AMC MCQ Recalls MARCH 2021

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Australian Medical Council (AMC) MCQ Recalls MARCH 2021 compilation

1) 6yrs old girl Jelly fish sting in QLD beach, she has resp distress, what to do next
-Antivenom
-Wash with water
-wash with Vinegar
-O2
-Remove the tentacles

2) Pedestrian with gunshot by a gang comes with distended abdomen , low bp, gcs is good what will u do
Ct
Fast
Laporotomy

3) young lady return from thailand.fever ,maculopapular rash,red eye, myalgia,low wbc,plt normal,UE normal,CORONA virus negative.next step?
throat swab
blood culture
urine culture
isolation
cxr

4) depressed patient has the highest risk of attempting suicide?
When the depression deteriorates
After discharge from the hospital

5) In a urine dipstick test, a 26-yr-old man is only positive for 1+ proteinuria. no significant medical history. next step?
a/ Serum electrolytes, urea, and creatinine
b/ 24 hour urinary protein assay

6) An ecg with pt on multiple drug taken with history of dm,hypertension asking cause of AF
a.dehydration
b.ischaemic heart disease
c.hypertensive heart disease
d.high cholesterol

7) woman with …. OCP for 10 yrs comes, what’s the cancer risk increasing for her, her BMI is >30
Ovarian Ca
Endometrial Ca
Breast Ca
Colorectal Ca

8) 40-yr-old patient with heart burn & chest pain started developing difficulty swallowing food in the last 12 mths. Has regurgitation when lying down but eases when raising arms. Diagnosis?

1. Esophageal cancer
2. Esophageal strictures

9) Woman, BMI>30, on COCP, grandma with ovarian ca at 65 years old, what can reduce the risk of ovarian ca?
A. Weight loss
B. BRCA screening
C. Stop OCPs
D. Ca-125 yearly
E. Breast ultrasound?

10) WPW with AF treatment
adenosine
verapamil
lignocaine
digoxin

11) most common adverse effect of aripiprazole?
a Light-headedness
b Dizziness

12) Mentally retarded child brought by caretaker as he threatened his roommate with knife what to do next
Inform police
Refer to ED

13) Gross hematuria next investigation
CT urography
Cystoscopy

14) Lecture on sex education has been given to 13-yr-old school girls. Next most important topic to be covered?
Sunscreening
Regular cancer screening

15) 23-year-old woman presents to your clinic with amenorrhea for 6 weeks. Which one of the following, if found on history or exam, will make you decide to proceed to emergency intervention?
a Vaginal bleeding
b Lower abdominal pain

16) Ankylosing spondylitis bamboo spine , what’s the tx?
-Inflaximab

• paracertamol
  -Nsaids
• prednisolone

17) IV drug abuser guy come with symp of pul abscess, CX ray is given fluid level with the cavity after 2 weeks antibiotic tx, he is not good, what will be your next?

• CXR
  -bronchoscopy
• Refer to the surgeon
• Continue the treatment

18) 24-yr-old woman with BMI of 25 is extremely worried about her weight & body size. Exam & lab values are all within normal range. Diagnosis?
i. Bulimia nervosa
ii. Body dysmorphic disorder

19) 30-yr-old woman complains of episodes of headache, sweating, palpitation, tingling sensation in her hands, shortness of breath & severe anxiety. Medical workup reveals no pathological finding. Causes?

• Increased free plasma epinephrine
• Decreased serum glucose

20) 60 yrs old man with the history with hep C, he got cirrhosis, abd distension and sepsis? What inx will you do for him?
There is no paracentesis in options , only Ammonia in option

21) a man with fever, fatigue, rusty sputum , pic of his left foot is given , multiple brownish red spot, with wt loss what is the diagnosis?
TB
Cancer
Sarcoidosis
Cellulitis
melanoma

22) Melanoma on the eyelid

• refer to surgeon

23) Man wants to travel by airplane distance is 5000 kilometres he is concerned about Dvt what would be your advice??
prophylactic LMWH
therapeuticlmwh
compression stockings
fluids
tell him to get up and walk where every can find the path

