Liver CT scan picture with irregular big mass inside the liver… Half of liver is occupied. Dx…
a. Intrahepatic Ca
b. Secondary metastasis
c. Hydatid cyst
Liver CT – inside the liver I could see like hemorrhages. Its big area
a. Intrahepatic hemorrhage
b. Spleen hemorrhage
c. Spleen laceration
Child fallen and started vomiting and is drowsy after fall. Small swelling over scalp in right side. Child is okay after few hours. Ask what to do next. Vitals are okay
a. Send home
b. CT scan
c. MRI
So many questions on carotid artery stenosis
75 y/o female, presents with left arm weakness. Carotid artery studies show some degree of stenosis. 50% asked what to do next for diagnosis of the condition
a. MRI
b. CT
c. ECG
d. Echo
Acute upper gastric pain over one hour. Settled after vomiting. No abnormalities on clinical examination. How to diagnose?
a. Upper GI endoscopy… gastric ulcer
b. S/Lipase
c. USS Abdomen
d. CT Abdomen
Unlock AMC Solved Recalls & Qbank!
10 year old, history of retrosternal chest pain. Relieved with antacids. What to do next?
a. Endoscopy
b. USS Abdomen
c. CT Abdomen
May be GERD… initial 24-hour pH monitoring… any red flag points then endoscopy. GERD… trial PPI > endoscopy
Nephrotic Xn scenario: Teenage boy, BP mildly high. Protein ++, RBC ++. What’s the BEST finding to come to a diagnosis?
a. Low S/Albumin
b. C3 levels
c. Blood culture
d. Urine analysis & Urine culture
Acute post streptococcal glomerular nephritis (APSGN)—common in kids
Man traveled to Jakarta 5 days ago, now presents with fever, myalgia, rash and eye soreness. No splenomegaly. No fever
a. Malaria
b. Dengue
c. Flavivirus
d. Japanese encephalitis
25-year-old woman with menorrhagia, irregular cycle between 3 – 6 months. She got promoted and needs to travel a lot and this becomes trouble for her. She didn’t want to get any contraception.
a. Merina… best contraceptive
b. COC pill
c. Tranexamic acid because she did not want
In aged care, caregiver notices blood-stained panties of an old lady. On examination, nearly 3 or 5 cm laceration at vagina. Dx
a. Ca endometrium
b. Lichen sclerosis
c. Assault
d. Candidiasis
3 or 5-year-old boy presents with diarrhea and later he’s scratching his anus. On examination, there’s fissure and mucous discharge from anus. What’s the cause?
a. E. coli
b. Giardiasis
c. Candida
d. Entero worm—Enterobius vermicularis
A new drug is found to have a 25% reduction of prostate cancer. Incidence of prostate cancer in the population is 8/100. How many people do we need to treat to reduce the prostate cancer in 1 person?
a. 10
b. 50
c. 100
d. 200
A 57-year-old new patient, on sertraline 50mg, aspirin 100mg, history of MDD, SVT (ablated), family history of diabetes in parents. Why taking aspirin?
a. Low-dose aspirin has been shown to reduce the risk of colon cancer in those aged 50 – 74 years
b. Low-dose aspirin has been proven to reduce episode severity in depression, related to the neuro-inflammation hypothesis
A 35-year-old with C677T MTHFR gene variant. Ordered by naturopath. No symptoms, 2 healthy children. Appropriate step?
a. Refer her to a clinical genetics unit to discuss cascade testing for other family members
b. Reassure her that MTHFR gene variants are common and do not increase the risk of particular health problems
Elderly woman living by herself, her siblings live close to her and help her in her daily life. She suffered a fracture and was admitted. Before discharging her, you need to be sure that?
a. Prepare meals by herself
b. Take medication by herself
c. Able to walk with or without assistance
24-year-old lady, SOB, wheeze, worse with exercise, used boyfriend’s inhaler, bilateral expiratory wheeze, raised FEV1 post-bronchodilator. What’s correct?
