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AMC November 2024 Recalls 

Australian Medical Council (AMC) MCQ Recalls NOVEMBER 2024 compilation 

80yo woman in nursing home admitted for uncomplicated Colles’ fracture. Upon admission, had incontinence and CBD inserted, urine sample taken. Result: E. coli in urine, nitrites & others negative. Pt denies dysuria. Next step?
a. allow discharge without any antibiotics
b. give oral antibiotics and discharge
c. stay admitted in hospital to commence IV antibiotics
d. repeat urine culture

32yo woman referred to specialist for permanent contraception. Has 3 kids, doesn’t want more. Currently using condoms. Husband doesn’t want sterilization but supports her decision. What to do?
a. bilateral salpingectomy
b. hysterectomy
c. Depo Provera
d. refuse any intervention
e. advise to come back at 35yo

Foreign body magnet scenario in 6yo. Toy magnet ingested, X-ray shows it in the small bowel area. Serial X-rays after 6 and 12 hours show battery hasn’t moved, magnets are close to each other, child is asymptomatic. Next step?
a. reassure and send home
b. surgical removal
c. continue serial X-rays

First-time mum brings 4-week-old baby with firm, non-tender neck lump on the right side below mandibular angle. No erythema, baby appears well. What’s the next step for diagnosis?
a. ultrasound of the neck
b. fine needle biopsy

62M with COPD presents with worsening cough, purulent sputum, fever, and increasing breathlessness. He is on 6 puffs of salbutamol q4hrs with no improvement. What antibiotic regimen for COPD exacerbation?
a. prednisolone 50mg daily for 5 days & amoxycillin 500mg 8hrly for 5 days
b. prednisolone 75mg daily with taper & amoxycillin 1g 12hrly for 5 days

52F with vomiting (no nausea/pain), history of chronic back pain, AF, iron deficiency, HTN, depression, and melanoma excised 10 years ago. What’s the most likely differential?
a. cerebral metastases
b. alcohol use
c. antidepressant adverse effect

29M with sub-fertility, sperm results: FSH 30, LH 35, T 4, prolactin normal. What’s the most likely cause of sub-fertility?
a. testicular failure
b. eating disorder
c. abnormal spermatogenesis

33F in QLD, fair skin, limited sun exposure, uses sunscreen daily. What UV index level requires sun protection?
a. UV Index ≥ 3
b. UV Index ≥ 1
c. UV Index ≥ 2

Colleague smoking marijuana between patient consults due to stress. What should you do?
a. report to AHPRA
b. talk to colleague before and see what his response is
c. report to clinical director
d. report to hospital head

You are a Medical Officer on duty, patient having surgery for fracture on the 2nd day. While attending him, he asks you to sign his will. What should you do?
a. refuse
b. be the witness
c. ask the senior
d. check mental capacity
e. ask him to let you know after discussing with admin

A man having joint arthritis for the last 1 year and receiving treatment. He lost his job due to health issues, isolated himself from club and social activities, wakes up in the morning, lost weight, decreased sleep, speaks less, and during consultation says he is searching for a job and it is tough to adjust. Diagnosis?
a. adjustment disorder (<3 months)
b. MDD (>6 months)
c. schizophrenia
d. anxiety disorder

AF ECG, stable patient asking for management.
a. metoprolol (rate control)
b. younger people – rhythm control → digoxin, unstable (shock)

Stab injury to the back of the chest, inability to move hand and fingers. Which nerve involved?
a. radial
b. median
c. posterior interosseous
d. common peroneal

40 weeks pregnant primi with vaginal bleeding after intercourse, BP 80/56, uterus tender hard. What is the initial management?
a. ultrasound
b. speculum examination
c. induction
d. IV fluid
e. blood transfusion

70M with metastatic prostate cancer, worsening pain despite paracetamol. What opioid to prescribe for pain management?
a. morphine
b. fentanyl
c. hydromorphone

30M factory worker with dry cough, wheeze, hayfever, and smoking. Symptoms improved on holiday, but returned. Advice?
a. best prognosis if avoids sensitizing agent
b. wear a mask at work to reduce exposure

6F collapses, unresponsive, abnormal breathing. What’s the recommended compression-to-ventilation ratio in Paediatric Advanced Life Support?
a. 15:2
b. 30:2
c. 30:3