24) 8-yr-old boy with red swelling behind the right ear complains of right ear pain & purulent discharge since yesterday. He has the history of chronic bilateral otitis media for which he underwent bilateral grommet procedure. Next step?
a/ Take samples for culture
b/ Hearing assessment

25) 67-yr-old woman complains of headaches for the past 2 weeks. Headache is worse in the morning & associated with vomiting but no nausea. Painkillers doesn’t work. Diagnosis?
a/ Migraine headache
b/ Cluster headache

27) 36-yr-old man underwent splenectomy 2 yrs ago seeks for advice about vaccination before he goes on a business trip to Cambodia. Infection most susceptible during this trip?
a/ Dengue fever
b/ Hepatitis B

28) Mobitx type 2 ecg with very slow HR, options for

• amiodarone
• pul pacemaker

29) Old man after prostactectomy comes with fever and chills, what is the casue?

• wound infection
  -peritonitis
• inf with gram negative bacteria

30) 25 yrs old female came with history of her grandmother having ovarian ca . What we do for her ?
A) ca125
B)sonography
C) mammography
D) nothing

31) Prostate ca, underwent surgery. After prostactomy PSA rising too quick. What to do next ?
A) Pet scan
B) Mri
C) Abd ct

32) RTA with seat belt , abd pain , shock despite of 3L colloid . Next step ?
A) laparotomy
B) FAST
C) CTAP
D) abd tap.

33) 67-yr-old presents with a firm & non-mobile left breast mass. There is no lymphadenopathy. An ultrasound scan found a 2×3 cm hypoechoic mass with irregular borders. Next step?
a- Excisional biopsy
b- Mastectomy

34) 72-yr-old man has been treated several times for depression. He smokes 15-20 cigarettes a day & wants to quit smoking. Most important option for him to assist his quitting?
a- Cognitive behavioral therapy (CBT)
b- Nicotine replacement therapy (NRT)

35) Lab test results for Jane confirmed systemic lupus erythematosus (SLE). You write a referral letter to a local rheumatologist for consultation. She wants to know for how long this referral letter is valid?
a- Three months from the date of issue
b- Three months from the first visit by the specialist

36) menopausal woman come with post coital bleeding what is the best inx to do
a- Endometrial biopsy
b- Only that rem

37) 55 yrs old woman with sexually active, greeny brown discharger
a- Chlamydia
b- endometria ca

38) woman with Hbs Ag positive , male partner had vaccine, he wants to check it ? What will you check?

• Hbs Ab
• HbeAg

39) A boy has come back from Correctional center , he is aggressive he doesn’t want to go back to that place, what will you do for his tx?
-Anger mx
-CBT

40) correct statements about Perthes disease?

• Hip mobility is reduced especially abduction and external rotation
• Ultrasound is the modality of choice to make a diagnosis

41) You are a hospital medical officer & an intern on rotation approaches for a prescription of benzodiazepine. He complains of stress, lack of sleep & irritation most of the time. Response?

• Report him to the coordinator of interns program
• Report him to the medical board

42) 48-yr-old painter falls from a height of 3 meters & lands on his both heels. He suffered a minor wound on the forehead. There is severe swelling below the left ankle and moderate tenderness over the lumbar area. Next step?

• CT scan of the head to exclude intracranial hemorrhage
• AP and lateral x-ray films of the left and right foot

43) 40-yr-old heavy alcohol drinker complains of vertigo and shaky hands. He says: “like I am floating, and my head is light”. He denies any sensation of spinning or moving around. Diagnosis?

• Temporal lobe epilepsy
• Anxiety

44) PAD Q, lower limb pulses are palable, the best inx?

• Doppler
• Angiography

45) what the tx of DVT>?

• Heparin
• Wafarin

46) pt on warfarin, takes amoxillicin, massive bleeding in inf fossa, no ct

• Rectus shealth haematoma

47) man with chronic constipation, what will you lead to dx?