a. She should be commenced on a PRN short-acting beta-agonist, a regular low-dose inhaled corticosteroid, and a short course of oral prednisolone
b. A family history of asthma is not considered a risk factor for the development of asthma
35-year-old lady, progressive lower back pain, worse in mornings, HLA-B27 positive. Consistent feature with ankylosing spondylitis?
a. Back pain which improves with rest
b. Morning stiffness which lasts for more than 45 minutes
14-year-old boy, tackled in rugby, no head hit, mild pressure headache, no LOC, no vomiting, normal neuro exam. Wants to return to sport for final in 4 days. Advice?
a. Advise him that as long as his headache resolves by the time of the grand final, he will be able to play in the match
b. Advise him that he will not be able to return to full play prior to the grand final
Old lady on dialysis for 5 years. Comes to see you with her son. He states that she is tired of dialysis and would like to stop. She understands that without the treatment she is going to die. What to do?
a. Ask for psychiatric evaluation
b. Family court
c. Speak with her alone
d. Palliative care
Unlock AMC Solved Recalls & Qbank!
4-year-old boy, fall from local reserve, head injury, ‘passed out,’ tonic-clonic seizure for 20 seconds still ongoing. Next management step?
a. Phone his parents to gain consent prior to commencing any active treatment
b. Immediate active treatment, administration of oxygen, gaining IV access, check sugar, administer midazolam (IV, IM, or buccal)
c. Referral to tertiary
21-year-old lady, G1P1, 6 weeks post-partum, glucose intolerance in pregnancy, breastfeeding. Advice on diabetes and breastfeeding.
a. She should check her blood glucose levels, by fingerprick, prior to each breastfeed to ensure she is not at risk of an acute hypoglycaemic episode
b. Breastfeeding post-partum has been shown to reduce diabetes risk post-gestational diabetes
Young adult male with multiple male partners always uses condoms, came for routine review. Most appropriate test?
a. HIV
b. Hepatitis C
c. HPV
d. Chlamydia
37-year-old lady, left periorbital swelling, mosquito bite, pain, fatigue, muscle aches, swollen left eye (given photo), conjunctival injection, reduced upwards gaze, diplopia. Known complication?
a. Maxillary sinusitis
b. Venous sinus thrombosis
c. Dental pulpitis
16-year-old male, sudden intense right testicular pain, vomiting, nausea, no trauma, sexually active. Right teste elevated, absent cremasteric reflex, pain persists. Testicular torsion??? Correct statement?
a. Regardless of time to presentation, this condition needs to be referred for urgent surgery
b. This patient should undergo immediate manual detorsion
59-year-old lady increasing vulval itch, post-menopausal, on oral terbinafine, erythema, no vaginitis/discharge, no satellite lesions, diagnosis?
a. Psoriasis
b. Lichen sclerosis
c. Lichen planus
66-year-old male, rapid 1cm dome-shaped nodule with central keratin plug on L forearm. Likely keratoacanthoma. Management?
a. There is no need for any treatment
b. Excisional biopsy of the whole lesion
32-year-old male, itchy, tender glans penis, multiple erythematous scaly lesions, not circumcised, poorly controlled type 1 diabetes. Next management step?
a. Refer him to a surgeon for consideration of a circumcision
b. Commence hydrocortisone + clotrimazole 1% cream topically twice daily until 2 weeks after the skin is clear
42-year-old lady, strong family history of heart disease, smoker, BMI 38kg/m2, coronary artery calcium score 150 AU, no fasting bloods yet. Recommended treatment?
a. Recommend statin therapy for primary prevention of myocardial infarction
b. Recommend both aspirin and statin therapy for primary prevention of myocardial infarction
32-year-old man brought to emergency room after report by people in the shop area, singing loud songs, changing tunes and lyrics. Says he’s the best singer, unkempt, foul odour, makes eye contact and animated.
