GMDC MOCK 2 34 ALL THE BEST THANK YOU Quiz 1 / 40 Acetaminophen-induced toxicity most commonly affects the Heart Bone marrow Lungs Kidneys Liver 2 / 40 Which of the following drugs IS NOT used to inhibit premature labour? Ritodrine Phenobarbital. Indomethacin. Magnesium sulfate. Nifedipine. 3 / 40 A child born in Ghana in 2016 will routinely receive the following vaccinations except Meningococcus Pneumococcus Rubella Mumps Rotavirus 4 / 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 Endometrial polyps Endometritis Anovulatory bleeding Leiomyomata uteri 5 / 40 Which is true about placental abruption? Abruption occurs after placental delivery Fetal assessment techniques can predict abruption with good precision The chance of repeated abruption is twice There is no means to predict abruption The chance of repeated abruption is not different 6 / 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. Vaginitis. Marginal sinus bleed. Uterine rupture. Abruptio placenta. 7 / 40 The risk of acute bilirubin encephalopathy in a newborn is increased with the use of Ceftriaxone Phenobarbitone Ampicillin Gentamycin Phenytoin 8 / 40 What is wrong about vaginal hematoma after delivery? An incision on the site if pain is severe and hematoma enlarges Observation if hematoma is small Mattress suturing the bed of hematoma Pressure dressing should be applied on the hematoma bed for 12-24 hours Vulvar hematoma can occur after improper episiotomy repair 9 / 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 Bartholin's gland abscess - gland excision Prolapse of the urethra - topical estrogen Condylomata acuminate - TCA acid Skene gland abscess - antibiotic and evacuation 10 / 40 In determining the Apgar score of a newborn, the following would be assessed except Respiratory effort Skin colour Muscle tone Oxygen saturation Response to stimulation 11 / 40 The following diseases are associated with the Epstein Barr virus except Wilm's tumour Burkitt's lymhpoma Nasopharyngeal carcinoma Hodgkin's lymphoma Post-transplant lymphoproliferative disease 12 / 40 Which of the following diseases is caused by a virus? Amyloidosis Diphtheria Pneumocystis jirovecii pneumonia Lassa fever Histoplasmosis 13 / 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 14 / 40 This is false about diabetic ketoacidosis 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 serum bicarbonate level is more than 18mEq/l 15 / 40 The most likely finding in the initial stages of septic shock is Hyperpnoea Tachypnoea Delayed capillary refill Abnormally low blood pressure Absent femoral pulses 16 / 40 An innocent murmur is likely to be Associated with a thrill Non-radiating Loudest at the left sternal border Diastolic Persistent into early adulthood 17 / 40 The following are features of prematurity in a neonate except Flat areola Abundant lanugo Thick ear cartilage No creases on sole Empty scrotum 18 / 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 placental perfusion Severe preeclampsia may be a cause Reduced fetal urine Reduced fetal renal blood perfusion 19 / 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 Fracture of the left femur None of the above Septic arthritis of the left hip joint Multiple myeloma 20 / 40 A low weight for height in a three-year-old child indicates Underweight Marasmus Wasting Stunting Kwashiorkor 21 / 40 Non-steroidal anti-inflammatory drugs are not generally used for long term tocolysis because they: Produce marked hypertension. Are too expensive. Are ineffective Are associated with lactic acidosis. May cause premature closure of fetal ductus arteriosus. 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? Tubal obstruction Anovulation Male factor Intrauterine synechiae Endometriosis 23 / 40 Low birth weight is defined as Below the 10th percentile for gestational age Below the average weight for the age and parity of the mother None of the above Below 2500g Below -2 z-score for gestational age 24 / 40 Contraindication to medical therapy (Methotrexate) in tubal pregnancy is History of active hepatic and renal disease. Absence of active bleeding. Size of the ectopic gestational sac is 3cm for less. No fetal heart motion on ultrasound. Desire for future fertility. 25 / 40 Clinical features of childhood acute lymphoblastic leukaemia include Chloromas Proptosis Bone pain Dental anarchy Gum hyperplasia 26 / 40 A child with severe haemophilia A would have an abnormal All of the above None of the above Prothrombin time Blood film morphology Platelet count 27 / 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 MgSO4 Labetalol IV Phenobarbital 28 / 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 continued by a specialist only Curettage should be completed and patient should remain under observation 29 / 40 In the fetal circulation, the INCORRECT statement is: Prostaglandins maintain patency of ductus arteriosus. The blood is shifted from the right atrium to the left atrium via the foramen ovale. The ductus venous connects the umbilical vein with inferior vena cava. There are two umbilical veins and one umbilical artery. The inferior vena cava contains both oxygenated and deoxygenated blood. 30 / 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 Hysteroscopy Methotrexate and leukovorin Methotrexate and folic acid and iron supplement 31 / 40 Haemorrhagic cystitis is a recognized complication of Cisplatin VIncristine Cyclophosphamide Adriamycin Methotrexate 32 / 40 ECG changes associated with hypokalemia include Appearance of a U wave Upright T wave Shortened PR interval Right axis deviation ST segment elevation 33 / 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 Blood transfusion is a must Observation Tranexamic acid to control bleeding 34 / 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 Speculum examination Ergot Bimanual uterine massage Oxytocin infusion 35 / 40 Which is not among pathophysiological changes of preeclampsia? DIC Increased thromboxane A2 Increased resistance to angiotensin Platelet dysfunction Reduction in prostacyclin 36 / 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 Fasting lipid profile Liver function tests 37 / 40 A 9-month-old girl may Build a tower of four or more blocks Know the names of items in a picture book Have temper tantrums Stand on tiptoe Be afraid of strangers 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 Intravenous Ringer's lactate Immediate intraosseous access for rehydration Stat dose of broad spectrum intravenous antibiotics Intravenous Dextrose saline Oral rehydration solution if the child can drink 39 / 40 In Preeclampsia all are correct EXCEPT: It is a significant cause of maternal mortality. Is more common with women with a first degree relative who has preeclampsia. 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. 40 / 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 pregnancy risk is about 90% Ectopic pregnancy and intrauterine pregnancy cannot be ruled out Ectopic can be ruled out by careful physical examination Ectopic pregnancy is ruled out Your score is The average score is 63% LinkedIn Facebook Twitter 0%