• colonoscopy
• stool exam & culture

48) 25-yr-old woman with a history of greenish-yellow vaginal discharge is tested positive for chlamydia infection. She has multiple sex partners in the past 6 months. Advice?
a Trace all her sexual contacts in the past six months and treat them
b Ask her to bring her most recent sexual contacts for testing and treatment

49) woman at emergency with vomiting, abdominal pain and distention. has congestive heart failure. Her abdomen is distended but not tender. cause of abdominal distention?

• Hypokalemia
• Digoxin toxicity

50) old man believe is vertigo. when stood up from a sitting, felt dizzy and nauseated. diabetes and ischemic heart disease, currently on valsartan, metoprolol, atorvastatin, metformin and glimepinde. diagnosis?

• Stroke
• Myocardial infarction

51) Woman at 37 weeks gestation. contractions started and painful every 5 minutes. no leakage of fluid or vaginal bleeding. Fetal movement is normal. amniotic sac is tense and palpable. next step?
a. Amniotomy
b. Cesarean delivery

52) pic was given , child with mass on his umbilicus, no tender

• hernia
• lipoma

53) ECG was given, young male with dizziness, HR 150, brought to hospital by ambulance

• recaller couldn’t dx ecg ..
• SVT or something

54) Couple came – lady with heavy and prolonged menstruation with regular cycles.
They dont want to get pregnant for 1 more year . what to give?
A. POP
B. COCP
C. Naproxen
D. Implanon
E. Mirena

55) A 13-year-old girl presents to your practice asking for an abortion. Eight weeks ago, she is a raped in party. After missing her due period, she performed a home pregnancy test which showed she is pregnant. The girl had left home 2 years ago and lives by herself. Which one of the following is the most appropriate next step in management?
A. Refer her for an abortion as she wishes.
B. Inform the police.
C. Inform the Child Protection Service.
D. Inform the Sexual Assault Services.
E. Inform her parents.

56) a Malaysian student,uni student ,his gf went back to attend dad’s funeral now this guy become restless ,irritable and cant sleep and complains that his gf talking behind his back
Dx?
Suspicious cannabis (amphetamines would be best)
Grief reaction
Panic psychosis
Reactive psychosis
Onset of schizo

57) woman progressive fatigue, myalgias, and muscle weakness in both lower extremities. difficulty getting up from a chair, cramping in the legs . normal erythrocyte sedimentation rate and elevated serum creatine kinase level. next step ?
a/ ?Antinuclear antibody test
b/ Discontinuation of lisinopril

58) man accidentally amputated right thumb with bandsaw. picked up the amputated part in a plastic bag. amputated part is in one piece without contamination. best way to transport the amputated?
a/ Directly covered by ice on all sides
b/ Left open to air in a plastic bag over a bed of ice

59) man of traces of blood after bowel movements. abdomen soft and nontender with normal bowel sounds. traces of red blood visible on the glove. next step?
a/ iFOBT
b/ Proctoscope (should be this)
c/ colonoscope
d/ sigmoidoscope

60) Woman 16 weeks gestation had nausea and vomiting. no vaginal bleeding or cramping. cold knife conization 2 years ago for cervical intraepithelial neoplasia. additional interventions?
a/ 24 hour urine protein collection
b/ Early glucose challenge test

61) A child with severe asthma was brought to emergency hospital by ambulance.
When measured spo2 level very low, the patient was very dyspnoeic with gasping,
comatose, silent chest. The oxygen cylinder in ambulance not working. Child went
to apnea. The parents were distressed and aggressive and asked for compensation.
A. The hospital manager will be responsible and face criminal case
B. No court case but hospital has to pay compensation
C. The doctor is responsible to investigate the case and report parent
D. Its just an accident. So nobody is responsible
E. The ambulance driver would have to attend civil court

62) Woman, BMI>30, on COCP, grandma with ovarian ca at 65 years old, what can reduce the risk of ovarian ca?
A. Weight loss
B. BRCA screening
C. Stop OCPs
D. Ca-125 yearly
E. Breast ultrasound?

