Australian Medical Council (AMC) MCQ Recalls AUGUST 2024 compilation
35 yr female, came with complaints of severe nausea, abd pain and vomiting. Recently Came from Thailand. She mentioned here husband and son also had same food but they don’t have any symptoms at all. Her menstrual history is fine with 27 days cycles and bleeding for 3 days except last week when periods came a week late and for 9 days. On physical examination he has generalised tenderness. What is the most accurate test to make the diagnosis?
- Hcg
- Lipase
- upper USG
- STI screening
Concern about Alzheimer’s for new anti depressants Drug study ?
Cohort/case control/Randomized
Death certificate in primary cause of death ( #neck of femur ,Pulmonary embolism )
22 lady, new mom, anxious, teary, struggling w/ 6-wk-old baby. Mood swings, losing interest, irritable. No hx of mood problems. Diagnosis?
a. Post natal depression
b. Adjustment disordera
c. Bipolar Affective Disorder
62 male, painter, freq. urination, poor sleep, urinary incontinence. Smokes, smooth prostate, normal neuro exam. Next tests?
a. Bladder diary, eGFR, fasting blood glucose, PSA, bladder scan, renal tract imaging
b. Fasting blood glucose, PSA, bladder scan, cystoscopy, eGFR, bladder diary
42 male Melanoma patient on immunomodulatory Rx now present with watery diarrhoea and normal except fatigue. What to do
Gancyclovir
Hydrocortisone
Azithromycin
Infliximab
77 male, routine BP check, full-time carer for wife w/ Alzheimer’s. Receives home help. Correct statement?
a. Comprehensive training can delay functional decline in dementia
b. No evidence that training impacts dementia outcomes
Menopause lady with itching and redness of vulva for 3 months, no other symptom, next
Punch biopsy
Skin scraping
Estrogen levels
32 male, 1-wk cough, worse in 24h, vomiting after coughing. No fever, clear chest. Recent contact w/ cousin. Management steps?
a. Nasopharyngeal aspirate for pertussis PCR
b. Pertussis serology
45 male, STI screen, returned 2wks ago from trip, multiple partners, inconsistent condom use. Asymptomatic. Testing frequency?
a. 3 monthly
b. yearly
c. Twice per year
case of left leg both bone fractures with laceration , pale , swelled but pulses are intact. Pt is given analgesics What to do next
Wound debridement
Fracture reduction
Fasciotomy
Antibiotics
Analgesics
28 lady, new patient, 6wks 5d pregnant, irregular periods, no pregnancy supplement. Advice on folic acid 5mg?
a. If type 1 diabetes
b. If PCOS
c. If BMI 27kg/m²
A 26-year-old woman presents for her first antenatal visit at 1othweek of her pregnancy. On history, her mother has type II diabetes mellitus. Which one of the following would be the recommended screening test for gestational diabetes mellitus (GDM) for her?
A. 2-hour 75 gr OGTT between 24 and 28 weeks.
B. 2-hour 75 gr OGTT now.
C. Fasting blood glucose (FBS) now.
D. Fasting blood glucose (FBS) between 24-28 weeks.
E. 3 hour 100 gr OGTT between 24-28 weeks.
17 lady, heavy periods, easy bruising, epistaxis, on oral contraceptives. Suspect Von Willebrand Disease. Correct statement?
a Von Willebrand Disease is the most common inherited bleeding disorder
b Von Willebrand Disease causes Factor V deficiency
A woman presented with tiredness and fatigue. Her TSH was normal, T4 was decreased and T3 was normal. Repeated tests after 1 month showed the same findings. What will you do next to establish the diagnosis?
A – MRI brain
B- Thyroid scan
C – Anti-TPO antibodies
D – Thyroglobulin antibodies
E- Xray head and neck
22 male, rolled L ankle, pain, swelling, tenderness. Unable to weight-bear initially, now hobbling. Next step?
a Ankle x-ray and same-day review
b Ankle strapping and review in 2-3 days
58 lady, gradual R hip pain, worsens at night, radiates down thigh, point tenderness over greater trochanter. Diagnosis?
a Trochanteric bursitis
b Osteoarthritis of the hip
c Meralgia Paraesthetica
atorvastatin 40 mg started 6 months alcoholic 1-2 std per day liver enz raised GGT AST ALT 2 times all other are normal underling DM HTN taking thiazide and..no symptoms at all
appropriate next step –
USG abd
stop statin
advise to stop alcohol
review previous blood tests
Pt with DM, undergone CABG 5 yrs ago.
On aspirin Presented with r/ TIA features.
Carotid duplex reveals bfl carotid artery stenosis 60% whats is the next appropriate mx?