Old lady after femur fracture surgery, upon discharge, urine R/M/E – RBC and E coli found more than normal range. She had a catheter during surgery. What antibiotic should be given during discharge?
a. ceftriaxone
b. cefalexin
c. trimethoprim (first-line, empirical therapy)
d. sulfonylurea

48-year-old F, mother had breast carcinoma at 60 years. She is having pain and greenish discharge from multiple ducts. Diagnosis?
a. carcinoma in situ
b. ductal cell carcinoma
c. duct ectasia
d. inflammatory breast disease

Husband and wife came to the clinic complaining that their neighbor is keeping an eye on them, they think the neighbor wants them to move out. Husband is unable to sleep at night, with obsession to check on neighbors through the window regularly. They even talk about the sex life of their neighbors with other society members. Diagnosis?
a. OCD
b. delusional disorder
c. paranoid personality
d. borderline personality
e. schizophrenia

8F with bluebottle sting, pain, linear raised marks on R hand, no swelling or breathing issues. First aid management?
a. Soak hand in hot water until pain resolves
b. Soak hand in vinegar for 20 mins

19M with left foot injury, swelling and tenderness over calcaneus, antalgic gait, able to weight bear. Correct statement?
a. Ottawa ankle rules recommend foot x-ray in all ankle pain patients
b. Ottawa ankle rules don’t apply to calcaneal injuries

43F with R foot pain, burning sensation, tingling in 3rd/4th toes. No trauma or pain at night. Next step in management?
a. Refer to podiatrist for wide shoes, firm sole, metatarsal pads
b. Initial treatment is surgical; refer to ortho foot surgeon

67F in rural clinic, gardening, saw brown snake nearby but no bite sensation. Scratches on hands. Management for possible snakebite?
a. Apply pressure immobilisation & transfer urgently to regional hospital
b. Check normal vitals & reassure, 4hrs since possible bite

8-year-old boy with face and periorbital swelling, BP increased, urine protein 4+. Most appropriate initial management?
a. Low protein
b. High protein
c. Protein and water limit
d. Prednisolone

Molluscum contagiosum long scenario and pic. Diagnosis?

VT ECG unstable patient asking for management?

Lacerated wound in back, tetanus vaccine completed 7 years back. Appropriate management?
a. IV ceftriaxone
b. Debridement
c. Immunoglobulin
d. Tetanus vaccine
e. Both vaccine and immunoglobulin

Female presented with prolonged menstrual period and heavy blood loss. Most appropriate treatment?
a. COCP
b. IUCD
c. Mefenamic acid
d. Tranexamic acid
e. Norethisterone

28F with smooth, fluid-filled lump on buccal mucosa, present for 4 weeks, no pain. Type 1 DM well controlled. Management plan?
a. Refer to oral/maxillofacial surgeon for further assessment
b. No further treatment; lesion is benign

10F with 3-day fever, painful sore throat, enlarged L tonsil, uvula displaced to R, muffled voice, pooling saliva. First-line treatment?
a. Urgent referral to ED for ENT review
b. Phenoxymethylpenicillin 250mg BID for 10 days

Tardive Dyskinesia patient on haloperidol.
a. Switch to quetiapine
b. Reduce haloperidol
c. Benztropine
d. Propranolol

44F with pain/swelling over radial styloid, aggravated by writing/grasping, positive Finkelstein’s test. Likely diagnosis?
a. De Quervain’s tenosynovitis
b. Carpal Tunnel syndrome
c. Trigger thumb

33F with fair skin, blue eyes, concerned about Vitamin D deficiency due to family history of osteoporosis. Risk factor for which condition?
a. Bowel cancer
b. Coeliac disease
c. Age-related cataracts

60F with 6-day rhinorrhea, blocked ears, non-productive cough, progressive R ear hearing loss. Exam normal except for tympanic membrane. Diagnosis?
a. Cholesteatoma
b. Acute Otitis Media
c. Tympanic Perforation

67F with tinnitus and L ear hearing loss for 2 weeks, no pain/vertigo, normal exam. Weber test lateralizes to R. Type of hearing loss?
a. Left-sided sensorineural hearing loss
b. Left-sided conductive hearing loss

23M new job at cattle farm, needs Q Fever vaccination. No prior vaccination, but up-to-date on childhood shots. Advice for Q Fever vax?
a. Pre-vaccination screening required (skin & blood tests)
b. No pre-screening needed; GP can administer Q Fever vax

RTA patient BP 80/50, GCS 12, SPO2 95%, breathless, all other vitals normal. What is the immediate next management?
a. Intubation
b. O2 (following ATLS order)
c. Negative blood
d. 1L Normal Saline

36F, obese, heavy drinker and smoker, BMI 32, CA breast. Asking contraception. Which should be considered prior to prescription?
a. Alcohol
b. Smoking
c. Obesity
d. CA breast

Traveler going climbing, high altitude syndrome. What to do?
a. Dexamethasone
b. Prednisolone
c. Acetazolamide
d. Advice not to go

Hemolytic anemia scenario asking for diagnosis.

