AMC MCQ Recalls JULY 2024

Australian Medical Council (AMC) MCQ Recalls JULY 2024 compilation

As GP doctor & U want to help Aboriginal people to prevent STDs in their communities, what is the best way to do that?
1) TV advertising about the STDs
2) school campaigns for students
3) Posters public transportation
4) individual teaching for young adults about STDs and it’s complications
5) scheduled events for students about this topic

OC pill is requested by 14 yr old minor.
A. Call her parents
B. Give her OC pill
C. Ask her partner’s age

30w poa primi mother meets with an RTA. Mild abdominal tenderness. SFH 34cm. No vaginal bleeding. CTG HR 176, reduced baseline variability, no decelerations. What is the diagnosis
Uterine dehiscence
Placental abruption
Splenic rupture

11 months of age, baby having syndromic features of down syndrome. What screening is offered at this age
FBC
Thyroid functions Celiac screen
C spine screen

A 48 years old patient fell from a stair and sustains a colles fracture. She is worried about her risk of developing further fractures. What to do next?
A. Do nothing
B. Bone density

women with severe anger issue,husband left her,now problem with doctor what
indicates diagnosis?
Dx.borderline personality disorder?
A.family issue
B.alcohol abuse ?
C.gambling

You see many trachoma cases in indigenous community. What to do to prevent trachoma cases?
A) Give eye drops to community
B)Give eye drops to contact
C) Give treatment to community
D) Give treatment to contact

80 years old, mild dementia, she says with medication having a normal routine. Son and family not concerned about mother’s medication and mother says she doesn’t need the drug. What next?
a. Send a social worker to house to give medication
b. Accept what patient says
d. Tell patient you must take medicine if you want to live alone

New patient in clinic from interstate with letter from GP known spondylolisthesis with CT result. Asking for Oxycodone prescription old GP is not answering on phone.
What to do?
a. Give panadeine forte
b. Give Oxycodone for 5 days
c. Consult shopping pharmacy department
d. Do not write script

.lady with 39week gestation. passed out fresh blood 1L per vaginally. BP 140/80,
HR 100. FHR 150+. No contractions felt. What will help in diagnosis?
A.. Fetal heart rate
B. Maternal HR
C. Maternal BP
D. Uterine contraction

middle aged man with hypertension and dyslipidemia. Sudden onset chest pain,
radiating to the back. Initially well on the ambulance. Upon arrival to ED, patient
collapsed. No pulse palpable
cardiac monitor showing sinus tachycardia!?
A. Acute MI
B. Ruptured aortic aneurysm???
C. Cardiomyopathy

A pregnant woman delivered a 3.6 kg baby via NSVD. She was given syntocinon and delivered placenta after 3 mins. After 15 mins, she also lost 1500 ml blood pv, and shows shortness of breath. Diagnosis ?
A. Concealed placental abruption
B. Cervical laceration
C. Atonic uterus
D. Uterine inversion

24 male presented with left eye pain, mild blurred vision post nail gun incident. No flashes, floaters, or diplopia. Immediate diagnosis & advice to nurse?
a. Hyphaema. Bed rest with head elevated 30°, eye shield, analgesia & antiemetic (phone order).
b. Subconjunctival haemorrhage. Paracetamol & ibuprofen (if no contraindications).

38 lady with general lower abdo pain, 3cm left ovarian cyst on US. No free fluid. Appropriate advice re: cyst?
a. Simple cysts resolve in 3 menstrual cycles, no investigation needed.
b. Repeat ultrasound in 3 months for cyst resolution.

42 male with otitis externa, severe pain, ongoing hearing loss, ear discharge. Afebrile, narrowed ear canal, yellow/grey discharge. Most appropriate treatment?
a. Referral to ENT for IV antibiotics.
b. Ear toilet & supportive analgesia only.

60y old Teacher saying bad words to students and inappropriate sexual language and insults , Poor self care . What will be deranged in Mmse ?
inability to recall 3 objects
inability to name prime minister
right side neglect

A patient came to ED with abdominal pain and vomiting. On exam, his BP normal, PR 102/min, and X-ray shows SBO features. Few hours after the initial management, his pain increased, and PR increased to 120/min. What to do next?
A. CT abdomen
B. USS
C. Surgical exploration
D. Nasogastric tube

22 lady, 10 wks gestation, singleton pregnancy, BMI 21 kg/m2. Screening for gestational diabetes?
a. At 24-28 weeks gestation with an oral glucose tolerance test.
b. At 24-28 weeks gestation with a HbA1c.