63) man painful swelling right lower eyelid. right eye shows localized swelling along the margin of the lower eyelid with associated erythema and tenderness. appropriate management?
a Erythromycin ointment
b Incision and curettage

64) back pain increases when straining and coughing. examination shows 2+ symmetrical knee and ankle jerk reflexes. most likely underlying etiology?
a/ Apophyseal joint arthritis
b/ Intervertebral disc degeneration

65) colon cancer screening. mother developed colon cancer at age 85. no hematochezia, melena, or unexpected weight loss. does not use tobacco or alcohol. two small hyperplastic polyps are found and removed. next step?
a/ Colonoscopy in 1 year
b/ Colonoscopy in 10 years
c/ iFOBT every 2 yearly

66) right shoulder and arm pain. examination shows spasm of the cervical paraspinal muscles. pain improves when the patient lift the right arm and rest the hand on the top of his head. diagnosis?
a Cervical muscle strain
b Cervical radiculopathy

67) blood pressure increases to 170/115 mm Hg and pulse is 54/min. 15 minutes later, blood pressure is 172/117 mm Hg and pulse is 53/min. severe headache and an episode of emesis. next step?
a/ Furosemide
b/ Hydralazine

68) Older female from Indonesia, hasn’t been to Indonesia in many years, came with night sweats, fever, o/e basal crackles otherwise all other examinations normal. What to test?
A. Mantoux
B. IGRA
C. Chest CT
D. CXR
E. Sputum AFB

69) Male complain of brown snake bite. o/e 5cm laceration wound but no bite mark. What to do?
A. Take swabs and pressure bandage
B. Tranfer to tertiary hospital 150KM away by ambulance
C. Venous torniquet
D. Administer anti-venom

70) Middle aged woman with hypertension on amlo, epigastric pain on fennel (?), schizoaffective on risperidone, and some other drugs complain of breast discharge milky no lumps etc. Cause?

A. Amlo
B. Fennel
C. Risperidone

71) discharged after treatment for splenic rupture and intraabdominal bleeding following blunt abdominal trauma. vaccinations planned in 2 weeks. antibiotics should be prescribed?
a/ Amoxicillin-clavulanate
b/ Clindamycin

72) abdominal cramping, nausea, vomiting, and diarrhea. has common variable immunodeficiency. episode of sinusitis a month prior that was treated with amoxicillin/clavulanate. most likely cause?
a. Contamination of treatment infusions
b. Drinking inadequately purified water

73) history of ischemic stroke causing right-sided weakness and uses a cane to ambulate. recently has had dysuria and urinary urgency. Dysmetria is present on finger-nose testing, and the gait is wide-based. cause?
a- Epidural abscess
b- Folate deficiency

74) 1-month-old girl. Weight and length are stable at the 45th percentile. Pulse is 120/min, and respirations are 35/min. chest x-ray reveals an enlarged left heart contour. cause of x-ray findings?
a/ Asymmetric septal hypertrophy
b/ Decreased left ventricular contractility

75) commit suicide. pupils are 3 mm bilaterally. oropharynx is erythematous with some mild ulcerations. heavy drooling. abdomen is benign with normal bowel sounds. explanation symptoms?
a/ Anticholinergic medication
b/ ???Caustic cleaning product

76) A woman 12 weeks gestation, O negative, done CVS for Down syndrome. Given a list of blood panels including
HbsAG negative
HbSab postive
Hep C negative
Anti-D negative

77) What to do next?
A. Hep B vaccine
B. Administer anti-D

78) Small smooth lump in the vaginal opening, what to do? (Can’t remember whether it was painful but no discharge, not itchy, no systemic symptoms)
A. Marsupialization
B. Excision
C. Electro cautery
D. Cryotherapy

