AMC MCQ Recalls AUGUST 2023

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Professor Steve Robson, the President of the AMA, communicated with health ministers nationwide to express the association’s opposition to the upcoming rise in medical registration fees. The letters were directed at state, territory health ministers, and Federal Health Minister Mark Butler. This action was taken based on information received by the AMA indicating that AHPRA’s registration fees are projected to see an approximately 16% increase for the next year.

Within these letters, Professor Robson conveyed his disapproval of the fee hike, highlighting that much of this escalation is attributable to initiatives mandated by health ministers. These initiatives encompass reforms in cosmetic surgery and endeavors aimed at facilitating the entry of international medical graduates into the system.

Professor Robson conveyed to the ministers that the additional funding required for AHPRA to carry out these vital regulatory functions should be sourced from governments, rather than transferring the financial burden onto physicians themselves. In his correspondence, he emphasized the notion that there exists a strong rationale for the Health Ministers’ assembly to contemplate supplemental funding for AHPRA. This additional funding would enable AHPRA to effectively fulfill its routine obligations while also managing the growing demands being placed on it by Health Ministers.

We would like to extend a huge thank you to those who have provided us with these recalls. It is now our turn to do our part and help solve them for you. You can obtain them from here.  

Australian Medical Council (AMC) MCQ Recalls AUGUST 2023 compilation

Mother with 12-year-old child requesting screening for familial hypercholesterolemia as her father recently diagnosed to have that and there are many other family members with premature heart diseases. Your action?
a) Lipid profile
b) Screen the whole family
c) Screen the daughter
d) Say that daughter is not eligible now

22male with sudden onset dyspnea, sharp R-sided chest pain worsened by inspiration)cough. Smoker, BMI 19.3 kg)m2. Chest x-ray: small R apical pneumothorax. Next step?
a) Chest tube placement
b) Supplemental oxygen
c) Talc pleurodesis

A 57 male w nausea, dark urine, decr. urine output. Fatigue, muscle pain, weakness for 1 wk. Hx: CAD, stent, HTN, gout, OSA. Meds: aspirin, ticagrelor, simvastatin. Right great toe inflamed. Next step?
a) Renal ultrasonogram
b) Serum creatine phosphokinase

A patient with history of Esophageal operation due to cancer last week.
He feels constant pain over his left lower chest since last week.
In Examination RR :30 PR;130
Decreased lung sound in left lower lobe along with dullness in percussion.
ECG Irregular Irregular
What’s the best investigation for diagnosis?
a).ECG
b).CXR
c).CTPA
d).CT of abdomen
e).esophagoscopy

56 male w) hx kidney transplant (1yr ago) for FSGS. Follow-up for HTN. Meds: amlodipine, lisinopril, tacrolimus, prednisone. Tacrolimus level normal. Next step?
a) Renal vascular imaging
b) Tacrolimus discontinuance

3yo baby girl with first-time seizure, language delays. Twitching in all limbs, loss of consciousness (1min). Erythematous patch on R forehead, 5-cm hyperpigmented macule on abdomen. diagnosis?
a) Sturge-Weber syndrome
b) Tuberous sclerosis

A patient with a history of smoking ,presented with weight loss,ptosis and miosis along with shoulder pain.
Which investigation?
a).Brain CT
b)EEG
c).douplex of cervical vessels
d) Chest CT

9yo boy w) seizure at school. Sustained flexion of arms, extension of legs, clonic movements (5 min). Decreased muscle strength on L side, brisk reflexes L arm)leg. MRI shows space-occupying lesion R parietal lobe.
a) Ependymoma
b) Glioblastoma
c) Medulloblastoma

Woman presenting with signs of PCOS BMI is 29 trying to conceive for the last 6 months what is your most appropriate management
weight loss
Metformin
clomiphene citrate
hysteroscopy

Question about blood gas changes In hyperventilation due to panic attack
a) pao2 102, ph :7.48 Pco2 27
b) Pao2 102 ,ph: 7.28 ,pco2 43
c) pao2 72 ,ph 7.52 .pco2 27
d) pso2 72, ph 7.28.pco2 43

