AMC MCQ Recalls MARCH 2025

32 lady, refugee from Afghanistan, well, no PMHx, unknown vax status. Non-smoker, no EtOH, no illicit drugs. Infectious diseases to test?
a Strongyloidiasis, HIV, tuberculosis
b Hepatitis C, schistosomiasis, malaria

New Rx study for novel virus. Mortality: control 20%, Rx group 10%. ARR?
A ARR = 10%
b ARR = 20%

28 lady, asymptomatic, on OCP, unvaxxed for HPV. CST: HPV (not 16/18) detected, NILM, intermediate risk. Next step?
a Repeat her Cervical Screening Test in 12 months
b Refer to a gynaecologist for colposcopy examination

67lady with COPD, 4-day cough, runny nose, mild SOB post-grandson’s URTI. No fever, stable vitals, usual sputum. Wants abx. Initial mgmt?
aSalbutamol 100mcg MDI w/ spacer, 4-8 puffs q3-4h
b Paracetamol 1g PO QID PRN

88lady in RACF, recurrent UTI hx. New freq urination + confusion. Urine dip: +leuk, blood, nitrites. Mgmt?
a Do not commence prophylactic antibiotics
b Recommend intermittent self-catheterization

40lady, 12-month weakness, fatigue, 5kg wt loss, ↓ appetite. Labs: mild hypoNa, hyperK, fasting glucose 3.3. Diagnosis?
a Addison’s disease
b Cushing’s syndrome
c Conns syndrome

74 yo man, severe lower abdo pain, acute urinary retention. Hx of nocturia, hesitancy, poor flow, enuresis. DRE: smooth, enlarged prostate. Cause?
a BPH
b Acute bacterial prostatitis

55 lady, fever, CP, SOB, dry cough, RA on MTX & ramipril. Exam: bibasal crackles, CXR: diffuse infiltrates. Cause?
a Drug induced pneumonitis
b Bacterial pneumonia

35 lady, 2-mo R facial pain radiating to ear, jaw, neck. Dull ache, worse w/ chewing. Exam: afebrile, diffuse mild tenderness R temple to jaw. Diagnosis?
a Temporomandibular joint dysfunction
b Dental abscess
c Parotitis

63 male, snoring w/ apnea, wife concerned. Rural GP, in-home sleep study preferred over travel. Medicare criteria?
a OSA50 >5 OR STOP BANG >4 AND Epworth Sleepiness Scale >8
b OSA50 >6 OR STOP BANG >5 AND Epworth Sleepiness Scale >10

Child w/ 1-day limp, able to walk but uncomfortable. Improves w/ paracetamol. Afebrile, limited hip ROM, esp internal rotation. Age range?
a 3 – 10 years
b 6 months – 18 months

79 male w/ 3 falls in 12 months, no acute injuries. On frusemide, amlodipine, sertraline, atorvastatin, teazepam. Recent bloods normal. Fall prevention strategy?
a/ Encourage tai-chi
b/ Recommend hip protector

12month girl w 3-day fever, irritable, vomiting. Mottled, lethargic, weak cry, dry mucosa, no rash. No focal signs, no fever source on exam. Likely cause?
a Urinary tract infection
b Pneumonia

Clinic receptionist w/ mild lower back pain & stiffness after lifting printer. No known med hx, never seen as pt before. Next step?
a Advise seeing a doctor outside her clinic
b Full hx & exam needed in dedicated appt

4month old w/ 2-day fever, rhinorrhea, cough, wheeze, ↓ feeding. RR 60, HR 170, SpO2 92%, mod resp distress, crackles, wheeze. Management advice?
a Amoxycillin 30mg/kg PO q12h x 5d
b Amoxycillin 15mg/kg PO q8h x 5d

7 month with hx of bee sting allergy, had anaphylaxis (rash, wheeze) post-sting. Mother gave IM adrenaline, now well, SpO2 95%, mild wheeze. Next step??
a/ Observe in ED ≥3h, give Salbutamol 8-12 puffs (100μg) w/ spacer
b/ IM promethazine, d/c w/ safety advice

45man with 2-day SOB, cough, lethargy, fever. Temp 38.7°C, RR 28, crackles at L base. Most likely organism?
a Streptococcus pneumoniae
b Chlamydia pneumoniae
c Legionella pneumophilia

42lady wants wt loss surgery, failed diet & exercise. BMI 34, hx of HTN on perindopril. Eligibility criteria?
a BMI >35 or >30 w/ obesity-related comorbidity unresponsive to non-surgical tx
b BMI >30 or >25 w/ obesity-related comorbidity unresponsive to non-surgical tx

54M w/ CRC concern after friend’s dx. Well, no meds, no fam hx. FOBT neg 9m ago. Risk reduction advice?
a Ensure he avoid or limit the intake of alcohol
b Annual faecal occult blood tests

29 lady planning Fiji trip in 2m. Staying in resort, exploring islands. No sig med hx, up-to-date childhood & COVID vax, never had travel vax. Travel vax & prophylaxis?
a Hep A, typhoid, cholera, polio vax
b Mumps, rotavirus, diphtheria vax

