AMC MCQ Recalls JULY 2021

Australian Medical Council (AMC) MCQ Recalls JULY 2021 compilation

1) Doctor after night shift from emergency department went to bar. He found his colleagues there and some are having illicit drugs. They have to go to hospital for duty 2 hours later. What will u do?
a) Report to director of emergency department
b) Tell directly to those colleagues
c) Leave and said nothing
d) Inform APHRA

2) 11 year old Child injury during game. Focal tenderness anterior tibia. Fever.
A. Osteomyelitis
B. Osgood Schlatter
C. Septic arthritis

3) Woman with DNR she doesnt need CPR she just need some treatment?

4) Homosexual man has come to screening he has screened for HIV what else you screen for?
a) Hepatitis C
b) Chlamydia
c) Syphilis

4) 12 year old boy with spherocytosis with splenomegaly Hb 4 Rt count of 0.01 wanted to ask treatment
a) Glucocorticoids
b) Steroids
c) Splenectomy

5) Questions about mass in testes sonography of testes sorrounded by fluid transillumination was positive wanted next investigation
a. Check tumor markes

6) 30 weeks pregnant woman with fundal height of 27 weeks first trimester screening was normal whats the cause of discrepancy
a. Renal atresia
b. IUGR
c. 18 trisomy

7) Abdominal xray of a farmer with upper Right quadrant pain the calcified laces and wanted the diagnosis
a. Hydatid cyst

8) ECG of Vtach in adult with low BP and instability whats the tx

9) A man with 24 hr epigastric pain ECG is normal but in sonography bowels are dilated particularly wanted the next step
a. ERCP
b. MRCP
c. CT scan

10) 5 or 6 year old boy with habits like ADHD cant sit in the classroom but milestones and development was normal two things were mentioned about doing something like OCD washing his hands too many times putting his belongings in same order and wanted diagnosis
a. Autism
b. Autism spectrum disorder
c. OCD

11) We give the Child with meningitis Antibiotics treatment and contacts prophylatic to contacts what is the reason of giving prophylactic antibiotics to the contacts
a. Decreasing the incidence of the disease
b. Contacts are without symptoms and they can spread the disease
c. Treating the contact

12) A young boy with fever and pain in testes what to do next
a. UA
b. Blood culture
c. FBE
d. UR?

13) 40 year old man with too many scars in both ear drums and conductive hearing loss in both ears and wanted the reason
a. Intercoastal Tumor??
b. Presbycusis

14) A picture of hyphema after cataract surgery was given what is the dx

15) Young Angry man aggressive was caught by police he had insomnia was agressive was saying some words to police that were like grandiosity and narcissitic what else will help you in diagnosis?
a. Pressured speech

16) Good student recently dropped his grades he is staying at his own room all the time and like covering the windows and everything what will help you to reach diagnosis
a. Talking to himself

17) 72 yr old man with chronic constipation with distention of abdomen nausea and vomiting whats the cause
a. Sigmoid volvuls
b. Fecal impaction
c. Rectal cancer

18) Melanoma of eye what to do
a. Refer him to surgeon

19) A man with multiple peptic ulcers and Hpylori positive with allergy to penicillin what will be the tx for him a. Tetracylin +erythromycin +PPI

20) A case of pneumonia which didnt respond to empiric antibiotics strept A For 48 hours RESULTS came back as pseudomonas antibiotics sensitivity test has not been received what will you do
a. Continue tx with same AB as before
b. We change AB to empiric tx of psuedomonas

21) An old pt diagnosed with cancer treated with oxycodone for his pain what should we give besides oxycodone
a. TCA
b. SSRI
c. Senna

22) Colleague of us taking recreational drugs between visiting patients but it doesnt influence his performance reason for using drugs was separation of his wife
a. Talk to him alone
b. Tell the supervisor about it
c. Report AHPRA

23) As a junior doc you realize a gauze has been left in surgery in opening of the patients body who will you inform
a. Tell the surgeon himself
b. Tell them to count the remaining gauzes out of surgery procedure
c. Tell head nurse

24) A 3 days…??? total bilirubin 244 direct bilirubin 20 her mothers blood group was 0 + this is her first pregnancy what is the cause
a. ABO incompatibility
b. Loss of hepatic uptake
c. Hepatic drug

25) A patient with irreregular red reflex of the eye and visual problem whats the cause
a/ Retinal detachment
b/ CRVO
c/ Papilloedema

26) A patient with FBS 5.7 what to do next
a/ Check OGTT
b/ Check FBS annually
c/ Check OGTT every 2 years