A 19 year old lady presented w red, painful R eye. Uses 2 weekly disposable contacts longer due to cost. Blurry vision, yellow discharge. Corneal infiltrate, injected conjunctiva, purulent discharge. plan?
a) Commence oral cipro AND topical CMC 0.5% eye drops, advise her to wear glasses instead of contact lenses until treatment is complete
b) Refer for emergency opth review the same day, advise her to wear glasses instead of contact lenses and to take her contact lens with her to the appointment today so that they can be sent for culture

74 lady unconscious in GP waiting room, abnormal breathing. Started Basic Life Support, compressions and rescue breaths. Recommended compression to rescue breath ratio for optimal survival?
a) 30:1
b) 30:2

There was a question about a man with a mixed aortic valve problem. Hx of endocarditis 10 years back . Now, he wants to go for a prostate biopsy. His urine misstatements culture was negative.
Was asking about prevention of endocarditis
A)not necessary
B)oral ciprofloxacin 24 hours before
C)oral ampi + metronidazole one hour before
D)IV Ampi +ceftriaxone during procedure
E)IV Ampi + Ceftriaxone one hour before

child 6yrs old brought by foster carer with complaints of imitating sexual activity with neighbor , planned to stop placement.child’s mother was prostitute and child was bought to foster care coz of physical abuse. what is immediate next step?
a) refer to child psychiatry
b) immediately notify child protection service
c) placement to experienced carer
d) counseling to carer

7month old baby girl with eczema, mother worried about food allergies. Breastfed, tried rice, carrot, tomato, potato (rash w tomato). Advice on food allergies in babies?
a) continue avoid feeding tomatoes until after age 12 months due to the rash that developed around her mouth
b) offer her baby peanuts (pureed to avoid choking risk e.g. peanut butter) regularly prior to the age of 12 months to reduce the risk of developing peanut allergy

71month old w) fatigue, SOB, dizziness, palpitations, chest discomfort. Irregular pulse, urgent ECG. diagnosis?
a) Atrial flutter
b) Ventricular fibrillation
c) Atrial fibrillation with rapid ventricular response

you got a call from police that one of you patient is disturbing neighbour’s, not behaving appropriately…police is asking you whether the patient is on any psychotic drugs?
a.answer the question
b.advice to admit
c.reject as you need patient’s consent

A lady who was not able to speak in English was accompanied by her husband for something non urgent.
Husband is refusing to use a male interpreter.No female interpreter
a) Ask husband to interpret
b) Telephonical interpreter
c) Make a close appointment to use a female interpreter

6mo boy w) lump in L groin for 2 days. More noticeable when crying, unsure if painful. Born at term, no complications. Firm non-transilluminating lump. Reduces with pressure. Next step?
a) Advise the mother that you need to order an ultrasound to confirm the size of the defect and whether any further action is required.
b) Provide the baby with a standard referral to paediatric surgical outpatients to have the condition surgically fixed.
c) Reassure the mother that the condition is unlikely to recur and no further action is required.

8yo boy w) 24hr diarrhoea, abd cramps, mild dehydration, soft abdomen, mild tenderness. cause for bloody stools?
a) Adenovirus
b) Campylobacter
c) Rotavirus

An elderly lady with feeling of fullness in her back and pelvic
In her blood test, Hb was low
MCV decreased
Calcium and phosphate normal
investigation?
a.Serum protein electrophoresis
b.colonoscopy
c.Flow cytometry

A child with repeated body movements since 7 months back.
He bends to touch the floor pulling his arms in the air
Kids are bullying him at school.
Management
a) Habit change?modification?
b) interpersonal
c) psychotherapy

They gave a picture of the abdomen of a child with some bulging just above the umblicus
The mass was soft in examination.
Diagnosis?
a.umblical hernia
b.epigatric hernia
c.lipoma

4yo boy, undescended testes at 6wks. Now, testes appear high but can be moved to base of scrotum. advice?
a) The baby should be referred to a paediatric surgeon as soon as possible for orchidopexy.
b) Advise the mother that the baby requires yearly review and examination with a doctor as one testis or both testes may ascend.

