Australian Medical Council (AMC) MCQ Recalls AUGUST 2024 compilation
35-year-old female with severe nausea, abdominal pain, and vomiting after coming back from Thailand, while her husband and son, who ate the same food, are symptom-free. Menstrual history shows a late period with prolonged bleeding. Physical exam shows generalized tenderness. What is the most accurate test to make the diagnosis?
a. HCG
b. Lipase
c. Upper USG
d. STI screening
Concern about Alzheimer’s for new antidepressants drug study?
a. Cohort
b. Case control
c. Randomized
Death certificate: primary cause of death (neck of femur fracture, pulmonary embolism).
22-year-old lady, new mom, anxious, teary, struggling with a 6-week-old baby, experiencing mood swings, losing interest, and irritability, with no previous history of mood problems. Diagnosis?
a. Post-natal depression
b. Adjustment disorder
c. Bipolar Affective Disorder
62-year-old male, painter, frequent urination, poor sleep, urinary incontinence, smokes, smooth prostate, normal neuro exam. Next tests?
a. Bladder diary, eGFR, fasting blood glucose, PSA, bladder scan, renal tract imaging
b. Fasting blood glucose, PSA, bladder scan, cystoscopy, eGFR, bladder diary
42-year-old male melanoma patient on immunomodulatory treatment now presenting with watery diarrhea and fatigue. What to do?
a. Gancyclovir
b. Hydrocortisone
c. Azithromycin
d. Infliximab
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77-year-old male, routine BP check, full-time carer for wife with Alzheimer’s. Receives home help. Correct statement?
a. Comprehensive training can delay functional decline in dementia
b. No evidence that training impacts dementia outcomes
Menopausal lady with itching and redness of vulva for 3 months, no other symptoms. Next step?
a. Punch biopsy
b. Skin scraping
c. Estrogen levels
32-year-old male, 1-week cough, worse in 24 hours, vomiting after coughing, no fever, clear chest, recent contact with cousin. Management steps?
a. Nasopharyngeal aspirate for pertussis PCR
b. Pertussis serology
45-year-old male, STI screen, returned 2 weeks ago from a trip, multiple partners, inconsistent condom use, asymptomatic. Testing frequency?
a. 3 monthly
b. Yearly
c. Twice per year
Case of left leg both bone fractures with laceration, pale, swollen but pulses are intact. Patient is given analgesics. What to do next?
a. Wound debridement
b. Fracture reduction
c. Fasciotomy
d. Antibiotics
28-year-old lady, new patient, 6 weeks 5 days pregnant, irregular periods, no pregnancy supplement. Advice on folic acid 5mg?
a. If type 1 diabetes
b. If PCOS
c. If BMI 27 kg/m²
26-year-old woman presents for her first antenatal visit at 10th week of her pregnancy. Her mother has type II diabetes mellitus. Recommended screening test for gestational diabetes mellitus (GDM)?
a. 2-hour 75 g OGTT between 24 and 28 weeks.
b. 2-hour 75 g OGTT now.
c. Fasting blood glucose (FBS) now.
d. Fasting blood glucose (FBS) between 24-28 weeks.
e. 3-hour 100 g OGTT between 24-28 weeks.
17-year-old female, heavy periods, easy bruising, epistaxis, on oral contraceptives. Suspect Von Willebrand Disease. Correct statement?
a. Von Willebrand Disease is the most common inherited bleeding disorder.
b. Von Willebrand Disease causes Factor V deficiency.
A woman presents with tiredness and fatigue. Her TSH is normal, T4 is decreased, and T3 is normal. Repeated tests after 1 month showed the same findings. What will you do next to establish the diagnosis?
a. MRI brain.
b. Thyroid scan.
c. Anti-TPO antibodies.
d. Thyroglobulin antibodies.
e. X-ray head and neck.
22-year-old male, rolled left ankle, pain, swelling, tenderness. Unable to weight-bear initially, now hobbling. Next step?
a. Ankle x-ray and same-day review.
b. Ankle strapping and review in 2-3 days.
58-year-old lady, gradual right hip pain, worsens at night, radiates down thigh, point tenderness over greater trochanter. Diagnosis?
a. Trochanteric bursitis.
b. Osteoarthritis of the hip.
c. Meralgia Paraesthetica.
Atorvastatin 40 mg started 6 months ago in an alcoholic (1-2 standard drinks per day). Liver enzymes raised (GGT, AST, ALT 2 times normal), all other are normal, underlying DM and HTN, taking thiazide, no symptoms. Appropriate next step?
a. USG abdomen.
b. Stop statin.
c. Advise to stop alcohol.
d. Review previous blood tests.