70y Patient with PMR, DM, HTN came with unsteady gait, Lower Abdominal distension and pain, Diuiculty in voiding and back pain
O/e lower abdomen tender and reduced power and reflexes in LL Patient was on tamoxifen, metoprolol and prednisolone.
Most appropriate next investigations
CT spine
MRI spine
pelvis uss
lumbosacral xray

The prevalence of stroke is 6 out of 100 in non-smoker, and 50% more in smoker populations. A newly developed drug reduces 1/3rd risk in smokers. What percentage of population will still get a stroke if they use this drug ?
A. 4%
B. 6%
C. 9%
D. 10%
E. 20%

In a health survey, 1 in 99 people taking aspirin, and 2 in 98 people not taking aspirin (control), are developing health problems. What is the ARR ?
A. 1%
B. 2%
C. 33%
D. 50%

2 yr old with haematuria and hypertension history of recurrent nephrotic syndrome ( thrice in the last 18 months). Symptoms unresponsive to steroids. Diagnosis?
A Iga nephropathy
B PSGN
C vesivoureteral reflux
D Family history of kidney disease
E flank non tender mass

Post op.appendecectomy Develop after 3 days. Complaint of pain over right iliac
fossa. No guarding, but tender over right iliac fossa. Wound and dressing clean. Vitals
stable, but having fever.
asking likely cause?
A. Wound infection
B. Stump leak
C. Abscess

5F with food allergy reaction (itchy rash post tuna mornay). Antihistamine settled rash. True statement re: skin prick testing?
a. Avoid cetirizine 4 days before skin prick test.
b. Skin prick testing can’t provoke anaphylaxis to allergen tested.

20 lady with painless neck lump, fatigue, itch, night sweats. 5cm rubbery mass, anterior neck triangle. Most likely investigation for diagnosis?
a. Excisional biopsy of the neck lump
b. Chest x-ray
c. Full blood count and biochemistry

54 years old lady on metformin 1 g daily presents with impaired HbA1C more than 10%, invx also shows renal function impairment. What is the appropriate mx?
a. continue the same
b. gliclazide
c. pioglitazone
c. sitagliptin

pt with severe MR. What to consider prior to sx?
Dobutamine scan
MRI heart
Endoscopic USS
?Coronary angio

37 wk preg, guess of slight green watery discharge. No antenatal issues.
Currently no pain, FHR 148/ min, Cephalic pre, 3/5 felt abdominally
cervix not dilated next

1. Amniotomy
2. PGN
3. LSCS
4. Oxytocin

19 male with left ankle injury from basketball, swollen, tender medial midfoot. Correct statement?
a. Ottawa ankle rules: foot x-ray for navicular tenderness.
b. Ottawa ankle rules: foot x-ray for ankle pain.

9month old kid scratched by bat, up-to-date immunisations, no rabies vaccine. Most important FIRST step to reduce risk of Australian bat lyssavirus?
a. Clean wound w/ soap & water for 5 mins.
b. Give tetanus booster, last dose at age 4.

7yo girl Aboriginal w/ asthma, worsening SOB, trouble speaking in sentences, past non-compliance w/ meds. CORRECT regarding asthma?
a Indigenous Australians have 2.3x asthma death rate compared to non-Indigenous.
b Children >5 yo can usually perform spirometry.

49 lady on telmisartan, hydrochlorothiazide, amlodipine, BP 150/100mmHg. Screening for primary aldosteronism as cause of hypertension?
a Hypertension resistant to 3 antihypertensives (incl. diuretic).
b Hypertension w/ spontaneous or diuretic-induced hyperkalaemia.

Gestational Diabetes screening in a woman with family history of DM. Choose the best answer for this patient.
a. OGTT at 26wks with 50g glucose
b. OGTT at 26wks with 75g of glucose
c. Glucose challenge test at 26wks with 50g of glucose
d. Glucose challenge test at 26 wks with 75g of glucose?