A. carotid angiogram
B. Add warfarin
C. Add clopidogrel
D. Carotid endarterectomy
26yr old lady pregnancy test positive and 6 weeks of amenorrhoea present with small amount of vaginal bleeding.Vitals normal.BP 100/70 PR 88 Spo2 100 O/E mild supra pubic tenderness.On palpation speculum examination long cervix with fornix mass Os open mild pv bleeding. What is the best dx
- Cornual ectopic pregnancy
- Fibroid complicating red degeneration of pregnancy
- Cervical pregnancy
- Ruptured ovarian cyst
2yo boy, hoarse voice, barking cough worse at night, no stridor at rest, slight wheeze. Management?
a. Oral prednisolone 1mg/kg now and next evening
b. Oral prednisolone 2mg/kg for one night
78 man, HIV+ since late 1980s, on various antiretrovirals. Age-related comorbidities?
a Increased risk of osteoporosis, MI, neurocognitive decline
b Increased risk of osteoporosis, MI, bowel cancer
2 yo girl, skin lesions on legs, pearly papules w/ umbilication. Not itchy or bleeding. Advice for condition?
a Condition spread by shared baths/towels
b Papules resolve in a few weeks
3wks old baby, fever, rhinorrhoea, feeding less. Temp 38.8°C, no rash. Next step?
a. Immediate ED referral for septic workup and antibiotics
b. Reassurance of likely viral infection and safety netting
64 year old pain in right ancillary region. On examination painful vesicular rash for 5 day duration .mx
- Acyclovir
- Prednisolone
- Carbamazepine ( Trigeminal Neuralgia )
- Acylcovir + prednisone
- Sumatritan injection
Wife bitten by monkey in Thailand, no rabies prophylaxis, last tetanus 12m ago. Advice?
a. Immediate wound management, rabies vaccine, and rabies immunoglobulin
b. Immediate wound management and rabies vaccine
Patient with clcd. On awaiting inguinal hernirapohy . In post op assessment. Plt 90 INR 1.8 what’s is the most appropriate methods to reduce bleeding during surgery
- Plt transfusion
- Ffp
- Tranexamic acid
65 yr male palnning for hemicolectomy for diverticulitis. Asking about DVT profilaxis
Enoxa until discharge
Enoxa for 14 days
Enoxa for 28 days
30 lady, 34wks gestation, itching on hands/feet, elevated ALP. No rash or xerosis. Next step?
a. Recheck liver function and bile salts in 1 week
b. Prescribe ursodeoxycholic acid
12 boy, painful, red, tender foreskin, discharge. Likely diagnosis?
a- Balanitis
b- Smegma collection
c- Dermatitis
Patent with DM. Alchohol history +. On dietory management of DM had diarrhoea had developped acute SOB.CBS 6.5.ABG shows ph 7.12
HCO3 15
PaO2 100
PaCO2 48
Diagnosis ..
Hyperclorimoc metabolic acidosis
Lactic acidosis
hypercarbia
Diabetic ketoacidosis
Alkoholic acidosis
36 lady, 1m headache, nausea, ringing ears, blurred vision. Bilateral disc swelling. Diagnosis?
a. Idiopathic intracranial hypertension
b. Cerebral tumour
c. Cervical Spondylosis
52 guy, bronchiectasis, increased cough/sputum, low-grade fever. Allergy to penicillin. Best treatment?
a. Doxycycline 100mg BID for 10-14 days
b. Amoxicillin 500mg TID for 10-14 days
36 lady, 3d painful, watery R eye, worse w/ movement, slight vision blur. Cause?
a Scleritis
b Bacterial keratitis
c Corneal foreign body
57F, COPD, concerned about flight. Supplemental oxygen threshold for resting SpO2?
a SpO2 < 88 %
b SpO2 < 98%
c SpO2 < 96%
58 lady, post-menopausal, on denosumab for osteoporosis. DEXA confirms T-score -2.8 hip, -2.7 spine. Denosumab statement?
a Denosumab for osteoporosis in high-risk postmenopausal women
b Denosumab given IV once a year
58 lady, antero-lateral thigh pain with tingling, burning, worse walking, better sitting. Reduced sensation on exam. Likely diagnosis?
a Meralgia Paraesthetica.
b Multiple sclerosis.
71 male, wants QUS instead of DXA for osteoporosis, concerned about radiation. Evidence-based advice?
a QUS of heel not useful for osteoporosis diagnosis
b No evidence for QUS in osteoporosis management
29F, 2wks vaginal spotting, L-sided pelvic pain, IUD in situ. Mild lower abdominal tenderness, closed os. Important diagnosis?
a. Ectopic pregnancy.
b. Appendicitis.
c. Implantation bleed.
50M, 6m dry cough, SOB on exertion, fine bibasal crepitations, finger clubbing. Likely diagnosis?
a. Interstitial lung disease.
b. Acute asthma.
c. Acute pulmonary oedema.
patient with lumbar stenosis being assessed for surgery. has MDD and HTN. taking Duloxetine tramadol peridopril and Amitriyline. what to do before suergery?
