Australian Medical Council (AMC) MCQ Recalls OCTOBER 2024 compilation
64F, painful left foot, intermittent attacks over 6 months, warm and swollen. Distal pulses palpable, loss of sensation, erythema on mid-foot. Cause?
a. Charcot’s arthropathy
b. Acute episode of gout
c. Osteomyelitis
A pregnant woman has spontaneous rupture of membranes. The CTG results show fetal HR 140-160/min with 2 deep late decelerations. On exam, OS is 5 cm, fully effaced, fetal head just engaged. What is the most appropriate next step?
a. Tocolysis
b. Fetal scalp sampling
c. LSCS
d. Continue CTG monitoring
e. Instrumental delivery
A patient diagnosed with abdominal wall cellulitis, treated with IV flucloxacillin. Later, the patient presents with persisting fever and confusion. What is the next step?
a. Change to clindamycin
b. Add vancomycin
c. Surgical debridement
d. Ticarcillin/Clav
e. IV Augmentin
10-year-old girl, recent immigrant, increasing drowsiness, abdominal pain, vomiting, increased thirst/urination. Urine dipstick ++++ glucose and ++++ ketones. Key life-threatening complication?
a. Cerebral oedema
b. Hyperphosphataemia
c. Acute renal failure
A 32-year-old woman informs the GP that she lives in constant fear because of her husband’s aggression but doesn’t want you to call the police. On exam, she has several bruises all over her body. What to do next?
a. Inform police anyway
b. Advise her to inform police
c. Offer her the phone number of a safe shelter
d. Offer counselling about domestic violence
e. Take pictures of the bruises
30-year-old woman, 5w6d pregnant, vaginal bleeding since this morning, no pain, vitals normal. Beta hCG 1700 IU initially, 2100 IU after 48 hrs. Next step?
a. Refer for transvaginal ultrasound to locate gestational sac
b. Urgent review by gynaecologist at local maternity hospital
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63M, erectile dysfunction for 6 months, no libido changes or mental health issues. In good health, no meds. Initial investigations?
a. Serum testosterone, HbA1c, fasting glucose, lipid profile
b. Full blood count, fasting lipid profile, liver function tests
72M, advanced Parkinson’s, dependent on care, no hospital transfer if unwell. Vomited this morning, ongoing nausea. Which anti-emetic?
a. Domperidone 10mg orally
b. Metoclopramide 10mg orally
c. Prochlorperazine 5mg orally
40M, difficulty seeing computer screen for 1 day, no pain, normal pupils. Light reaction abnormal. Important diagnosis to consider?
a. Optic neuritis of L eye
b. Retinal artery occlusion of R eye
c. Tumour in apex of R lung
66-year-old female, recently visited Southeast Asia, suffered from a single episode of diarrhea and RUQ pain, which resolved on its own. Now presents with RUQ pain, fever, malaise, and jaundice. What is the diagnosis?
a. Hydatid cyst
b. Cholecystitis
c. Cholangitis
d. Hepatitis
e. Liver abscess
A patient with a history of epilepsy since age 10. Experienced early morning fit after a sober Saturday night. He is taking carbamazepine 200 mg tds. Had another fit a few days ago. What to do now?
a. Increase carbamazepine to 400mg bd
b. Add phenytoin 100 mg tds
c. Check anticonvulsant levels
d. Do EEG
e. Do MRI
23M, plumber, back, groin, and hip pain after football camp, feverish, soft abdomen. Pain reproducible on hip flexion. Important diagnosis?
a. left psoas abscess
b. urinary tract infection
c. labral tear of the left hip
5M with 3-day fever, sore throat, +Strep pyogenes. Red, enlarged tonsils with exudate, tender lymph nodes. Most appropriate antibiotic?
a. phenoxymethylpenicillin 15mg/kg orally 12hr for 10 days
b. amoxicillin 15mg/kg orally 8hr for 7 days
Pediatric patient 10 months, clear rhinorrhea, fever, pharyngeal erythema, no exudate, neck lymphadenopathy, no findings at the pulmonary level: management?
a. azithromycin
b. amoxicillin
c. oseltamivir
25F traveling to Nigeria, needs Yellow Fever info and vaccination. What’s the best advice?
a. yellow fever vaccination contraindicated for egg anaphylaxis
b. booster dose of yellow fever not required
Couple trying to conceive for 12 months, wife has regular cycles. Interested in ovarian reserve testing. What investigations to assess?