A 5y old child with multiple vomiting for 5 days. Asking about electrolyte abnormality.
a. Nа 115,K2.5 PH7.55
b. NA 125, K3.6 PН7.55
c. NA 136 K 2.5 PH 7.57
d. NA 115 K 2.5PH7,2
e. NA 115 K3,5PH7.2

54 male with T2DM, controlled, HbA1c 6.0%. Urine ACR increased to 3.2mg/mmol. Statements re: albuminuria?
a Elevated urine ACR more common in CKD than decreased eGFR.
b Urinary protein excretion highest in the morning.

2 years old girl with recurrent respiratory and skin infections. Gingivitis and granuloma of skin present. Dx?
a. Agammaglobulinemia
b. Chronic granulomatous disease
c. Transient hypogammaglobulinemia

16 guy with sudden intense R testicular pain, nausea, vomiting, no trauma. Suspect torsion. Expected signs?
a. Negative Prehn’s sign
b. Positive Prehn’s sign
c. Intact cremasteric reflex

72 guy with COPD exacerbation, advanced care plan. Deteriorating, on non-invasive ventilation, ABG shows pH 7.29, pCO2 55. ABG interpretation?
a. Type II resp. failure w/ resp. acidosis and acute-on-chronic metabolic compensation.
b. Type II resp. failure w/ resp. acidosis and acute metabolic compensation.

35 male with blood in semen, no family hx of prostate cancer, no weight loss or nocturnal pain. Initial investigations for haematospermia?
a/ Urine MCS, cytology, FBC, coagulation profile.
b/ FBC, coagulation profile, scrotal U/S, urine MCS.

28 guy w 2-month intermittent abdo pain, diarrhea with blood & mucus, decreased appetite, fatigue. Father has UC. Correct statement?
a/ Faecal calprotectin distinguishes IBD from IBS accurately.
b/ Faecal calprotectin results not affected by NSAIDs.

27 lady, 2 wks post-vaginal delivery, 2nd-degree tear, mild discomfort with urination/bowel actions. Long-term consequences of tear?
a/ Refer back to OB if severe dyspareunia.
b/ Second-degree tears may cause long-term faecal incontinence.

Obese pregnant mother 36 POA , pendulous breast, BMI 41, can’t palpate the uterus. USG and CTG normal , referred to tertiary care hospital. What assessment should be done now.

-Anesthesia
-lactation mx
-dietitian
-endocrinology

13M with L foot pain post-football injury, tender 5th metatarsal, x-ray: non-displaced Jones fracture. Correct statement?
a/ Treatment: short leg NWB cast 6-8 wks, repeat x-ray.
b/ Treatment: immobilize in stiff-soled shoe 6-8 wks, repeat x-ray.

7M Aboriginal with sore throat, fever, reduced appetite, no rhinorrhea/cough. Exam: inflamed pharynx, petechiae, swollen tonsils w/ pus. Correct management?
a/ First-line for suspected GAS: oral phenoxymethylpenicillin.
b/ First-line for suspected GAS: oral cephalexin.

46 lady, post-hysterectomy for AIS, recovered, no cervical pathology on histopath. Need for future screening?
a/ Advise vaginal vault annual co-testing indefinitely.
b/ Advise HPV testing of the vaginal vault every 5 years.

13M w/ L foot pain post-football, tender 5th metatarsal, x-ray: non-displaced mid-shaft fracture. Correct statement?
a/ Immobilize L foot in CAM walker 4-6 wks, clinical review.
b/ Strap foot w/ compression bandage for 4 wks.

53F with HF, LVEF 35%. On enalapril & bisoprolol, normal renal function. What other med expected?
a/ Spironolactone 25mg orally daily
b/ Diltiazem 180mg orally daily
c/ Frusemide 20mg orally daily

66 male retired farmer, hx BCC, extensive sun exposure. New 7mm pigmented lesion on back, asymmetric, irregular border, blue-white veil. Next step?
a/ Urgent excisional biopsy w/ 2mm margins.
b/ Urgent deep shave biopsy.
c/ Urgent 4mm punch biopsy.

19 lady student w/ painful red R eye, hx asthma, uses old contact lenses. Blurry vision, yellow discharge, corneal infiltrate, purulent. Pathogen for >60% keratitis?
a/ Pseudomonas aeruginosa
b/ Neiserria gonorrhoea
c/ Corynebacterium diphtheriae

28 female never had cervical screening, prefers self-collection, no symptoms, negative pregnancy test. Advice on self-collected cervical screening?
a/ If HPV 16/18 detected, refer for colposcopy & liquid-based cytology.
b/ Not eligible for self-collected cervical screening.