16-year-old pale, unconjugated bilirubin, others vitals normal. Long scenario with lab. Asking diagnosis?
a. Hepatitis
b. Hemolytic jaundice
c. Gilbert syndrome

GP with forgetfulness, shares one patient history with another, going through family problem. What to do?
a. Console
b. Ask to take leave
c. Advise to take psychiatrist counseling
d. Inform APRHA
e. Inform medical board

7-day-old female, baby birth weight 2.2 kg delivered at 36 weeks, brought by mother to GP for routine checkup and asking the time of starting vaccination.
a. According to chronological age
b. As per standard
c. When the weight gain
d. When mother wishes

1 state. question about negative predictive value

breast and colon cancer screening questions.

3/4 jaundice related question.

Hyperthyroid in pg .ix

Thyroid nodule management

2-year-old boy with cough, irritability, not eating properly, wheeze, grunting, intercostal retractions, SpO2 normal. Which test will help to reach the diagnosis?
a. CXR
b. CBC
c. Blood culture
d. ABG
e. Spirometry

White-tail spider bite; after giving analgesics and antihistamines, pain persists and the patient’s condition is deteriorating. What is the next best management?
a. Transfer to ICU
b. Antivenom
c. Repeat analgesic
d. Antibiotic

Picture of basal cell carcinoma asking for management.
a. Excision
b. Punch biopsy
c. Cautery
d. Observe

Pancreatitis scenario: patient admitted, asking when to perform CT?
a. After 24 hours
b. When condition deteriorates (in severe cases, after 48-72 hours)
c. No need (in early stage)
d. When SpO2 falls

Woman with 4 children requests permanent contraception. Husband supports, but is not keen for vasectomy. What is the next step?
a. Bilateral Salphingo-oophorectomy
b. IUCD

NG tube placement: method to confirm?
a. Bubbling sound
b. CXR

Pregnant lady at 18 weeks, 52, with persistent nausea unrelieved by Metoclopramide. Sudden onset of RIF pain. Likely diagnosis?
a. Red degeneration
b. Acute appendicitis

10-month-old baby, low feeding, no cyanosis, bibasal creps, systolic murmur, splenomegaly. Diagnosis?
a. Congestive heart failure (CCF)

How to confirm orbital floor fracture?
a. Epistaxis
b. Facial muscle weakness
c. Cranial fluid leak from ear
d. Diplopia
e. Some discharge from eyes

Picture of firm immobile swelling on eyebrow (sebaceous cyst, dermoid). Likely diagnosis?
a. Osteoma of frontal bone (hard)

Patient presents with acute anxiety attack. Expected ABG findings?
a. Normal PO2 levels, reduced PCO2 levels, increased pH (hyperventilation)

Scenario with Wegener’s/Goodpasture’s syndrome.
a. Anemia (IDA, MCHC interpretation: MCH low, MCV low, microcytic, microchromic anemia)

Young lady, no known medical issues, presented with thin whitish vaginal discharge post Mirena insertion. No fever, not foul-smelling. Likely diagnosis?
a. Candidiasis
b. Foreign body cervicitis

Teacher, 34 weeks pregnant, felt fluid trickling down. No fever, stable vital signs, abdomen soft, FH 140 bpm. Which of the following will be an indicator to transfer her to a tertiary center?
a. Fetal fibronectin

Farmer fell backward from a horse, GCS 4, right pupil dilated, intubated. Neurosurgical center 1 hour away by air. What is the next management step?
a. IV Mannitol 20%
b. Send to neurosurgical doctor with a flying doctor
c. IV Dexamethasone

Young man with a midline swelling which moves with tongue protrusion. What is the next management?
a. simple excision
b. extended excision
c. ultrasound