a. Acute mania
b. Schizophrenia
c. Methamphetamine abuse
d. Schizoid effect
72-year-old man, 6-month lesion, previously had basal cell carcinoma on the face. 6mm pink papule, well-circumscribed, arborizing vessels, central ulceration. Suspected basal cell carcinoma. Most appropriate removal method?
a. Elliptical excision measuring 16 x 48 mm
b. Elliptical excision measuring 12 x 36 mm
78-year-old lady, difficulty reading in dim light, central vision problems. PMH: Ischaemic heart disease, hypertension, type 2 diabetes, osteoarthritis. Most likely diagnosis?
a. Age-related macular degeneration
b. Chronic glaucoma
78-year-old man collapses, unresponsive, abnormal breathing. What’s the chest compressions-to-breaths ratio in Basic Life Support?
a. 30 compressions : 2 breaths
b. 15 compressions : 1 breath
c. 30 compressions : 1 breath
21-month-old boy, worried about development. What developmental expectations at this age?
a. Speak six or more words
b. Able to put on his clothing
c. Jump on the spot
6-year-old with headache, drowsy. What exam finding suggests raised intracranial pressure?
a. Widened pulse pressure
b. Tachycardia
c. Hypotension
49-year-old man, smokes 20/day, wants to quit. Seizure history, taking carbamazepine and sodium valproate. Effective smoking cessation medication?
a. Nicotine 21mg/24-hour patch daily with nicotine lozenge 2mg as needed
b. Nortriptyline 10mg orally daily
Aboriginal mother with 4-month-old child. Wants to immunize the child quickly, but avoids eye contact. What’s the most appropriate action?
a. Motivate to bring someone next visit
b. Observe in next visit
c. Report to CPS
68-year-old man, asymptomatic, wants osteoporosis testing for Medicare rebate. What conditions qualify for DXA rebate?
a. Multiple falls, low body weight, parental history of fracture
b. Coeliac disease, hyperthyroidism, hypogonadism
64-year-old lady, acute epigastric pain, vomiting, fever, tachycardia. Elevated WBC, GGT, AST, ALT, LDH. Lipase normal. Next investigation?
a. Abdominal X-ray
b. Upper abdominal ultrasound
42-year-old lady with non-specific pelvic pain, CA125 48U/mL. Possible cause?
a. Corpus luteum cyst
b. Uterine prolapse
c. Uterine fibroids
Research paper mentions 95% confidence intervals for a new oral hypoglycaemic agent. Describe confidence intervals?
a. The 95% CI means that there is 95% certainty of the efficacy of a treatment
b. A 95% CI means that it is 95% certain that the true value lies in the given range
17-year-old boy, headache following helmet-to-helmet sports injury 5 days ago. No LOC, but tender temporal region. What’s the next step?
a. CT brain
b. MRI brain
c. Skull X-ray
d. No investigation required
27-year-old woman with Crohn’s disease on azathioprine and sulfasalazine. Blood test shows:
-
- HB: Normal
-
- WBC: Reduced
-
- Platelets: Reduced
What’s the next step?
- Platelets: Reduced
a. Stop sulfasalazine
b. Stop azathioprine
c. Check creatinine
Patient with renal symptoms, high BP, red cell casts. What’s the cause?
a. Interstitial nephritis (drug-induced)
b. Glomerulonephritis (red cell casts)
c. IgA nephropathy
Man in prison swallows razor blades. On exam, abdominal tenderness. Abdominal X-ray given. Treatment?
a. Admit for observation
b. Colonoscopy
c. Endoscopy (blade above pyloric sphincter)
d. Laparoscopy (if gas under diaphragm)
Counselling for Down syndrome baby. What complications should be mentioned?
a. Leukaemia
b. Medulloblastoma
c. Retinoblastoma
d. Wilms tumour
Prisoner with foreign body ingestion says he will die soon. X-ray shows white cross marks. What’s the disorder?
a. Bipolar disorder
b. Factitious disorder
18-year-old Aboriginal girl with chronic otitis media, not immunized since 18 months due to parental belief. After oral antibiotics, what’s next?