56 lady with T2DM, poor dentition, inflamed gums. True statement re: periodontitis and T2DM?
a/ Type 2 DM doubles risk of periodontal disease.
b/ Periodontal disease doesn’t affect blood glucose control.

17 male with fever, sore throat, abdo discomfort, started on antibiotics. Developed itchy rash, enlarged tonsils w/ pus, tender cervical nodes. Advice?
a. The rash will self-resolve without treatment
b. Strictly avoid penicillins in the future

67 male with 12-month worsening SOB, dry cough. Diagnosis of ILD supported by?
a/ Signs of pulmonary hypertension
b/ Low FEV1/ FVC ratio
c/ Signs of left-sided heart failure

62 male with hx MI, HTN, hypercholesterolemia, depression, prostate cancer w/ bony mets. Interested in Sativex for pain. Advice on medicinal cannabis?
a/ Avoid THC products (e.g., Sativex) due to MI history.
b/ Therapeutic CBD doses lower than THC: 2-10mg vs 20-50mg.

24 male with gender incongruence, starting feminising hormones, on estradiol & spironolactone. Advice on anti-androgenic therapy?
a/ Anti-androgenic therapy reduces erection ability.
b/ Libido unchanged despite spironolactone.

45 lady newly diagnosed w/ hypothyroidism. Daughter wants to know most common cause in Australia. Common cause?
a/ Autoimmune lymphocytic thyroiditis
b/ Amiodarone
c/ Amyloidosis

55 male with hx diverticulitis, now w/ 1-day severe abdo pain, vomiting, fever, leaving for biz trip tmr. Needs antibiotics to recover. Next action?
a. Advise in-person visit for examination, not phone appt.
b. Order CT abdomen/pelvis scan.

36 male going to Cairns during rainy season, plans rainforest visits. Worried about dengue. Advice?
a. Advise him that repeated infections with dengue can be life-threatening.
b. Advise him that the mosquitoes infected with dengue in Australia are usually found outdoors.

72 female w/ T score -2.1 hip, -2.0 spine, low vit D (40). Sun exposure daily but covered up. Advice for vit D deficiency?
a. For mild Vit D deficiency (30-49nmol/L), 1000-2000 IU/day.
b. Aim for at least 900mg calcium/day from diet.

50F fingers change color, turn white and painful in cold. Hx gardening. Next treatment after gloves?
a. Amlodipine 5mg orally daily.
B, Metoprolol 25mg orally twice a day.
C, Aspirin 100mg orally daily.

83 old man w/ CKD, widespread itch disturbing sleep, no rash, dry skin, or infection. Using emollient. Other treatments?
a/ Oral evening primrose oil.
b/ Oral prednisolone.

25 man new mildly itchy rash on back, hx manual labor. Hyperpigmented tan macules, diagnosed as pityriasis versicolor. First-line treatment?
a/ Anti-fungal shampoo (e.g., Ketoconazole 2%) daily for 5 days.
b/ Diprosone 0.05% ointment daily until resolution.

67 lady with diabetes, ongoing R shoulder stiffness 6-8 wks, no pain, no trauma. Restricted ROM, esp external rotation. Likely diagnosis?
a/ Frozen shoulder
b/ Rotator cuff strain
c/ Sub acromial bursitis

29 male adventurer, had acute mountain sickness on Kilimanjaro, plans trip to Cusco. Seeking advice on Acetazolamide prophylaxis. Advice?
a/ Acetazolamide strongly recommended as prophylactic therapy.
b/ Acetazolamide unnecessary for 2-day Cusco trip.

68 male had vesicular rash L T4, now has severe electric pain at site, oral meds not helping. Next treatment?
a/ Lidocaine 5% patch, up to 3 patches, wear 12 hrs.
b/ Fentanyl patch 12mcg/hr, change every 72 hrs.
c/ Oral naproxen 500mg BID.

27 female with L upper limb DVT, no family hx of clotting disorders. Discussed treatment and thrombophilia testing. Advice on testing?
a/ Thrombophilia testing indicated, eligible for Medicare rebate for Factor V Leiden and prothrombin variant.
b/ Thrombophilia testing not indicated, no family history.