27) 16 yr old girl with sort of at 12 years with no periods but having pain in the tummy at the same time every month. Whats your dx
a/ Imperforate hymen
b/ Septum of vagina
c/ Atresia of vagina
d/ Atresia of uterus
e/ Atresia of uterus without atresia of vagina
??She is got uterus but vaginal atresia

28) A young pregnant lady with no risk factor of GDM when to check her blood glucose
a/ 24 – 26 weeks FBS
b/ Check FBS in first vist
c/ Check 24 26 weeks OGTT
d/ Check OGTT in first visit

29) A 50yo man presents with low mood, poor concentration, anhedonia and insomnia. He has had 2 episodes of increased activity, promiscuity and aggressive behavior in the past. He was arrest 8m ago for trying to rob a bank claiming it as his own. Which drug is most likely to benefit him?
a. Haloperidol
b. Citalopram
c. Desipramine
d. Carbamazepine
e. Ethosuximide

30) 11 year old Child injury during game. Focal tenderness anterior tibia. Fever.
A. Osteomyelitis
B. Osgood Schlatter
C. Septic arthritis

31) Tear drop cells, immature granulocytes… best inv (AML)
A. Plasmapheresis
B. Cytogenetic studies
C. Bm aspiration

32) 33weeks gestation, MVA, tender abdomen, Fhr 180/min
A. Cs now
B. Cs later

33) Creamy greenish discharge from nipple:
A. Ductal ectasia
B. Papilloma
C. Ductal cis

34) Mullerian agenesis – Bulging bluish discolouration from introitus.
Midline expansion over pubic symphysis
A. Imperforate hymen
B. Vaginal septum
C. Bicornuate uterus

35) Slit lamp exam red reflex. 40 years.
A. Trachoma
B. Herpes simplex
C. Herpes zoster
D. Cataract

36) Vesicles over the eyes. Loss of vision. Sudden.
A. Herpes simplex
B. Zoster

37) Hypersegmented neutrophils what to check?
A. Vit B 12 levels

38) 11 yrs pld child following trauma, focal tenderness on the upper tibia,
a.osgood b. osteomyelitis c.septicc

39) Adult causes of vertigo. Hallpike mentioned.

Acoustic Neuroma
BPPV
Menieres
Labyrinthitis

40) Pt comes in heaviness on one side which of the following will have the most effect
A. Aspirin If after 4.5 hours
B .Heparin
C. warfarin
D. tpa If within 4.5 hours

41) Patient needs 2 vaccines because he’s traveling but refuses. Agrees only for yellow fever vaccine. What will you do?
A. Listen to the patient
B. Encourage him to get both
C. Report the patient
D. Refer the patient to somewhere else

42) Jehovah witness pregnant patient. Which of the following does she refuse?
A. Vaccine
B. Anti D

43) Patient with burning & itching, vesicles on the vulva, watery discharge.
A. Chlamydia
B. Herpes

44) Ct head. 23 year old. Trauma. Diagnosis

45) X-ray- distended transverse colon & splenic flexure. Epigastric pain x 2 hours. Constipated x 3 days. Now no pain.
A. Abdominal aortic aneurysm
B. Pancreatitis

46) Patient on Rifampicin, enalapril, etc. which to stop

47) Anaphylactic Shock – Mx

48) ECG – SVT + Hypertension. Mx

49) 30weeks Pregnant woman fundal height 27 weeks us on 1st trimester was normal.. asking cause? oligohydromnios ,iugr, renal genesis

50) Abdominal picture of a Upper right quadrant pain gallstones cholecyctitis, cholangitis

51)Ecg of vetch adult with low bp and instability asking tx dccardioversion

52)Man with 24 hr epigastric pain ecg is normal but us shows the dilatation want to know next step Ercp mrcp ct scan ercp

53) 6yr girl with adhd sit in classroom behavioural modification programs methylphenidate stimulants nonstimulants

54) Meningitis child and asking tx and prophylactic antibiotics to contacts treatment: benzyl penicillin ceftriaxone..treatment to contacts: ciprofloxacin children and those adults having abnormal renal and liver functions, rifampicin adults asking reason to give antibiotics to contacts…. decrease transmission

55) Epidiymoorchitis young boy with fever and pain in testes asking diagnosis? uo ua and blood culture and fbe were the options treatment: ceftriaxone and azithro.. investigation us blood scans

56) 40yr old man with too many scars on ear drum amd conductive hearing loss in both ears and asking dx tympanosclerosis

57) Picture of hyphema after cataract surgery asking dx blood in anterior chamber usually 2 to 14days after surgery, treatment: conservative managemnt like elevation of head 45 degree avoid trauma etc .. if not controlled give topical corticosteroids.. if option of refer to opthalmo mark it

58) young Man caught by police have insomnia etc and grandiosity.. narcistic pd

59) Good student recently dropped his grade etc Asking what reaches to dx.. talking to himself( just one option rememeber)

60) 70yr with chronic constipation distension nausea vomiting asking dx sigmoid volulus fecal impaction cancer

61) Melanoma of eye what to do refer to surgeon

62) Man with multiple peptic ulcers and hpylori positive with allergy to penicillin tx for him.. ?