Diagnosis: thyroglossal cyst

High impact MVA with ankle deformity, no chest injuries. On examination, sudden tachypnea with raised JVP. Next management?
a. ICT
b. needle thoracocentesis
c. ECHO (pericardiocentesis)

Diagnosis: cardiac tamponade

Post MI last week, presented with sudden collapse. Next investigation?
a. urgent ECHO (complication post MI → rupture)
b. CT coronary

Young guy, went to Thailand for 6 weeks. After 4 weeks, came back with fever/myalgia. Options:
a. malaria (1-3 weeks incubation period)
b. dengue
c. typhoid (GI symptoms)

57F with Type 2 DM, elevated fasting blood sugar. What lifestyle management goals based on SNAP guidelines?
a. Smoking: 0 cigs/day; Nutrition: healthy; Alcohol: ≤2 drinks/day; PA: 150min aerobic + 2-3 resistance/wk
b. Smoking: 0 cigs/day; Nutrition: healthy; Alcohol: ≤2 drinks/day (men), ≤1 drink/day (women); PA: 150min aerobic + 2-3 resistance/wk

Patient on multiple drugs (Thiazide, celecoxib, paracetamol, perindopril). GFR went down to 20 from 30 something. What drug combination is the cause?
a. celecoxib and thiazide
b. perindopril and thiazide
c. celecoxib and paracetamol

4yo boy with clear rhinorrhea, hit head on rock, briefly passed out but fine since. Tympanic membrane looks unusual. Concerned diagnosis?
a. fracture involving the floor of the cranial vault
b. meningitis
c. epidural hematoma

20F with sexual assault history, follow-up visits for support & investigations. Police request for statement. Best course of action?
a. provide written statement after obtaining consent
b. provide verbal statement to police station

80F with weight loss, anxiety, poor hygiene, bruise on L cheek, vague about incident. Most important differential?
a. elder abuse
b. new diagnosis of depression
c. new diagnosis of dementia

27F with easy bruising, epistaxis, menorrhagia, petechiae. Normal prothrombin & PTT. Likely diagnosis?
a. von Willebrand disease
b. acute immune thrombocytopenic purpura
c. aplastic anemia

Obese man with daytime somnolence. Likely diagnosis?
a. Obstructive sleep apnea
b. Narcolepsy
c. Idiopathic hypersomnia

Girl with headache and fever for 1 week. Mother has similar history of recurrent headache. Next investigation?
a. LP
b. MRI

URTI with greenish sputum. Most likely causative agent?
a. Klebsiella
b. S. pneumonia
c. Legionella

Patient with NKMI, FBS 5.8. Next step?
a. Repeat OGTT in 3 months

Young lady with sore throat and fever, given amoxicillin, presents a few days later with a diffuse rash, persistent fever, and sore throat. What investigation to confirm diagnosis?
a. Throat swab
b. Blood culture
c. Specific IgE for penicillin

Indication for LSCS (Lower Segment Cesarean Section)?
a. Placenta previa
b. Cephalopelvic disproportion
c. Malpresentation

Lady with breast cancer and lytic lesion on femur. Next management?
a. Surgery
b. External radiation
c. Chemotherapy

Lady with eye signs of upward gaze after IV Metoclopramide. Likely diagnosis and treatment?
a. Occulogyric crisis, treated with Benztropine
b. Neuroleptic malignant syndrome, treated with Naloxone

Gilbert syndrome, G6PD deficiency, or primary biliary cholangitis? (Separate questions with blood parameters)
a. Gilbert: Normal liver enzymes, unconjugated hyperbilirubinemia
b. G6PD: Low G6PD enzyme activity, hemolysis
c. Primary biliary cholangitis: Elevated ALP, AMA positive

Post-local anesthesia, patient develops tongue tingling. What to reverse it?
a. Midazolam
b. Intralipid

Lady in labor, BP drops after delivery, profuse vaginal bleeding. Likely diagnosis?
a. Amniotic fluid embolism
b. Pulmonary embolism
c. DIC (Disseminated Intravascular Coagulation)

9-year-old boy with asthma using reliever 2-3 times a week, night symptoms once every 6 weeks. Indicator of poor asthma control?
a. Daytime symptoms >2 days/week lasting for minutes to hours
b. Nighttime symptoms >once every 6 weeks