A no action needed
B Cease Duloxetine
C reduce Duloxetine to once a day
D crease Duloxetine gradually
E stop TCA
42M, Hep A outbreak, positive Hep A IgM, elevated AST/ALT, never vaccinated. Should wife get Hep A vaccine?
a- If wife is a carer of a developmental disability
b- If wife is a residential aged care worker
67M, 6wks hoarseness, no cough or dysphagia, past URI. Gravelly voice, unremarkable exam otherwise. Best advice?
a- Urgent ENT referral
b- Cease perindopril, start amlodipine 5mg daily
patient came with complaint of macroscopic hematuria .. he was diagnosed with c ANCA vasculitis couple of months ago due to recurrent hematuria and started on Prednisolone and Cyclophosphamide .. uranalysis showed ++ RBCs negative for UTI .. Wht would be next appropriate management:
Cease Cyclophosphamide
Cystoscopy
CT IVP
USG
34F, hair loss 3m postpartum, general thinning, no scalp inflammation, nail changes. Likely cause?
a Telogen effluvium
b Alopecia areata
c Hypothyroidism
5M, foreskin not retracting fully, no urination issues, smegma, normal foreskin exam. Management advice?
a No intervention needed for child
b Foreskin should retract by age 5; refer to urologist
27M, snake bite, stable vitals, nausea, abdominal pain. When to consider anti-venom?
a Spontaneous epistaxis and gingival bleeding
b Vomiting; other signs/tests normal
65F wants DXA scan for osteoporosis after friend’s diagnosis. What risk factors qualify for a Medicare rebate for DXA?
a Anti-androgen therapy
b History of multiple falls
c Hypothyroidism
middle-aged women diabetic hx + presented with tingling sensation on lower limbs and LMN signs in both upper and lower limbs but lower limbs affected more than upper …no sensory loss mentioned:
pernicious Anemia
myasthenia gravis
Acute inflammatory polyneuropathy
Diabetic neuropathy
55M, on ramipril, amlodipine, statin, aspirin, omeprazole, has daily leg swelling but no SOB or calf tenderness. Next step?
a Cease his rosuvastatin
b Cease his amlodipine
48F, 2d dizziness, rotational nystagmus, worse w/ head turns, no hearing change. Likely diagnosis?
a Benign paroxysmal positional vertigo
b Acoustic neuroma
middle age man with prostate CA With spinal Mets and was started on ADT , presented for assessment of BMD and found to be T-score -1.0 with normal Calcium and Vitamin D levels ..Wht will be your next additional management for him :
Start Calcium and Vit D supplements
Start Alendronate
No additional therapy
BMD assessment 6monthly
32F, daily frontal headaches worsening, no nausea, light/sound sensitivity, resolves by evening. Likely diagnosis?
a- Tension type headache
b- Acute bacterial sinusitis
28M, itchy rash on extensor surfaces, weight loss, recurrent diarrhea. Suspected Dermatitis Herpetiformis. Confirmatory tests?
a Skin biopsy for histopathology and direct immunofluorescence
b IgA levels
c Thyroid function tests
83F, red, swollen, tender knee, no injury, normal joint movement. Most likely diagnosis?
a Acute gout
b Osteoarthritis
c Rheumatoid arthritis
58F, distressed about sister’s breast cancer, normal mammogram 12m ago, wants to reduce her risk. Advice?
a Reduce her alcohol consumption
b Adopt a low-fat diet
One was related to MVA / deteriorating condition .. patient came with tachycardia ,Tachypnae,Hypotension ,distended neck veins and crackles throughout lungs ..asked for which feature will limit your success of resuscitation :
Tachycardia
Tachypnae
Hypotension
Raised neck veins
Crackles in lungs
74F, finger pain, hip/knee pain relieved by rest, diagnosed with osteoarthritis. True statement about OA?
a Crepitus and reduced range of motion in joints
b Commonly affects metacarpophalangeal joints
65M/F couple, cruise ship holiday, recent norovirus outbreak. Best advice for them?
a High-risk foods for norovirus: sandwiches, salads, ice, oysters
b No risk of norovirus for new cruise passengers as ship decontaminated
32F, 6m fatigue, nausea, loss of appetite, low BP, elevated potassium, low sodium. Likely diagnosis?
a. Addison’s disease
b. Pheochromocytoma
c. Conn’s syndrome
A patient working as manager in company with delaying in Work, studies postponed, & difficulties in organizing works W poor conc. All started after an event (don’t remember) before 3months asking what you look to support diagnosis?
A. Increased forgetfulness
B. Anxious and fidgeting appearance
C. Impaired memory and concentration
D. Difficulty in organizing tasks and postponed activities
A child has been diagnosed with impetigo; and a cephalosporin has been prescribed Considering this, which recommendation regarding school exclusion would be most appropriate to prevent the spread of the infection?
A. Exclude the child from school until the completion of the antibiotic course.
B. Allow the child to attend school but advise frequent handwashing and avoidance of close contact
C. Exclude the child from school until the lesions are completely healed
D. No need for school exclusion; impetigo is not highly contagious.