63) Pneumonia not responding to antibiotic therapy

64) Old patient dx with cancer treated with oxycodone bcz of pain what to do beside oxycodone ?
a. Tca
b. Ssri
c. Senna

65) Colleague of us taking drugs during hospital work but doesn’t change his performance what should you do (ethics qs). Reason for drugs taking is separation from wife.. whats next? asking the colleague to stop it as injurious to health

66)As a junior doc a guass is left in surgery in patient body.. whom will you inform/what to do? let the nurse count the guass

67) 3days baby with total bilirubin to 104 and direct b to 40 mother is o+ with 1st baby abo incompatibilty l

68) Irregular red reflex of eye with visual problem cataract

69) Preg woman with pap smear of hsil what to do
a. Colposcopy

70) Non-smoker 35-yr-old man comes with persistent cough & shortness of breath. CT scans reveal mucosal thickening of the paranasal sinuses & fibrosis at bilateral lung bases. Next step?
a Bronchoalveolar lavage
b Flow cytometry of peripheral blood
c Quantitative immunoglobulin assay

71) 50-yr-old man complains of itchy rash on his lower abdomen. The affected skin is noted to be thickened & dry. Likely cause?
a Chronic plaque psoriasis
b Exposure to an allergenic metal

72) 82-yr-old man complains of itch from a long-time large & dark spot on his back. Next step?
a/ Cryotherapy destruction of the lesion
b/ Excisional biopsy of the lesion

73) 26-yr-old woman developed an intensely pruritic rash on her back that has been present & spreading for the past 24 hours. Oropharyngeal & cardiopulmonary exam reveal no abnormalities. Next step?
a/ Obtain serum IgE level
b/ Prescribe an H1-receptor antagonist

74) Woman presents with persistent cough & shortness of breath. Had 3 episodes of pneumonia over the last 3 years & severe sinusitis a year ago. Chest x-ray reveals a right lower lobe infiltrate. Cause?
a/ Measurement of CD4+ T lymphocyte count
b/ Methacholine challenge test
c/ Quantitative measurement of serum immunoglobulin levels

75) Woman brings her 2 children ages 4 & 3, to the pediatrician for routine check. Medical records indicate no immunizations have been given. The mother refuses vaccinations for them. Next step?
a/ Document in the medical chart that the risks and benefits of vaccination have been explained
b/ Explain that physicians are obligated to report cases of vaccine refusal to the local health dept

76) 68-yr-old man comes with severe epigastric pain. Ultrasound revealed several small gallstones. Had hypertension, type 2 diabetes mellitus, coronary artery disease & heart problem. Cause?
a/ Acute cholecystitis
b/ Acute gallstone pancreatitis
c/ Perforated peptic ulcer

77) 22-yr-old man comes with an irregular, soft mass in the left scrotum above & separate from the left testis. The mass increases in size during Valsalva maneuver & does not transilluminate. Cause?
a/ Cystic dilation of the epididymis
b/ Dilation of the pampiniform plexus

78) 56-yr-old man comes for follow-up of high blood pressure. BP 146/97, BMI 27. Drinks 1-2 glasses of wine nightly. Diet mainly of fried foods & meat, with limited intake of fruits & vegetables. Diagnosis?
a/ DASH (Dietary Approaches to Stop Hypertension) diet
b/ Isometric resistance training

79) 45-yr-old man is brought with acute-onset headache. BP 150/90. The patient appears lethargic & somnolent. There is obvious right-sided ptosis & right pupil is bigger than the left. Diagnosis?
a/ Carotid artery dissection
b/ Cavernous sinus thrombosis
c/ Subarachnoid hemorrhage

80) 35-yr-old man comes with left knee pain. Rarely exercise & has type 1 diabetes mellitus & vit D deficiency. Previous reconstruction of the left anterior cruciate ligament. Drinks 1 or 2 beers a night. Cause?
a/ Alcohol use
b/ Physical inactivity
c/ Prior trauma

81) 54-yr-old woman complains of double vision & a droopy eyelid. Adduction & upward gaze are impaired on the right side. Pupils are 2 mm on the left and 5 mm on the right. Next step?
a/ Anti-acetylcholine receptor antibody assay
b/ CT angiography of the head