Abdominal xray of a patient was given with toxic megacolon.
She was managed conservatively for 2 day in the hospital.
She changed condition. Her Bp was about 90
Feverish
General abdominal tenderness
Her management?
1.further observation and management in ICU
2.total colectomy

A 15 yo female presented with, 2mo fatigue, intermittent diarrhoea, nausea, flatulence, 3kg weight loss. No abd pain. Stool PCR neg, iron & folate deficiency. diagnosis?
a) Coeliac disease
b) Atrophic gastritis
c) Giardiasis

here was an 80 years old elderly lady from old age home who was not having alzheimer’s Disease and was not taking any medication.
She was brought to hospital because of aggressive behavior and agitation.
In her urine disptiks nitrate was positive.
I’m addition to antibiotics what is your approach to her agitation
1.physical restraint
2.to stay in a drak room
3.start her on antipsychotics

Son comes to your practise regarding his 82 year old mother saying that the nurse from your practise is using his mother for financial purpose as she has been giving her expensive gifts and recently added her to her will as a beneficiary. What will you do?
a) Ask son to speak to nurse
b) Arrange appointment with the mother
c) Raise issue with the nurse
d) Report her to APHRA

A 27 yo gentleman, progressive lower back pain worse at night, improves w) movement. Morning stiffness, decreased ROM. Suspected ankylosing spondylitis. Common extra-axial feature of seronegative spondyloarthritis?
a) Irritable bowel syndrome
b) Atrophic gastritis
c) Giardiasis

78M, stage 4 lung cancer, palliative care. New oral lesions, tongue and mouth affected. Odd taste, mouth dryness. appropriate management?
a) Fluconazole 50mg – 100mg orally daily for 7 days
b) Amphotericin B lozenges, suck 1 lozenge (10mg) four times daily for 7 – 14 days

Bleding peptic ulcer patient came with vigorus bloody vomiting. Controlled with fluid replacement. You did endoscopy and found bleeding ulcer spots. Biopsy of the bleeding tissue shows H. Pylory. What will you do next?
a.Adrenalin injection in the bleeding site.
b.Start triple therapy.
c.Start PPI.

A 20 yo male, small patch hair loss on scalp. History of atopic eczema. Normal skin on dermoscopy. Short hairs, tapered appearance. diagnosis?
a) Alopecia areata
b) Folliculitis decalvans
c) Kerion

Patient with abdominal pain, vomiting, BP normal, PR 102/min, X-ray of SBO features, after some hours of initial management, pain increased, PR 120/min, what next?
a) CT abdomen
b) USS
c) Surgical exploration
d) Nasogastric tube

62 man, sildenafil for erectile dysfunction. Mild headache once. Wife wants to know other side effects. Discuss common side effects.
a) Vision loss, dry mouth, palpitations
b) Nasal congestion, flushing, dyspepsia

4mo girl, mother needs advice for introducing solids. Son had egg anaphylaxis, husband had childhood asthma, mother has coeliac disease. advice?
a) Delay the introduction of nut products into the baby’s diet until she is at least 2 years old
b) Introducing solids from 4 months of age may decrease the risk of coeliac disease

18mo boy for routine vaccinations. No significant past medical history, term birth, no contraindications, no known allergies. Recommended vaccination?
a) Measles, Mumps, Rubella, Varicella (MMRV)
b) Measles, Mumps, Rubella, Varicella (MMRV) and Diphtheria, Tetanus, Pertussis (DTPa) and Haemophilus influenzae type b (Hib)

Female frequently preset to gp with bruices and petechae,now presented to gp and complain that physical violence by husband is more severe,husband is waiting out side for her(seems like he is waiting to harm her)
What is the most appropriate next step
a)Call husband inside to counsell
b)Admit wife to hospital
c)Call police

48F w hyperthyroidism, high T4, low TSH. Poor radioisotope uptake. diagnosis?
a) Subacute thyroiditis
b) Thyroid carcinoma
c) Toxic adenoma

36M w painless lesion inside L cheek. Dad has oropharyngeal SCC. Non-smoker, no PMH, takes no meds. diagnosis?
a) Oral linear frictional keratosis
b) Oral lichen planus
c) Oral candidiasis

67M w severe central chest pain, nausea, sweating. ECG findings below. Diagnosis?
a) Acute posterior ST elevation myocardial infarction
b) Acute anterolateral ST elevation myocardial infarction

54M lawyer w recurrent painful, hot, swollen big toe (1st metatarsophalangeal joint) w) high serum urate. Diagnosis: gout. Treating acute flare w) NSAIDs. correct about allopurinol in gout tx?
a) Allopurinol can be started during an acute attack, alongside treatment for acute gout.
b) Allopurinol should be started at the maintenance dose of 300mg orally daily

