased resistance to angiotensin Reduction in prostacyclin 31 / 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 None of the above Fracture of the left femur Multiple myeloma Septic arthritis of the left hip joint 32 / 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 Hysterectomy Speculum examination Bimanual uterine massage 33 / 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 Leiomyomata uteri Endometritis Endometrial polyps Anovulatory bleeding 34 / 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 Muluscum - analgesics and steroids Prolapse of the urethra - topical estrogen Condylomata acuminate - TCA acid Skene gland abscess - antibiotic and evacuation 35 / 40 In determining the Apgar score of a newborn, the following would be assessed except Skin colour Response to stimulation Oxygen saturation Respiratory effort Muscle tone 36 / 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 Immediate intraosseous access for rehydration Intravenous Ringer's lactate 37 / 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 Administration of antibiotic If there is no hemorrhage in the first 24 hours after operation, the patient can be discharged Laparotomy 38 / 40 Low birth weight is defined as None of the above Below the average weight for the age and parity of the mother Below 2500g Below the 10th percentile for gestational age Below -2 z-score for gestational age 39 / 40 The following diseases are associated with the Epstein Barr virus except Hodgkin's lymphoma Wilm's tumour Nasopharyngeal carcinoma Post-transplant lymphoproliferative disease Burkitt's lymhpoma 40 / 40 Clinical features of childhood acute lymphoblastic leukaemia include Chloromas Proptosis Gum hyperplasia Dental anarchy Bone pain Your score isThe average score is 63% LinkedIn Facebook VKontakte 0%