82) 68-yr-old man is brought with “uncharacteristic behavior.” Recently diagnosed with restless leg syndrome, treated with ropinirole. Patient is restless, appears to be easily distracted & speaks rapidly. Next step?
a/ Obtain vitamin B12 level
b/ Order MRI of the head
c/ Stop ropinirole

83) 33-yr-old woman, gravida 3 para 2, at 37 weeks gestation in active labor. 1st child was born via cesarean delivery & 2nd via spontaneous vaginal delivery. Cervix is 10 cm dilated & 100% effaced & the fetal vertex has retracted to −2 station from +1. Next step?
a/ Administer amnioinfusion bolus
b/ Perform laparotomy and cesarean delivery

84) 67-yr-old woman complains of severe vulvar itching & burning. Had a total vaginal hysterectomy at age 48 for adenomyosis. Exam shows thin, dry, white, plaque-like vulvar skin with loss of the labia minora. Next step?
a/ Potassium hydroxide preparation
b/ Serum estrogen level
c/ Vulvar punch biopsy

85) 3-wk-old boy has several episodes of bilious, nonbloody vomiting. Abdomen is tense & distended with hypoactive bowel sounds. Tests indicate leukocytosis & metabolic acidosis. Likely imaging findings?
a/ Abdominal ultrasound with thickened pylorus muscle
b/ Abdominal x-ray with air in the bowel wall and portal veins

86) 7-yr-old girl is brought with a right arm injury from a fall from trampoline. Significant ecchymosis & swelling just above the elbow. X-ray reveals a supracondylar fracture with posterior displacement of the distal humerus fragment. Greatest risk?
a/ Axillary artery
b/ Axillary nerve
c/ Brachial artery

87) Boy is brought with a left-eye injury from a flying object. Has foreign body sensation, pain, excessive tearing & decreased vision in the eye. Findings most suggestive of acute globe perforation?
a/ Corneal cloudiness
b/ Fixed teardrop pupil

88) 54-yr-old man comes complaining of fatigue & upper abdominal pain. Lost 7 kg (15 lb) during last mth. Medications include ranitidine. Two mths ago he fell, hit his head. Former smoker with a 30-pack-yr history. Exam is significant for tenderness & fullness in the epigastrium. Diagnosis?
a/ Chronic subdural hematoma
b/ Duodenal ulcer
c/ Pancreatic cancer

89) 58-yr-old woman comes with left knee pain. Has a mild effusion, tenderness & decreased range of motion & fluctuant swelling along the posterior aspect of the knee is palpable. Cause?
a/ Calcification of cartilaginous structures
b/ Narrowing of joint space and osteophytes

90) Woman with dnr for treatment what will you do
Recaller choose send for emergency

91) Homosexual man come for HIV screening
Option were hepatitis c chlamydia and syphilis

92) 35yr with asbestosis and hb 4 and asking for treatment
Options glucocorticosteroids

93) Mass in testes options were us transilluminqtion positive asking for next investigation

94) Surgery was about to finish senior surgeon left sponge and you as a assistant surgery was thinking as he left it so what will you do:

Inform the surgeon
Wait for nurses to count them
There were more options

95) Patient needs 2 vaccines because he’s traveling but refuses. Agrees only for yellow fever vaccine. What will you do?
A. Listen to the patient
B. Encourage him to get both
C. Report the patient
D. Refer the patient to somewhere else

96) Patient with burning & itching, vesicles on the vulva, watery discharge.
A. Chlamydia
B. Herpes

97) X-ray- distended transverse colon & splenic flexure. Epigastric pain x 2 hours. Constipated x 3 days. Now no pain.
A. Abdominal aortic aneurysm
B. Pancreatitis

98) Jehovah witness pregnant patient. Which of the following does she refuse:
A. Vaccine
B. Anti D

99) 11 year old Child injury during game. Focal tenderness anterior tibia. Fever.
A. Osteomyelitis
B. Osgood Schlatter
C. Septic arthritis

100) Vesicles over the eyes. Loss of vision. Sudden.
A. Herpes simplex
B. Zoster

101) Slit lamp exam red reflex. 40 years.
A. Trachoma
B. Herpes simplex
C. Herpes zoster
D. Cataract

102) Mullerian agenesis. Bulging bluish discolouration from introitus. Midline expansion over pubic symphysis
A. Imperforate hymen
B. Vaginal septum
C. Bicornuate uterus

103) Case of pneumonia . Didn’t response for empiric antibiotic for 48 hrs. Result of sputum came pseudomonas positive. sensitivity test has not been received yet. Which antibiotics will start for him ?
A) Continue same t/t
B) Change to new t/t for pseudomonas .