72yrs old pt is having generalized abdominal pain,hx of past abdominal surgeries.x ray taken.there is dialated colon upto sigmoid and no gas noted in rectum.diagnosis
A)Sigmoidal volvulus
B)CA rectum
C)Cecal volvulus
D)Small bowel obstruction

you got a call from police that one of you patient is disturbing neighbour’s, not behaving appropriately…police is asking you whether the patient is on any psychotic drugs?
1.answer the question
2.advice to admit
3.reject as you need patient’s consent

62yrs old lady with high clinic BP (162/97 mmHg). Recommending home BP readings w clinic’s automated machine. Not keen on 24-hour ambulatory BP recording. correct about home BP readings?
a) Average home blood pressure readings of 135)85 mmHg or more is the threshold for diagnosing hypertension
b) Patients should be advised to take three blood pressure readings daily over a four week period

82F in Residential Aged Care Staff w) new itchy rash on R elbow. PMH: Alzheimer’s, gout, IHD, HTN. Meds: donepezil, aspirin, perindopril, atorvastatin, Panadol osteo, allopurinol. appropriate management?
a) Advise the nurse to immediately cease her allopurinol
b) Recommend a skin biopsy to confirm your suspected diagnosis before commencing ultrapotent topical steroids

Rectal polyp,excisional biopsy done.Changes for Ca extend to resected margines.Colonoscopy and Ct done and no lymph node enlargement.Most appropriate next
A) Sigmoidoscopy and resect remaining part
B) Colonoscopy
C) Follow up with colonoscopy

19 female w fatigue, tingling extremities. Hx: anorexia nervosa, attending Eating Disorders Treatment Program. investigation to order?
a) Iron studies
b) Serum phosphate level
c) Creatine kinase

30yrs female second pregnancy on 12th week of pregnancy. 1st pregnancy miscarried. now 2nd pregnancy with same partner….patient worried about baby getting downs syndrome. what will you advice?

  1. usg at 20 wks and quadruple test
  2. amniocentesis
    3.triple test and usg

80F w mild cognitive impairment, organised w) lists & diary. Daughter wants nursing home, mother prefers staying home. Daughter has Power of Attorney. advice?
a) The mother can only have her capacity assessed by a geriatrician.
b) The mother has capacity to decide where she wants to live if she is able to understand the facts of the decision, retain this information, weigh up the pros and cons and justify her decision.

Middle age man had an injury to left arm yesterday,arm swelling,bullae visible (even away from patient) IV antibiotic given.What’s next?
A Wound swab
B Bld C&S
C Dappled
D USG
E X ray

Young woman with vulva ulcer,viral serology and syphilis pending and patient only come back 2 weeks later,viral clear, RPR titre 1:64.
Treat the patient

A 81yr with MMSE 23/30 especially deficit in recall and location.What’s next?
Reaccess again
Tell patient she may have early Alzheimer
Refer to get care assessment

44F w worsening left foot pain, sharp)burning, worse on walking)standing, between 3rd & 4th toes. Tenderness on 3rd & 4th metatarsals. diagnosis?
a) Morton’s neuroma
b) Tarsal tunnel syndrome
c) Bursitis

10week old pregnant lady pregnant 8yrs ago and had pertussis vaccination.childhood immunization completed.she jot job in a hospital.before going to work she ask whether she need to have pertusis vaccine.your opinion
A)Vaccine at 20 weeks
B)Vaccinate now
C)No need of vaccination at all

73M with weaker urine stream, nocturia x6mo, ‘moderate’ impact on life. Well, normal exam, urinalysis, serum creatinine. initial investigation to guide management?
a) Prostate ultrasound
b) Urine cytology
c) Urinary tract ultrasound

Old man is having generalized abdominal pain and on examination no obvious deep tenderness.abdomen is mildly distended.x ray given.constipation.(colonic dialatation was there upto sigmoid colo)What is the next management
A)Nasogastric tube and IV fluids
B)Gstrografin enema
C)rectal suction tube
D)Sigmoidoscopy and relieve distention