Patient with DM, undergone CABG 5 years ago, on aspirin, presents with right-sided TIA features. Carotid duplex reveals bilateral carotid artery stenosis of 60%. What’s the next appropriate management?
a. Carotid angiogram
b. Add warfarin
c. Add clopidogrel
d. Carotid endarterectomy
26-year-old lady, pregnancy test positive, 6 weeks of amenorrhea, presents with small amount of vaginal bleeding. Vitals normal. BP 100/70, PR 88, SpO2 100%. On examination: mild suprapubic tenderness, speculum exam shows long cervix with fornix mass, os open, mild PV bleeding. What is the best diagnosis?
a. Cornual ectopic pregnancy
b. Fibroid complicating red degeneration of pregnancy
c. Cervical pregnancy
d. Ruptured ovarian cyst
2-year-old boy, hoarse voice, barking cough worse at night, no stridor at rest, slight wheeze. Management?
a. Oral prednisolone 1mg/kg now and next evening
b. Oral prednisolone 2mg/kg for one night
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78-year-old man, HIV+ since the late 1980s, on various antiretrovirals. Age-related comorbidities?
a. Increased risk of osteoporosis, MI, neurocognitive decline
b. Increased risk of osteoporosis, MI, bowel cancer
2-year-old girl, skin lesions on legs, pearly papules with umbilication. Not itchy or bleeding. Advice for condition?
a. Condition spread by shared baths/towels
b. Papules resolve in a few weeks
3-week-old baby, fever, rhinorrhea, feeding less. Temp 38.8°C, no rash. Next step?
a. Immediate ED referral for septic workup and antibiotics
b. Reassurance of likely viral infection and safety netting
64-year-old with pain in right axillary region. On examination: painful vesicular rash for 5 days. Management?
a. Acyclovir
b. Prednisolone
c. Carbamazepine (Trigeminal Neuralgia)
d. Acyclovir + prednisone
e. Sumatriptan injection
Wife bitten by monkey in Thailand, no rabies prophylaxis, last tetanus 12 months ago. Advice?
a. Immediate wound management, rabies vaccine, and rabies immunoglobulin
b. Immediate wound management and rabies vaccine
patient with clcd, awaiting inguinal herniorrhaphy. post-op assessment shows plt 90 and inr 1.8. what’s the most appropriate method to reduce bleeding during surgery?
a. plt transfusion
b. ffp
c. tranexamic acid
65-year-old male planning for hemicolectomy for diverticulitis. asking about dvt prophylaxis.
a. enoxaparin until discharge
b. enoxaparin for 14 days
c. enoxaparin for 28 days
30-year-old lady, 34 weeks gestation, itching on hands/feet, elevated alp, no rash or xerosis. next step?
a. recheck liver function and bile salts in 1 week
b. prescribe ursodeoxycholic acid
12-year-old boy, painful, red, tender foreskin, discharge. likely diagnosis?
a. balanitis
b. smegma collection
c. dermatitis
patient with dm, alcohol history, dietary management of dm, develops diarrhea and acute sob. cbs 6.5, abg shows ph 7.12, hco3 15, pao2 100, paco2 48. diagnosis?
a. hyperchloremic metabolic acidosis
b. lactic acidosis
c. hypercarbia
d. diabetic ketoacidosis
e. alcoholic acidosis
36-year-old lady, 1 month headache, nausea, ringing ears, blurred vision, bilateral disc swelling. diagnosis?
a. idiopathic intracranial hypertension
b. cerebral tumor
c. cervical spondylosis
52-year-old male with bronchiectasis, increased cough/sputum, low-grade fever, and allergy to penicillin. best treatment?
a. doxycycline 100mg bid for 10-14 days
b. amoxicillin 500mg tid for 10-14 days
36-year-old lady, 3 days of painful, watery right eye, worse with movement, slight vision blur. cause?
a. scleritis
b. bacterial keratitis
c. corneal foreign body
57-year-old female with copd, concerned about flight. supplemental oxygen threshold for resting spo2?
a. spo2 < 88%
b. spo2 < 98%
c. spo2 < 96%
58-year-old lady, post-menopausal, on denosumab for osteoporosis. dexa confirms t-score -2.8 hip, -2.7 spine. denosumab statement?
a. denosumab for osteoporosis in high-risk postmenopausal women
b. denosumab given iv once a year
58-year-old lady with antero-lateral thigh pain with tingling, burning, worse walking, better sitting. reduced sensation on exam. likely diagnosis?
a. meralgia paresthetica
b. multiple sclerosis
71-year-old male wants qus instead of dxa for osteoporosis, concerned about radiation. evidence-based advice?
a. qus of heel not useful for osteoporosis diagnosis
b. no evidence for qus in osteoporosis management
29-year-old female, 2 weeks of vaginal spotting, left-sided pelvic pain, iud in situ. mild lower abdominal tenderness, closed os. important diagnosis?
a. ectopic pregnancy
b. appendicitis
c. implantation bleed
50M, 6 months dry cough, SOB on exertion, fine bibasal crepitations, finger clubbing. Likely diagnosis?
a. interstitial lung disease
b. acute asthma
c. acute pulmonary oedema
Patient with lumbar stenosis being assessed for surgery, has MDD and HTN, taking duloxetine, tramadol, perindopril, and amitriptyline. What to do before surgery?