104) Surgery was about to finish senior surgeon left sponge and you as a assistant surgery was thinking as he left it so what will you do:

Inform the surgeon
Wait for nurses to count them
There were more options

105) Abruptio placenta 2-3 questions,

106) AP PLUS Intrauterine fetal death, vagina 3cm dilated, Patient already resuscitated, what’s next…. us scan

107) abruptio placenta , fhr 180 , fetus alive, what’s next … LSCS take her to ot maintain iv line do lscs

108) 11 year old Child injury during game. Focal tenderness anterior tibia. Fever.
A. Osteomyelitis
B. Osgood Schlatter
C. Septic arthritis

109) Tear drop cells, immature granulocytes… best inv (AML)
A. Plasmapheresis
B. Cytogenetic studies
C. Bm aspiration

110) 33weeks gestation, MVA, tender abdomen, Fhr 180/min
A. Cs now
B. Cs later

111) Creamy greenish discharge from nipple:
A. Ductal ectasia
B. Papilloma
C. Ductal cis

112) Mullerian agenesis – Bulging bluish discolouration from introitus.
Midline expansion over pubic symphysis
A. Imperforate hymen
B. Vaginal septum
C. Bicornuate uterus

113) Slit lamp exam red reflex. 40 years.
A. Trachoma
B. Herpes simplex
C. Herpes zoster
D. Cataract

114) Vesicles over the eyes. Loss of vision. Sudden.
A. Herpes simplex
B. Zoster

115) Hypersegmented neutrophils what to check?
A. Vit B 12 levels

116) 11 yrs pld child following trauma, focal tenderness on the upper tibia,
a.osgood
b. osteomyelitis
c.septic

117) Adult causes of vertigo. Hallpike mentioned.

Acoustic Neuroma
BPPV
Menieres
Labyrinthitis

118) Pt comes in heaviness on one side which of the following will have the most effect
A. Aspirin If after 4.5 hours
B .Heparin
C. warfarin
D. tpa If within 4.5 hours

119) Patient needs 2 vaccines because he’s traveling but refuses. Agrees only for yellow fever vaccine. What will you do?
A. Listen to the patient
B. Encourage him to get both
C. Report the patient
D. Refer the patient to somewhere else

120) Jehovah witness pregnant patient. Which of the following does she refuse?
A. Vaccine
B. Anti D

121) Patient with burning & itching, vesicles on the vulva, watery discharge.
A. Chlamydia
B. Herpes

122) Ct head. 23 year old. Trauma. Diagnosis

123) X-ray- distended transverse colon & splenic flexure. Epigastric pain x 2 hours. Constipated x 3 days. Now no pain.
A. Abdominal aortic aneurysm
B. Pancreatitis

124) Patient on Rifampicin, enalapril, etc. which to stop

125) Anaphylactic Shock – Mx

126) ECG – SVT + Hypertension. Mx

127) 43-year-old woman comes with a painful & swollen knee. Medical history is significant for glucose intolerance & vitamin D insufficiency. Patient is dressed in multiple layers of mismatched clothing, has flat affect & makes limited eye contact. Diagnosis?
a/ Delusional disorder
b/ Paranoid personality disorder
c/ Schizotypal personality disorder

128) 58-yr-old woman comes for her annual exam. She reports 3 days of light vaginal spotting 2 mths ago. Her uterus has multiple nontender masses consistent with fibroids. Next step?
a/ Measure a serum FSH level
b/ Perform an endometrial biopsy

129) Woman complains of tingling, numbness & weakness of the left upper extremity. Exam shows loss of pinprick sensation in the left thumb & index finger. There is mild weakness of the elbow flexion & biceps reflex is decreased on the left side. Cause?
a Median nerve compression
b Peripheral nerve demyelination
c Spinal nerve root compression

130) Woman comes with nasal congestion, rhinorrhea & postnasal drip which are worsened by cigarette smoke, strong fragrances & when the patient walks from indoors to outdoors on a cold day. Her nasal mucosae appear boggy & erythematous & rhinorrhea is clear. Next step?
1 Imaging of the sinuses
2 Intranasal glucocorticoids

131) Personality disorder patient who is aggressive doesn’t listen to other patients plea to behave
well.insist to see the doctor now
a.paranoid
b.anti social
c.borderline
d.histrionic
E.narcissistic (according to recaller)

132) 30 month old kid – what to look?
a) kick a ball
b)talk 3-4 word sentences
c) wash face and hands
d) dress by him self

133) X ray – SBO – management

134) AF ECG old not stable – Rx asked – DC cardioversion

135) HSIL in preg whats next – Colonoscopy

136) Epididymorchitis treatment – old man – Rx

137) 11 year old Child injury during game. Focal tenderness anterior tibia. Fever.
A. Osteomyelitis
B. Osgood Schlatter
C. Septic arthritis