79) A 18/19 year old male with vomiting etc Glucose high, ABG metabolic acidosis, no ketone given
A. DKA
B. Hyperosmolar Hyperglycemic State
C. Alcohol toxicity
D. Ethylene (?) toxicity

80) A 10yo boy brought by parents because he was fat. Weight >98th percentile, height >90th percentile. What could be potentially be found?
A. Reduced TSH
B. Increased Parathyroid hormone
C. Increased FBS

81) 6year old with ttttthey tttteaseeee meee
A. Stuttering, cant remember other options

82) Boy on Sertraline for 21 days no effect yet, what to do?
A. Continue first
B. Increase dose
C. Change to others
D. Add another drug

83) First Clostridium difficile infection treatment?
A. Metronidazole
B. Vanco
C. Others

84) Patient on Warfarin started on Roxi for infection, came with per rectal bleeding. INR 9, BP 90/60, PR 120, what to do first?
A. FFP
B. Vit K
C. Packed cell transfusion
D. Stop Warfarin

85) Older lady with lump in the supraclavicular fossa, otherwise no other symptoms, physical examination normal. What to do next?
A. FNAC
B. CT-scan of chest
C. Mammogram
D. Colonoscopy
E. CT brain

86) Lady with heavy menstrual bleeding, no pelvic mass etc etc don’t plan to get pregnant soon?
A. OCP
B. COCP
C. Implanon
D. Mirena

87) Male from prison (multiple jail time), history of Diazepam abuse, at ED because got laceration wound after trying to rob someone. Tells the doctor he will commit suicide if he goes to jail again, complains very painful although everything else normal except for the small laceration wound
A. Depression
B. Factititous disorder
C. Malingering
D. Bipolar
E. Drug withdrawal?

88) Teen hit with a tennis ball in the eye. Complain of floaters AND flashes, reduced viscual acuity, no other findings anteriorly,
A. Hyphema
B. Retinal detachment
C. Vitreous hemorrhage

89) Young lady back from Thailand (visited family). Didn’t take any prophylaxis whatsoever. Fever T 40, maculopapular rash, conjungtivitis, myalgi, WBC slightly decreased, otherwise all others normal including normal platelet. BP was normal too. COVID negative. Next step?
A. Throat swab
B. Blood culture
C. Urine Culture
D. Isolation
E. CXR

90) Male account does not want anti-psychotics, complain of fatigue, unable to sleep at night
A. CBT
B. Sleep Hygiene

91) Older man with urinary incontinence, what to give?
A. Incontinence pads
B. Oxybutinin
C. Doneprazil

92) Older woman, no symptoms but UA nitrates positive and WBC positive. What to do?
A. Ciproflox
B. Trimetrophim
C. Amoxcilin
D. Urine alkaliniser?

93) Patient writer to doctor saying she is unhappy with his treatment. What should the doctor do?
A. Inform medical board
B. Make an appointment to talk to her
C. Inform Hospital

94) Intern asking registrar for sleeping meds because studying for exam. What to do?
A. Inform intern supervisor
B. Prescribe
C. Ask to see GP
D. Report to AHPRA

95) Older menopausal women with itchy vagina, o/e white pale what to do?
A. Estriol cream
B. Gentamicin cream

96) Food poisoning scenario list of food and the number of people who ate and didn’t ate and whether they had symptoms

97) A table given and asked about incidence (not prevalence), town had 200 people, but asked per 1000 population or something like that

98) Boy with pink rash on the face with tender lymphadenopathy. What is significant?
A. Mother is pregnant
B. Cat at home
C. Other children at home
D. Immunisation up to date

99) In labour, on syntocinon, VE 9cm, bradycardia for 30 seconds to 60 then recovered. What to do?