20M with burning, itchy lesion on 3rd right toe after hiking, similar lesion on fingers. Prevention advice?
a. Cease smoking
b. Apply topical corticosteroids to fingers and toes daily

72M with 4-month history of painful swallowing, gravelly voice, L ear pain, 20 pack-year smoking, excessive alcohol use. Likely diagnosis?
a. Carcinoma of the oropharynx
b. Reinke’s edema
c. Parkinson’s disease

74F with early mild dementia, daughter wants to suspend her license due to driving concerns. True statement about dementia and driving?
a. Dementia drivers at higher risk for accidents
b. Driving co-pilot reduces risk in dementia

31F with 3-year-old daughter, struggling with tantrums, food throwing, hitting, and challenging behaviors. Best management?
a. Praise the behavior more than the child
b. Children need clear explanations of wrong behavior

7-year-old boy with widespread bruising, leg/abdominal pain, purpura on buttocks and legs, blood/protein on urine dipstick. Likely diagnosis?
a. Henoch-Schonlein purpura
b. Leukaemia

55M with left jaw pain, sharp, shooting, worse with chewing & hot/cold drinks, no trauma or swelling. Likely diagnosis?
a. Trigeminal neuralgia
b. Cluster headache
c. Temporal arteritis

28F with major depressive disorder, on sertraline, wants counseling to wean off meds. Best psychological therapy for moderate depression?
a. Interpersonal psychotherapy
b. Cognitive remediation therapy

39F with history of migraines with aura, stopped combined pill, considering progesterone-only pill. Absolute contraindication for it?
a. Current breast cancer
b. Past history of ischaemic heart disease

24M with gender incongruence, starting feminizing hormones (oestradiol, spironolactone). Correct statement about feminizing hormones?
a. Fertility reduces soon after starting oestrogen
b. Over 6-12 months, oestradiol reduces muscle mass, testicular volume, and causes voice feminisation

32M with alcohol dependence, drinks half bottle whiskey/day, no withdrawal symptoms, GGT mildly elevated. Next step in management?
a. Refer for inpatient detox via local Drug & Alcohol service
b. Start naltrexone 50mg daily

68F with blurred vision, T2DM, HTN, inconsistent meds. Likely cause of vision deterioration?
a. Hypertensive retinopathy
b. Diabetic retinopathy
c. Age-related macular degeneration

34M with chest pain, SOB, fever, diagnosed with pericarditis on ECG. What to expect on ECG?
a. PR depression and diffuse ST elevation, then T wave changes
b. Loss of P wave and tall T waves

12-month-old boy, well, up-to-date on vaccines. Recommended vaccine combo?
a. MMR, Pneumococcal, Meningococcal ACWY
b. MMRV, Hib, Meningococcal ACWY

4-year-old Aboriginal girl, up-to-date immunizations, next preventative health check based on Australian guidelines?
a. Check visual acuity, hearing, oral health, growth, behavior, developmental milestones, & child maltreatment risk
b. Check hemoglobin, visual acuity, hearing, & child maltreatment risk

76F with COPD, breathless, productive cough, needs prednisolone for illnesses. Expected FEV1 on spirometry?
a. 50%
b. 30%
c. 65%

Lady with breast lump at areola with itchiness/redness. Likely diagnosis?
a. Preductal mastitis
b. Duct ectasia

Boy post-white spider bite, vitally stable, erythema at bite site. Next step?
a. Cephalexin
b. Polyvenom
c. Swab
d. Antihistamines

Patient after dialysis developed hyponatremia, drowsy, wheezing. What next investigation?
a. CXR
b. CT
c. ABG
d. FBE

Foster parents bring 6-year-old girl demonstrating sexual acts towards a boy. What should we do first?
a. Notify child wellbeing service
b. Psych assessment
c. Drug screen

Woman after hip surgery developed confusion, fall, agitation, and shouting at nurses. Next step?
a. CT
b. Frontal lobe testing
c. CXR
d. Drug and alcohol assessment

CXR for man with SOB, normal exam. Diagnosis?
a. Cancer (no opacity)
b. Pulmonary embolism
c. Pneumonia (no consolidation, no perihilar change; likely PE)

Traveler in Colorado developed mountain sickness, now wants to travel to Peru. Next step?
a. Acetazolamide
b. Advise

Bat bite (clear wound, person was previously immunized)
a. Reassure
b. Vaccinate (this is the correct)
c. Ig

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