138) Jehovah witness pregnant patient O negative. Which of the following does she refuse
A) Vaccine
B) Anti D

139) Man with 24 hr epigastric pain ecg is normal but us shows the dilatation want to know next step
A) Ercp
B) mrcp
C) ct scan
D) Mrcp

140) Surgery registrar reports to the consultant that the Anaesthesist dozing off in between surg & very difficult to reach out when he req. Consultation says he is nice. What to do A)report APHRA B) report to sur head C)Hospital management

141) Your colleague takes Marijuna in tea room in between pts. You know that he is divorced A) Report APHRA B) talk to him

142) Couple came for HIV scr. Woman was negative and man is positive. He says he will use condoms and not to tell wife. (No option about tell wife)
A) contact tracing
B) refer to infection control dept

143) Pul Embolism CT

144) Impetigo on face. School exclusion asked
A) 24 after antibiotics
B) lesion dries
C) 5 days after lesion dries
D) 5 days after completion of antibiotics

145) Asymptomatic UTI in old pt A)no treatment B) Norflox C)ceftriaxone D) trimethoprim

146) Man in 60’s came for Prostrate screening – no sympts A) PSA B) DRE C) Nothing to do D) Bone scan

147) 48-yr-old woman with advanced-stage epithelial ovarian cancer undergoes surgery & adjuvant therapy with paclitaxel & carboplatin. After chemotherapy, there is thinning of the hair across the vertex & crown. Cause of hair loss?
a) Cell-mediated autoimmune reaction
b) Deposition of IgG and complement on epidermal keratinocytes
c) Interruption of follicular keratinocyte proliferation

148) 42-yr-old man complains burning, substernal chest pain after every meal. Endoscopy reveals mucosal irregularity ulceration of the squamocolumnar junction above the lower esophageal sphincter. Chest x-ray reveals a small, left pleural effusion. Best test?
a Repeat upper gastrointestinal endoscopy
b Serum amylase and lipase levels
c Water-soluble contrast esophagogram

149) 1-yr-old boy is admitted for severe respiratory distress & hypoxia requiring endotracheal intubation & mechanical ventilation. Has 2 prior episodes of pneumonia. His vaccinations are not fully up to date. At 2nd percentile for height & weight. Treatment?
a Antiretroviral therapy
b Broad-spectrum antibiotics
c Stem cell transplantation

150) 28-yr-old primigravida in active labor. Cervix was 7 cm dilated & 100% effaced, fetal head at +3 station & in the left occiput anterior position. Has been pushing for 4 hours. Tocodynamometer indicates contractions every 2-3 min. Next step?
a/ Apply uterine fundal pressure
b/ Decrease epidural infusion rate
c/ Perform vacuum-assisted vaginal delivery

151) 54-yr-old man comes with left flank pain, nausea & hematuria. Had idiopathic membranous nephropathy 6 mths ago. Dilated & tortuous veins are noted in the left scrotum, with bilateral 1+ pitting edema. Diagnosis?
a/ Decreased plasma oncotic pressure
b/ Hypercoagulability

152) 39 wk pregnant lady comes to you because she did ’t feel fetal movement for 2 days, general condition good. No pain and no loss per vagina. A CTG was given showing normal pattern. How will you advice her?
a. Come back in 24hrs
b. Come back in next routine followup
c. Admit and induce(near term and cervix favourable)
d. Admit and observ
e. Continuous CTG

153) A pregnant lady of 37 weeks gestation comes with complains of reduced fetal movements for the last 24hrs..CTG done it was normal and pt was sent home with reassurance…she now comes again after 3 days that she is not feeling any baby movements..what’s the most appropriate next step?
a-immediate CTG
b-obstetric USG
c- reassure that its normal at this gestation
d-Amniotomy
e-induction with prostaglandins

154) 32 years old lady , 39 weeks pregnant presents with complaint of did not feel fetal for past 12 hours .She was seen 2 weeks ago and everything was normal. what do you do?
A. CTG
B. USG
C. Reassure
D. Review in 24 hours
E. Admit and observe

155) A patient with a known duodenal ulcer presents with haematemesis and melaena requiring admission to hospital. Which of the following is the most important consideration favouring early surgical intervention?
(A) The ulcer is over 1 cm in diameter
(B) The patient is female
(C) The patient is 65 years old
(D) The patient’s blood group is O negative
(E) Previous acid secretory studies indicated a high acid output

156) builder 48 yr,weekness in left side of body for few minutes.past same episode for 5 times.advice after giving aspirin and discharge with follow up by local doctor
a. More antiplatelet
b. Can’t drive 6months
c. Can’t go to work without local doctor’s permission
d. No strenous work