12 female with hair loss, mainly front & sides, some short hairs retained. No rash, no scaling, normal follicles on dermoscopy. Upcoming dance comp, mom wants urgent fix. Diagnosis?
a Traction alopecia
b Tinea capitis
c Alopecia areata

4yo boy, fever x5 days, poor oral intake. Dry cracked lips, red tongue, red eyes w/o discharge. Cervical LN large & tender, red swollen palms/soles. Important diagnosis?
a Kawasaki Disease
b Roseola infantum
c Rubella

35F, 6wks joint pain/swelling in fingers, morning stiffness, better w/ activity. MCP joints swollen, erythematous, +MCP squeeze test. No fever, rash, or weight loss. Most specific RA test?
a/ Anti-cyclic citrullinated peptide (Anti-CCP)
b/ Anti-nuclear antibody (ANA)

42yo pt requests abx before wisdom tooth extraction, hx of alveolar osteitis. No PMHx, no meds, PCN allergy. Advice?
a/ Prophylactic abx not helpful
b/ Amoxicillin/clavulanic 875/175mg PO BID, start 2d pre-procedure

70M w/ metastatic prostate CA, lumbar mets, ongoing back pain. Started on morphine CR 15mg BD, needs breakthrough dose. Breakthrough morphine dose?
a/ 1/12 – 1/6 of total daily dose PRN
b/ 1/10 – 1/5 of total daily dose PRN

81yo in aged care, advanced Alzheimer’s, severe agitation. Risperidone 0.25mg BD trialed after non-pharm failed. Weekly review planned. When to wean & cease?
a/ 12 weeks time
b/ 16 weeks time

45M post-travel STI screen, MSM, inconsistent condom use. Painless penile ulcer, non-tender inguinal LN. Likely cause?
a/ Treponema pallidum
b/ Neisseria gonorrhoea

39F on POP (Microlut), missed dose by 4.5h, unprotected sex before remembering. Took missed pill 1h late, concerned about pregnancy. Advice?
a/ Get emergency contraception now, continue pill 8 AM daily, condoms till 3 consecutive pills taken
b/ No EC needed, continue pill 8 AM daily, condoms till 3 consecutive pills taken

44F w/ 4mo worsening headaches, exam shows bitemporal hemianopia. Suspect pituitary adenoma. True statement?
a/ Visual impairment from tumor extension to optic chiasm
b/ Pituitary adenomas usually benign

10yo boy, R shin pain worsening over 1h, spreading up leg. No injury, no bite mark, alert & oriented. Most concerning sign for red back bite?
a/ Agitation
b/ Hypotension
c/ Bradycardia

27M had unprotected sex 5 days ago w/ new male partner who had syphilis 6 months ago. No ulcers or rashes. Concerned about syphilis. Mgmt advice?
a/ Syphilis serology now, tx w/ benzathine benzylpenicillin 1.8g IM stat before results
b/ Syphilis serology now, tx w/ benzathine benzylpenicillin 1.8g IM stat if positive

46M w/ months of tiredness, unrefreshing sleep, morning HA, daytime sleepiness. Drinks beer most days after work. Obese (BMI 36), BP high. Dx?
a/ Obstructive sleep apnoea
b/ Anaemia
c/ Chronic fatigue syndrome

71M w/ T2DM (10 yrs), HbA1c 7.8%, early diabetic retinopathy. On irbesartan, simvastatin, sitagliptin/metformin. Which med slows DR progression?
a/ Fenofibrate
b/ Aspirin
c/ Perindopril

70F w/ bilat watery, itchy eyes, no response to antihistamines. Feels gritty in AM, occasional burning, yellow crusts on eyelids. VA 6/6. Next step?
a/ Warm compress, lash scrubbing w/ diluted baby shampoo
b/ Start saline lubricating eye drops

55F w/ COPD, 3-day fever, productive cough. RR 32, O2 sat 93%, bronchial BS RLL, CXR: RLL consolidation. Red flag sign ?
a/ Respiratory rate 32 breaths/minute
b/ Temperature 38.5 degrees Celsius

23M, footballer, w/ sudden L groin & scrotal pain, vomiting. L hydrocele, erythema, neg Prehn’s. Most important dx?
a/ Torsion of the left testis
b/ Left-sided epididymitis

34F, 32 wks preg, 2-day pleuritic CP & SOB. L calf pain/swelling 1 wk post-long car trip. HR 110, O2 94%. Next step?
a/ Arrange an urgent left lower limb venous duplex ultrasound
b/ Arrange an urgent D-dimer

5F, regular f/u w/ mother. Father (DV history, unknown custody status) calls for info. Next action?
a/ Cannot provide info w/o verifying custody
b/ Advise father to contact mother for medical info

38M, 3-month R groin pain, no injury. Antalgic gait, +Trendelenburg, painful ↓internal rotation. X-ray normal. Next test?
a/ Magnetic Resonance Imaging
b/ Ultrasound

21F w/ 4-month binge eating (3x/wk), fasting/laxative use, no vomiting/excessive exercise. BMI 24. Dx?
a/ Bulimia nervosa
b/ Anorexia nervosa