A. Stop syntocinon
B. Emergency C-sec
C. Scalp pH

100) Post vomiting, what the ABG, potassium, and sodium will be like? (it should be hypochloremic, hypokalemic, hypernatremic, metabolic alkalosis)

101) Patient with asthma and SVT, didn’t want Adenosine made him sick, vagal manouver failed. What to give?
A. Digoxin
B. Sotalol
C. Verapamil
D. Enalapril
E. Amiodarone

102) 15 year old obese boy with hip pain (given X-ray), otherwise no swelling whatsoever
A. SCFE
B. Perthes
C. DDH
D. Septic arthritis

103) Older woman, knee pain, joint effusion (+), no inflammation, pain on pressure only, what to do?
A. Xray
B. CT
C. MRI

104) Person with reduced pinser grip and reduced sensation over 4th and 5th fingers, where is the injury?
A. C8/T1
B. Brachial plexus
C. Wrist
D. Elbow

105) Case of flexor tenosynovitis
A. Pain on flexion
B. Finger in flexion
C. Fusiform swelling

106) Male, chronic smoke with cough etc etc, with Horner’s syndrome what to check?
A. Chest xray

107) Patient with Glesson score 4, on double antiplatelet following stent, what to do?
A. External beam radio
B. Radical protesctomy
C. Chemo

108) Patient with colon ca, with multiple lymph node involvement (I think it was 15?), what can improve life-span?
A. Chemo
B. Radio

109) Woman with regular menstrual cycles, patent tubes, primary infertility 5 years what to check?
A. Semen analysis
B. Hysterscopy
C. 21 day progesterone

110) Patient on colchine and allopurinol for gout intermittently, photo given – pseudogout. Serum urate elavated. What to do?
A. Stop allopurinol
B. Stop both
C. Regular allopurinol

111) Pregnant woman, RUQ pain, BP high, proteinuria ++ headache
A. HELLP syndrome
B. Acute cholecystitis
C. Other irrelevant optiosn

112) Patient with GBS +ve treated during follow-up. What to do after?
A. Repeat swab at 37-38 weeks
B. Treat baby with IV penicilin
C. Intrapartum IV Penicilin
D. Intrapartum IV Erythromycin

113) MSM with three partners, protective sex, Hep A, Hep B vaccines taken. What to do next?
A. Screening for STDs yearly
B. HIV three monthly testing
C. Vaccine for HPV

114) Child throws vase when angry with mother
A. Acting out
B. Displacement
C. Regression
D. Reaction formation
E. Projection

115) Woman, drinking during pregnancy, what to monitor in baby?
A. Fetal movements
B. Fundal height

116) Boy 14 ADHD doesn’t want to take meds, what to do?
A. Tell parents it’s their responsibility
B. Speak to the boy
C. Tell parents it is mandatory he takes meds

117) 20year old male with ADHD not on meds for some time, now asking for meds again, what to check?
A. Level of hyperactivity?

118) Childcare case of Hep A. What to do?
A. offer Hep A vaccine to everyone
B. Quarantine 4 weeks
C. Test food workers Hep A IgM
D. Cater food

119) Woman post-partum, suspicious of surrounding, hypervigilant, no fever or other complaints, what to check?
A. urine tox screen
B. ECG
C. CT-scan
D. CXR
E. Blood culture

120) memory problems. frequently forgot grandchildren’s names. difficulty finding words. never used alcohol or illicit drugs. Moca score is 15 on a scale of 30. abnormalities?
a Diffuse cortical infarctions
b Enlarged lateral ventricles
cant remember the question

121) thyroidectomy for Grave’s disease complains of anxiety, muscle cramps, and poor sleep. medications include daily multivitamin supplements and lansoprazole for acid reflux disease. diagnosis?
a Hyperkalemia
b Hypocalcemia

122) woman bizarre behavior has become increasingly paranoid. history of depression treated with bupropion. drinks alcohol but do not uses drugs. Family history is significant for bipolar disorder in a maternal uncle. next step?
a Administer a mood stabilizer
b Administer an antipsychotic medication

123) 2 years of persistent cough. coughs up whitish sputum. complains of exertional shortness of breath. smoked one pack of cigarettes daily for the past 40 years. Pulmonary function testing reveals a vital capacity that is 65%.
a Alveolar capillary membrane thickning
b Decreas functional residual cpacity