157) A mentally regarded patient became pregnant, the patient doesn’t want abortion but her mother and husband want,what should a physician do ?
A)abortion should be done
B)take informed written consent from patient
C)abortion should not be performed

158) Following a mva, pt developed decreases breath sounds, dull on percussion…trachea shifted to opposite side
A.needle thoracocentesis
B. Chest tube drainage

159) Ecg vt, pt hr 240, bp 80/60
A.dc cardio
B.iv amiodarone
C.reasure

160) pt came from Turkey, epigastric pain for 2 weeks.
Xray was given
1.hydatid cyst
2.abd aortic aneurysm
3.staghorn calculi

161) It was hydatid cyst..
a. Lesion was in the lungs..not in abd.

162) ulcerative colitis h/o, pt came with fever and obstructive features ( diagnosed it as toxic megacolon)..mix

Sigmoidoscopic decompression
total colectomy
observe.

163) Child having repetitive fractures history, parents are new to town. Came to ED with fracture femur. There was no other signs other than swelling around the fracture..

non accidental injury
osteogenesis imperfect.

164) Pt developed allergic malar rash after taking cefazolin…advise

stop all cephalosporins
can give cephalosporins other than cefazolin

165) Pregnant lady came with the h/o conductive hearing loss. Dx?

otosclerosis
choleasteaoma
acoustic neuroma

166) Pregnant lady, fetal demise confirmed by usg…tense tender uterus, blood loss of 1100ml ,cervix dilatation 3cm.. after resuscitation

spontaneous vaginal delivery
cs
amniotomy

167) 30yrs lady came with vaginal itching previously treated with cotrimoxazole…what u will do?

fasting blood glucose
chlamydia pcr

168) Young man came with dysuria..fever, tenderness in the scrotum intial inv

blood culture
urine culture

169) Child after eating peanut, developed wheals,urticaria.. management.

im epinephrine
Antihistamines

170) Psychotic pay on olanzapine, gained 10kgs..now asking for change of drug…what u will give

fluoxetine
aririprazole
risperidone

171) 18-yr-old man lost balance & hit his left chest against the coffee table. Patient appears uncomfortable & is taking shallow breaths. B/P 88/50, pulse 122/min & respirations are 28/min. Jugular veins are flat. Cause?
a/ Ascending aortic tear
b/ Bronchial rupture
c/ Intercostal vessel injury

172) 45-yr-old woman complains of tremor in her hands, especially when stressed. Has generalized anxiety disorder. High-frequency tremor of both hands prominent with finger-to-nose testing. Diagnosis?
a/ Cerebellar tremor
b/ Dystonic tremor
c/ Enhanced physiologic tremor

173) 4-yr-old boy is brought with difficulty breathing. Had recurrent epistaxis, sinus infections & pneumonia. Thin boy with audible nasal breathing & bilateral nasal polyps. Lung auscultation reveals diffuse, coarse crackles. Diagnosis?
a/ Cystic fibrosis
b/ Eosinophilic granulomatosis with polyangiitis

174) 14-yr-old boy comes for a checkup after his older brother experienced sudden cardiac arrest. Carotid pulse seems to have a dual upstroke. There is strong apical impulse & a systolic ejection murmur is heard along the left sternal border. Which is most likely to increase the murmur intensity?
a/ Leg raise
b/ Squatting
c/ Valsalva maneuver

175) 36-yr-old woman complains of weakness & dizziness on & off over the last 3 days. Has no chest pain or shortness of breath. The patient’s father had a myocardial infarction at age 68. Next study?
a/ CT angiogram of the chest
b/ Exercise stress testing
c/ Serum TSH level

176) 5-yr-old girl is brought with malodorous vaginal discharge & small amount of bleeding. Knee-chest position shows a whitish foreign body inside the vaginal introitus. Next step?
a Irrigate with warmed fluid after local anesthetic application
b Notify Child Protective Services immediately

177) A 42-yr-old woman has 2 syncopal episodes in the last 3 days. Had anorexia, nausea & abdominal pain for 2 wks. Skin shows hyperpigmentation in the palmar creases. Likely present?
a/ Hyperglycemia
b/ Hyperkalemia

178) 57-yr-old man complains of persistent tingling in both legs. Often bumps into furniture. Has a history of hip osteoarthritis, GERD & Barrett esophagus. Sensation to light touch & vibration are diminished in the feet bilaterally. Next step?
b/ Serum protein electrophoresis
c/ Serum vitamin B12 level test

179) Woman brought due to sudden severe headache. CSF analysis: O/pressure 260 mm H20, Glucose 3.3, Protein 4.8, Leukocytes 5, RBC 3500. Diagnosis?
a/ Bacterial meningitis
b/ Herpes simplex virus meningoencephalitis
c/ Subarachnoid hemorrhage