a. day 2-4 FSH, E2, AMH, transvaginal ultrasound for antral follicle count
b. day 2-4 LH, AMH, day 21 progesterone
4yo boy, recently moved to Australia, needs immunisations. Last doses in Canada at 18 months, only 1 MMR and no meningococcal/ hep B birth dose. Remaining vaccines match Aus schedule. What to administer?
a. requires meningococcal ACWY, diphtheria, tetanus, pertussis, poliomyelitis, and MMR booster
b. needs MMR booster + meningococcal ACWY vaccine
72-year-old lady with 2-month vulval/perianal itch, no discharge, stinging with urination. Tried antifungal pessaries, symptoms unchanged. Exam shows thickened skin, fissures, and ulcer. Main initial treatment?
a. potent topical steroids
b. long-term oral prednisolone
c. oral fluconazole
Patient with epilepsy for 10 years. Experienced early morning fit after sober Saturday night. Taking carbamazepine 200mg tds. Had same fit few days ago. Otherwise normal. What to do now?
a. increase carbamazepine 400mg bd
b. add phenytoin 100mg tds
c. check anticonvulsant levels
d. do EEG
e. do MRI
17M presents with dysuria, pus at urinary meatus after unprotected sex 5 days ago. Afebrile, no epididymo-orchitis. Swab for gonorrhoea taken, 1st-pass urine for NAAT. Best management option?
a. ceftriaxone 500mg IM in 1% Lignocaine + azithromycin 1g orally stat
b. amoxicillin 3g orally stat + probenecid 1g orally stat + azithromycin 1g orally stat
20F has 6 months of vomiting after meals, 1kg weight loss, avoids eating in front of others. Boyfriend thinks it’s bulimia. Findings likely in bulimia nervosa?
a. metabolic alkalosis
b. body mass index <18kg/m2
c. hypernatraemia
26F for life insurance check-up, urinalysis positive for blood, normal color. Microscopy shows 12 RBCs/HPF, denies dysuria or pain. True statement about haematuria?
a. normal urine <10 RBCs/high power field
b. >5 squamous epithelial cells/high power field indicates contamination
57M, repeat Rx visit, history of T2DM and HTN. Blood tests show elevated liver enzymes. Likely cause of deranged LFTs?
a. metabolic associated fatty liver disease
b. alcoholic liver disease
c. Gilbert’s syndrome
24M had seizure, minimal sleep, witnessed by partner. Stiffness, jerking, loss of consciousness reported. No prior seizure history. Correct statement?
a. epilepsy diagnosed after 2 unprovoked seizures (>24hr apart)
b. anti-epileptic treatment usually after 3 seizures
65M has new pigmented lesion on left scapula, increasing in size over 3 months. Risk factors include family history and sunbed use. Lesion is irregular, 7mm. Initial management?
a. surgical excision of lesion for histopathology with 2mm margin
b. surgical excision of lesion for histopathology with 1mm margin
72M with COPD, increased breathlessness over 6 months, now needs breaks every 100m. Spirometry shows FEV1 54%. Next step in COPD management?
a. prescribe tiotropium bromide 18mcg inhaler once daily
b. prescribe fluticasone 125mcg inhaler 1 puff twice daily
35F presents with lethargy, joint pain, mouth ulcers. ANA 1:80, positive anti-dsDNA, RF positive. Likely diagnosis?
a. systemic lupus erythematosus
b. systemic sclerosis
61M referred for prostate cancer, biopsy benign, diagnosed with BPH. Prostate volume 50mL, has moderate urinary symptoms. Wants to discuss treatment options. Best treatment option?
a. tamsulosin and dutasteride
b. prazosin
c. finasteride
37F with painful urination, fever, and painful vulval ulcers with inguinal lymphadenopathy. Likely diagnosis?
a. genital herpes
b. Behcet’s disease
c. candidiasis
2yo girl swallowed a possible button battery, no pain/vomiting, incident 30 minutes ago, honey given at home. Immediate management priority?
a. call Poisons Info Line; arrange neck, chest, and abdomen x-rays urgently
b. call clinical toxicologist; arrange chest x-rays urgently
3yo girl with 24h painful L knee, rash on buttocks, mild cramping pain, purpuric rash, trace blood in urine. Follow-up for suspected diagnosis?