a. Start all immunizations
b. Give HPV vaccine
c. Give pneumococcal/HiB vaccine
d. Start immunization as per age
6-month-old baby with diarrhoea, bottle-fed, and has recurrent loose stools. Advice?
a. Hypoallergenic milk
b. Lactose-free milk
c. Pure water
d. Stop bottle feeding
3-year-old boy sweating and pale during falls, no tonic-clonic activity, no drowsiness afterward. What investigation?
a. EEG
b. CT brain
c. Echocardiogram (cardiac cause)
d. Electrolytes
e. Blood sugar
Case about Biliary Colic (No fever / Jaundice) with intermittent pain in RUQ, severe pain with respiration suggestive of cholecystitis: 53-year-old woman complains of 10 kg weight loss and lymph node swelling in the upper left clavicle. What’s the diagnosis?
a. Ca lung
b. Ca stomach (more common)
c. Ca colon (less common)
Failure chest management: In AN care, a woman asks for epidural anaesthesia for pain management during labour. What investigation is needed?
a. Coagulation profile
b. Platelet count
13-year-old girl presents with menorrhagia. She started her period 3 months ago. What’s the most likely diagnosis?
a. V-W disease
b. Haemophilia
c. ITP
A cousin living with the patient has regular transfusions. What disease should be considered first?
a. Haemophilia
b. Thalassaemia
c. ITP
35-year-old woman presents with loss of consciousness for 3 times, lasting several seconds, and resolves. She stays in bed the whole day. What investigation will you consider first?
a. CT brain
b. MRI brain
c. Echocardiogram
d. Electrolytes
Patient presents with features of closed-angle glaucoma. What investigation will you do? (Fundoscopy done, no gonioscopy given in the answer)
a. Tonometry
Herpes keratitis and asks for treatment. acyclovir
Neonatal jaundice present 24 hours after birth, but no abnormalities in the mother’s antenatal care visits. What’s the cause?
a. ABO incompatibility
b. Rh incompatibility
c. Congenital
20-year-old boy presents with features of pneumonia, using a vape. CXR shows bilateral infiltration. What’s the diagnosis?
a. Vape-induced lung injury
b. Asthma
c. Mycoplasma pneumonia
d. Eosinophilic pneumonitis
26-year-old lady breastfeeding, 4-week-old baby. Left breast pain, red, hard, tender. Temp 38.2°C. Correct management?
a. First line treatment for this condition is oral clindamycin
b. The patient will require review within 24–48 hours
Athlete with ankle twisting, unable to change direction. What is important to diagnose?
a. Edema in hindfoot
b. Tenderness in lateral ligaments
c. Loss of reflex
d. Bony tenderness in fibula
65-year-old male, CKD stable at 50mL/min/1.73m². Now eGFR 34mL/min/1.73m². When is referral to a nephrologist indicated?
a. eGFR <50mL/min/1.73m²
b. A sustained drop in eGFR of 25% or more within 12 months
28-year-old male, 2 months of abdominal pain, diarrhea with blood, mucus, reduced appetite, fatigue, no travel, family history of Crohn’s and UC, smoking history. Correct statement?
a. Smoking is a risk factor for UC but is not associated with more severe disease
b. Smoking is a risk factor for Crohn’s disease and is associated with more severe disease
57 lady, 3 days heavy vaginal bleeding, resolved, spotting yesterday, postmenopausal, normal cervical screening 6 mo ago, 5mm endometrium. Important investigation?
a. Diagnostic laparoscopy
b. Endometrial biopsy
c. Pelvic CT scan
Long stem, cardiac patient. Elderly taking amlodipine. Diabetic presence with LVF, shortness of breath, crepts. Labs- mild raised sodium, potassium 5.8, chloride mild low, rest is normal. What to give?
A. IV furosemide.
B. spironolactone.
C. steroids.
D. salbutamol.
Unlock AMC Solved Recalls & Qbank!