52M w) no symptoms, wants prostate cancer screening. No family history or risk factors. advice?
a) Advise him that there are no risks associated with prostate cancer screening and he can choose to undergo prostate specific antigen testing if he wishes
b) Advise him that there are benefits and harms associated with prostate cancer screening in his case and if he chooses to participate, the most appropriate investigation will be a prostate specific antigen test

Truck driver presented with 3 month history of abdominal bloating,sometimes vomiting,constipation.amd sometimes diarrhoea.no loss of weight.one year back had similar episode and colonoscopy done was normal.what is the most important next step
A)advise to change his diatory habits
B)stool examination for ova,parasites
C)Colonoscopy

53F w hot flushes, menopausal, family hx of breast cancer. No HRT, appropriate treatment?
a) Clonidine
b) Clomiphene
c) Tamoxifen

76M w) pacemaker insertion 3 wks ago. Now red, swollen, painful site w) pocket hematoma. No infection)active bleeding. appropriate management?
a) Aspirate the haematoma with a needle
b) Apply a pressure bandage and contact the cardiologist for advice about his warfarin management

50 female w) bilateral joint pain, stiffness, swelling in wrists and fingers for 1 mo. true about rheumatoid arthritis?
a) Conventional synthetic disease modifying antirheumatic drugs (csDMARDs) take at least 6 months to take effect
b) Omega-3 supplementation can be used as an adjunctive treatment for mild residual joint pain

40M w) htn, gout, on perindopril 5mg & allopurinol 100mg. BMI 36m)kg2, waist circumference 104cm. Abnormal LFTs cause?
a) Gilbert syndrome
b) Metabolic associated fatty liver disease

Return from 6 days trip Thailand, fever, abdominal pain, headache. Likely diagnosis?
a) Malaria
b) Dengue
c) Hepatitis

20yo Aboriginal primigravida at 20 wks gestation. Smokes 10 cigarettes/day since 14yo, wants to quit. Advice?
a) Pharmacotherapy is not recommended for her at this stage.
b) Commence her on bupropion 150 mg orally daily, increasing to 150mg twice a day after three days.

Medical student had needle stick injury, vaccinated for Hep B, patient refusing to check status?
a) Apply to medical tribunal to check patient’s status
b) Discuss the benefits and risk of Post exposure prophylaxis
c) Check the serology later.
d) Give Post exposure prophylaxis

54M with gambling problem. Wife wants him to seek help. No significant medical hx or drug allergies. Not a problem with alcohol or illicit drugs. Management advice?
a) Advise that problem gambling is not a recognised mental health disorder and there are currently no evidence-based treatment options available.
b) Advise that you would recommend referral to a psychologist for cognitive behavioural therapy and further assessment for comorbid mental health disorders.

35M w) acute epididymo-orchitis. Red, warm, tender R scrotum. UA and scrotal ultrasound suggestive. Sexually active, training for a marathon. True statement?
a) Gram positive organisms are commonly the cause of epididymo-orchitis following instrumentation or catheterisation.
b) In sexually active men, epididymo-orchitis is often associated with sexually transmitted pathogens such as gonorrhoea and chlamydia.

Statin induced rhabdhomylosis now recovered. Total cholesterol 5-7 TG 2.1
a) ecetimibe
b) paruostatin
c) nicotine
d) exercise and diet

50F w/ bilateral hand pain, numbness, tingling. Trouble typing accurately, hyper-reflexia of biceps and brachioradialis reflexes. Struggles to pick up paperclips w) fingers. diagnosis?
a) Thoracic outlet syndrome
b) Carpal tunnel syndrome
c) Atlantoaxial subluxation

18F w anorexia nervosa, poor appetite, nausea, reflux, minimal intake for 1+ month. Weight 45kg, BMI 16. HR 45-50)min. factors for admission?
a) Electrolytes, ca, mg, PO4, ESR, electrocardiogram and mental health status
b) Electrolytes, ca, mg, PO4, glucose, full blood count, liver function tests, electrocardiogram and mental health status

You are performing a 45-49 year health assessment on male patient with Bipolar Disorder. You consider he may have high risk for developing T2DM and assess his risk based on the AUSDRISK assessment tool. His AUSDRISK score 12. Risk of type 2 diabetes in 5yrs?
a) Low risk, approximately 1 person in every 100 will develop diabetes
b) High risk, one person in every 14 will develop diabetes

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