a. weekly clinical review, BP check, urinalysis for 1 month, then fortnightly for weeks 5-12, single review at 6 and 12 months
b. monthly BP checks and urinalysis for 12 months
27M transgender male asking about PrEP for HIV prevention, motivated by friend’s recent diagnosis. Efficacy of daily PrEP?
a. PrEP can reduce HIV transmission risk by up to 99% from sex and 74% from IV drug use when taken daily
b. PrEP can reduce HIV transmission risk by up to 90% from both sex and IV drug use when taken daily
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5yo boy with 2h of penile pain, swollen glans after examination. Foreskin retracted, no trauma noted. Likely diagnosis?
a. paraphimosis
b. phimosis
c. balanitis
72F with hypermetropia, urgent appointment for painful L eye, nausea/vomiting. Additional symptom for differential?
a. headache
b. history of wearing contact lenses
c. ocular itch
69M with months of fatigue, low back pain after gardening, limited forward flexion, spinal tenderness L1-L3, bloods show normocytic anemia, leukopenia. Likely diagnosis?
a. multiple myeloma
b. osteomalacia
c. lymphoma
42F with 2w of allergic symptoms, worsening with blossoms, taking fexofenadine with little relief. Next step for management?
a. start mometasone 50mcg, 2 sprays each nostril daily for 4 weeks, then 1 spray daily, plus continue oral fexofenadine
b. switch to azelastine 1mg/mL nasal spray, 1 spray each nostril twice daily
73M concerned about new pigmented lesion on L forearm, 4mm, irregular borders. On aspirin and prasugrel after MI. Best management for skin lesion?
a. continue current meds; perform excision biopsy with 2mm margins under local anaesthetic
b. excision biopsy under local anaesthetic with 2mm margins; stop aspirin and prasugrel day before, resume after
28M with type 1 DM, planning 10-day trip to Bali in 6 weeks. First-time traveler, asking about vaccines/precautions for himself and 4yo son. Correct statement about traveler’s diarrhea in kids?
a. no chemoprophylaxis for traveler’s diarrhea in healthy travelers, including kids
b. anti-motility agents safe for kids under 12
17M re-presents 2 weeks post-amoxicillin for strep throat, now has widespread rash. Exam shows non-itchy erythematous lesions on trunk/limbs. Most likely diagnosis?
a. guttate psoriasis
b. drug-induced rash
c. glandular fever
28M with 2-month history of abdominal pain, diarrhea mixed with blood/mucus, and fatigue. Family history of Ulcerative Colitis. Which skin condition linked to inflammatory bowel disease?
a. pyoderma gangrenosum
b. lichen planus
c. pityriasis rosea
38F with new neck lump, likely thyroid nodule, TSH normal, benign FNA results. No prior thyroid issues, mother has Hashimoto’s. Advise on follow-up?
a. clinical monitoring with repeat thyroid ultrasound in 12-24 months for nodule change
b. no further follow-up needed
50M collapses in waiting room, clear airway but not breathing, ambulance called, IV access established. Most immediate treatment to start?
a. administer shock using defibrillator
b. administer amiodarone 150mg IV
c. administer adrenaline 1mg IV
2yo boy, 34 weeks gestation, runny nose, fever, coughing, lethargy, mild tachypnea, crackles in L lower zone, diagnosed with pneumonia. Likely pathogen?
a. respiratory syncytial virus
b. Bordetella Pertussis
c. Haemophilus influenzae
48F asks about 12yo daughter’s delayed period, some breast development/pubic hair present. At what age evaluate for primary amenorrhea if normal growth/sexual traits?
a. 15 years old
b. 10 years old
c. 12 years old
75F with intermittent palpitations, fatigue, SOB, past history of HTN/DM. ECG shows atrial fibrillation. What’s her CHA2DS2-VASc score?
a. 4
b. 1
c. 2
38F, 14 weeks pregnant, discussing first trimester screening results. Risks for chromosomal abnormalities noted. Most appropriate advice for the couple?
a. offer referral to high-risk obstetrics clinic for amniocentesis
b. offer referral to high-risk obstetrics clinic for chorionic villus sampling
63M, occasional respiratory infections, smoker, alcohol smell, presents with ulcer on L foot. Most correct statement about his situation?
a. pressure reduction (offloading) is required
b. general practice is suitable for ulcer management