49 male, new symptoms past 6 mo, consider androgen deficiency. What symptom constellation?
a. Reduced libido, breast discomfort, reduced shaving
b. Reduced libido, voice changes, hot flushes
6yo boy, 6 mo constipation, faecal soiling, withholding. Bristol type 1-2 stools, no blood. Born term, normal development. Exam & investigation?
a. Abdominal x-ray
b. Examination of the spine and sacrum
c. Barium enema
88 lady, low-level aged care, unconscious. Recently started insulin, BS 2.2mmol/L. Immediate treatment?
a. Glucagon 1mg IM stat
b. Oral glucose/sucrose
c. 20mls of 50% Dextrose IV bolus
34 lady, pre-conception check, well-controlled HTN on perindopril. Advice on perindopril during conception?
a. Advise her it is safe to continue on perindopril throughout her pregnancy and she should continue taking it
b. Advise her to cease her perindopril now and commence her on either labetalol or methyldopa
19 lady unprotected sex 2 days ago, regular 29-day cycle, day 10. No regular contraceptives. BMI 32, BP 110/70 mmHg. Counseling on oral emergency contraception. True statement about oral EC?
a. Levonorgestrel is more effective in preventing pregnancy compared with ulipristal acetate
b. After using ulipristal acetate, women should not be started on a hormonal contraceptive method for at least five days and should be advised to use barrier methods or abstain from sex until effective hormonal contraception has been achieved
Patient brought by husband; she saw her kid rolled over by a car few weeks ago. She feels guilty, thinks police will arrest her. Hears voices saying her it’s her fault.
A. schizophrenia
B. PTSD
C. brief psychosis
D. major depression
Aboriginal female child 12-year-old had not taken any immunisation after one year. What is best now?
A. ask to come at 13.
B. begin immunisation from starting again.
C. catch up with immunizations now.
10mo baby, widespread fine red rash on limbs. 4 days of high fevers up to 40°C, managed with paracetamol and ibuprofen. No family illness. Likely diagnosis?
a. Roseola infantum
b. Kawasaki Disease
c. Rubella
43 lady, tooth extraction 2 days ago, increasing pain, no facial swelling, allergic to penicillin. Pus in socket. Initial management?
a. Advise regular analgesia with paracetamol 1g orally 6 hourly; prescribe clindamycin 300mg 8 hourly 5 days; advise her to call the dentist first thing Monday morning to arrange further treatment.
b. Advise regular analgesia with paracetamol 1g orally 6 hourly; refer for a CT scan to check for collections that may need surgical drainage; review her with CT results first thing Monday morning.
2mo baby girl, breech birth, equivocal Ortolani and Barlow tests. Next step in management?
a. Advise that she requires a bilateral hip magnetic resonance imaging (MRI) scan
b. Advise that she needs a referral for a bilateral hip ultrasound
62 lady, postmenopausal, wrist fracture, T score 1.0. Next stage in management?
a. Consider specialist endocrinology referral
b. Commence oral alendronate 70mg weekly
Pregnant female with ankle pain question was there similar with compression bandage and advised elevation. What else? With different options:
A. rest
B. topical diclofenac
C. Ice pack
19 lady, pain post-intercourse, pain urination, unwell. Cervical redness, inflammation, ulceration. Vulvar ulcerations. Initial investigation for suspected diagnosis?
a. Swab for herpes simplex virus NAAT
b. Herpes simplex serology
60 male, painful perianal lump x2 days, no rectal bleeding, normal bowel habit. Tender skin-colored lump at 3 o’clock. No rectal lumps or blood. Advice on condition?
a. Advise him to increase his fluid and fibre intake, avoid straining when using his bowels and consider the use of stool softeners if required.
b. Refer him to a colorectal surgeon for rubber-band ligation of the lump.
A man aged 32 years, presented to his GP with a one month history of increasing bilateral breast swelling. He was distressed by the appearance and said there was some pain on breast palpation. He denied any other symptoms and was usually healthy. What will you do next?