a. no action needed
b. cease duloxetine
c. reduce duloxetine to once a day
d. decrease duloxetine gradually
e. stop TCA
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42M, Hep A outbreak, positive Hep A IgM, elevated AST/ALT, never vaccinated. Should wife get Hep A vaccine?
a. if wife is a carer of a developmental disability
b. if wife is a residential aged care worker
67M, 6 weeks hoarseness, no cough or dysphagia, past URI, gravelly voice, unremarkable exam otherwise. Best advice?
a. urgent ENT referral
b. cease perindopril, start amlodipine 5mg daily
Patient with complaint of macroscopic hematuria, diagnosed with c-ANCA vasculitis a few months ago due to recurrent hematuria, started on prednisolone and cyclophosphamide. Urinalysis showed ++ RBCs, negative for UTI. What would be the next appropriate management?
a. cease cyclophosphamide
b. cystoscopy
c. CT IVP
d. USG
34F, hair loss 3 months postpartum, general thinning, no scalp inflammation, nail changes. Likely cause?
a. telogen effluvium
b. alopecia areata
c. hypothyroidism
5M, foreskin not retracting fully, no urination issues, smegma, normal foreskin exam. Management advice?
a. no intervention needed for child
b. foreskin should retract by age 5; refer to urologist
27M, snake bite, stable vitals, nausea, abdominal pain. When to consider anti-venom?
a. spontaneous epistaxis and gingival bleeding
b. vomiting; other signs/tests normal
65F wants DXA scan for osteoporosis after friend’s diagnosis. What risk factors qualify for a Medicare rebate for DXA?
a. anti-androgen therapy
b. history of multiple falls
c. hypothyroidism
Middle-aged woman with diabetic history, presented with tingling sensation in lower limbs and LMN signs in both upper and lower limbs, lower limbs more affected, no sensory loss. Likely diagnosis?
a. pernicious anemia
b. myasthenia gravis
c. acute inflammatory polyneuropathy
d. diabetic neuropathy
55M, on ramipril, amlodipine, statin, aspirin, omeprazole, has daily leg swelling but no SOB or calf tenderness. Next step?
a. cease his rosuvastatin
b. cease his amlodipine
48F, 2 days dizziness, rotational nystagmus, worse with head turns, no hearing change. Likely diagnosis?
a. benign paroxysmal positional vertigo
b. acoustic neuroma
Middle-aged man with prostate cancer with spinal metastasis, started on ADT, presented for BMD assessment, T-score -1.0, normal calcium and vitamin D levels. What will be your next additional management?
a. start calcium and vitamin D supplements
b. start alendronate
c. no additional therapy
d. BMD assessment 6 monthly
32F, daily frontal headaches worsening, no nausea, light/sound sensitivity, resolves by evening. Likely diagnosis?
a. tension-type headache
b. acute bacterial sinusitis
28M, itchy rash on extensor surfaces, weight loss, recurrent diarrhea. Suspected dermatitis herpetiformis. Confirmatory tests?
a. skin biopsy for histopathology and direct immunofluorescence
b. IgA levels
c. thyroid function tests
83F, red, swollen, tender knee, no injury, normal joint movement. Most likely diagnosis?
a. acute gout
b. osteoarthritis
c. rheumatoid arthritis
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58F, distressed about sister’s breast cancer, normal mammogram 12 months ago, wants to reduce her risk. Advice?
a. reduce her alcohol consumption
b. adopt a low-fat diet
Patient with tachycardia, tachypnea, hypotension, distended neck veins, and crackles throughout lungs following MVA. Which feature will limit your success in resuscitation?
a. tachycardia
b. tachypnea
c. hypotension
d. raised neck veins
e. crackles in lungs
74F, finger pain, hip/knee pain relieved by rest, diagnosed with osteoarthritis. True statement about OA?
a. crepitus and reduced range of motion in joints
b. commonly affects metacarpophalangeal joints
65M/F couple, cruise ship holiday, recent norovirus outbreak. Best advice for them?
a. high-risk foods for norovirus: sandwiches, salads, ice, oysters
b. no risk of norovirus for new cruise passengers as the ship is decontaminated
32F, 6 months fatigue, nausea, loss of appetite, low BP, elevated potassium, low sodium. Likely diagnosis?
a. Addison’s disease
b. pheochromocytoma
c. Conn’s syndrome
A patient working as a manager with delays in work, studies postponed, difficulties organizing tasks, poor concentration, all started after an event (can’t remember) 3 months ago. What would support the diagnosis?
a. increased forgetfulness
b. anxious and fidgeting appearance
c. impaired memory and concentration
d. difficulty in organizing tasks and postponed activities
A child diagnosed with impetigo; cephalosporin prescribed. Which recommendation regarding school exclusion is most appropriate to prevent spread of infection?
a. exclude the child from school until the completion of the antibiotic course
b. allow the child to attend school but advise frequent handwashing and avoidance of close contact
c. exclude the child from school until the lesions are completely healed
d. no need for school exclusion; impetigo is not highly contagious