-
- reassure
-
- ultrasound of both breasts
-
- ultrasound of the testes
-
- measure serum prolactin
84-year-old lady in aged care, severe vit D deficiency effect on Ca & PTH levels?
a. Calcium decreased, PTH decreased
b. Calcium decreased, PTH increased
19 male, 2 wks lethargy, mild fever, sore throat, cervical LAD, tender liver. Likely dx?
a. Influenza
b. Infectious mononucleosis
CT scan abdomen given, showed a hematoma in liver.
Asked:
Intrahepatic hematoma
Intercapsular hematoma
Pancreatic hematoma
GB Stone
Q…5 different ECGs were given.
(AF, Flutter, VT, VF, CHB)
Patient having chest tightness, recurrent syncope and sweating, vitals were given. Asked which ECG describes the scenario best.Q. Breast cancer question…Patient 42, aunt diagnosed with Ca Breast at 54, recently. How to proceed:
a. Annual mammogram
b. USG only annually
c. Monthly self-breast exam
d. Mammogram bi-annually
e. Both bi-annually
Right answer is mammogram every 2 yearly after age 50.
Q. Mother brings 19-year-old with self-cut hx and says she is not inspired in life, no goal and is promiscuous and easily influenced. What in Hx helps in diagnosis?
a. Childhood sex abuse
b. Drug Abuse
c. Suicidal intent
d. Hx of Suicide attempt
e. Family Hx of mental disorder
Person was bitten for a spider with red back (red back spider) in the arm which was swelling, sweaty and a target sign. Indications for antidote:
a. Target sign in the arm
b. Sweaty arm
c. Positive test for venom
Pain arm is first indication
Girl 7 years complain of red rash over rectum, painful defecation, blood sometimes in stool:
a. Enterobium vermicularis
b. Streptococcus pyogenes
Child 8 years high fever apical opacity cough ask for treatment:
a. Benzylpenicillins
35 years breast pic nipple inverted, some secretion came out through nipple squeeze, ask the diagnosis:
a. Paget’s disease
b.Ductal carcinoma… Inverted nipple with discharge
c. Ductal ectasia
39 weeks BP decrease on examination, FHS 146 head engaged 2/5. What to do in cephalic presentation?
a. Send home
b. Admit and observe
Loss of pincer grasp, difficulty to hold pen, loss of sensory of 4th and 5th finger. Asked the reason:
a. C5/C6 damage
b. Elbow nerve trap
c. Carpal tunnel syndrome
Picture of eye. Dx:
a. CRVO
b. Retinal detachment
c. Hypertensive retinopathy
Same eye picture.. asked for management:
a. Oral Valacyclovir
b. Topical dexamethasone
c. Topical Acetazolamide
17 years old pregnant woman comes to AN care first time. What screening test you want to do?
a. Urine chlamydia test
b. CMV serology
c. HPV screening
JAK 2 mutation patient treatment?
a. Splenectomy
b. Rituximab
c. Plateletpheresis
d. JAK2 inhibitor, e.g., ruxolitinib
Orbital cellulitis ask for investigation:
a. CT head
A girl came to your GP asking for insulin for her boyfriend as he’s busy.
a. Call the patient to confirm the condition
b. Make an appointment with the patient
c. Give her insulin for one week
d. Explain to her why you can’t do that
A woman came to GP for hitting her lip and got haematoma. She put ice on it. On examination, you see some bruises on her cheek also. She didn’t give eye contact with you. How will you investigate this?
a. Take picture
b. Counsel with her husband
c. Admit her
d. Counsel her about domestic abuse
A 37 years old ( I’m not sure age but middle age not more than 40 ) has 2 children…. done with clip sterilisation HPV 16/80 detect and colposcopy show dysplasia at cervix and extension upward dun see clearly. Treatment?
a. colposcopy
b. excision of transitional zone
c. excision of cervix
d. biopsy
e. hysterectomy