180) 22-yr-old man is brought with agitated behavior & hearing voices. Patient is treated with quetiapine & appears much calmer. His mother is worried he becomes unmotivated to do anything. Next step?
a/ Dialectical behavior therapy
b/ Exposure therapy
c/ Family therapy

181) 5-yr-old boy is brought with swelling & pain in the right thigh after bumping into table. Maternal uncle died after developing intracranial hemorrhages from a minor head injury last year. Marked ecchymoses & swelling over the right quadriceps. Likely to be found in patient’s history?
a/ Episodes of joint pain with swelling
b/ Old, healed rib fractures

182) 57-yr-old man comes with progressive difficulty walking. Has hypertension & hyperlipidemia. Vibratory & pain sensation is decreased in both the hands and legs. Babinski sign is upgoing bilaterally. Prognosis?
a/ Advanced spondylosis of the cervical spine on radiography
b/ Elevated protein level with normal cell count on cerebrospinal fluid analysis

183) A person tried to jump in the car, he was arrested for his activities several times.today he was brought by he police for attempting to jump.no alcohol history. What u will give

bzd
droperidol

184) Child with multiple abscess, gingivitis.. and recurrent respiratory infections
What will u check

neutrophil level
complement level
antibody level

185) Dog phobia.. what u will do

show the pic
Pet a dog

186) Pt had heberden nodes, h/o oa and asthma, what u will give intial?

para
nsaids
mtx

187) Pt came after a mva , his gcs was 8, hypotensive, next immediate step

iv fluids
intubation

188) 12 yr old girl came with sore throat and drooling if saliva, o/e tonsil enlarged, drooling of saliva. It was quinsy

incison and drainage
endotracheal intubation.

189) Biostat nnt.. the value was 4-2 =2
Nnt = 1/2 ×100= 50

190) Lady came with anti DNA positve, anti ana and anca positive,, now present with left limb weakness, lt parietal lobe infarct.what will u give life long

anticoag and immunosuppression
antiplatelet and immunosuppression
anticoag and antiplatelet

191) child was bitten by snake, dad killed the snake and brought it to ed…child developed nausea vomiting

give common snake antivenom
polyvalent vaccine

192) Man was bitten by a snake in his Jeans, he had 2 fang Marks…he didnt develop any symptoms..
There was no option for PIB

common type snake antivenom
polyvalent vaccine
obseeve for 12 hrs and then give antivenom..

193) Child with impetigo, started with antibiotics, period of exclusion

24hrs from antibiotics
1 week exclusion
till blisters get dried

194) Coles fracture, what will make u think , the person is developing compartment syndrome

pain
tingling
numbness

195) Lady, who was obese went for diet and exercise with lifestyle modifications for losing weight… after 6 months she lost 1.5lbs.. she was not convinced with it .hwr bmi was 31.what u will do..

Refer for dietitian
Refer for lifestyle modifications
psychotherpay

196) Child with impetigo, started with antibiotics, period of exclusion
1.24hrs from antibiotics
2.1 week exclusion
3.till blisters get dried

197) Coles fracture, what will make u think , the person is developing compartment syndrome
1.pain
2.tingling
3.numbness

198) Lady, who was obese went for diet and exercise with lifestyle modifications for losing weight… after 6 months she lost 1.5lbs.. she was not convinced with it .hwr bmi was 31.what u will do..

Refer for dietitian
Refer for lifestyle modifications
psychotherpay

199) Diabetic pt..his hba1c was 8 ..he was not on any drugs..he controlled it with diet and exercise…after 6 months it became 7.6..now what u will do?

metformin
pioglutazone
insulin
continue with lifestyle modifications

200) Post OP oliguria, pt has been catheterised. His urine output was 50 ml despite giving 1 litres of iv fluids.. what u will check next

sr.urea, creat,electrolytes
renal biopsy

201) 40 yrs old male patient with Rheumatoid arthritis, on methotrexate and hydroxychloroquine, planning to start family whats your advice to him, his partner was completely ok no issues at all.
A. Stop methotrexate and continue hydroxy
B. Stop hydroxy and continue metho
C. Continue both drugs
D. Stop both and give adalimunab
E. Stop metho and start sulfasalazine

202) 32 years old woman who is a known case of uncontroled hypertention and taking warfarin for 6 months is presented with sharp abdominal pain. (no more clinical findings mentioned) The CT scan looks like below. Whats the most likely diagnosis?
A. Rectus sheath hematoma
B. Cecal volvulus
C. Aortic disection
D. Appendicitis
E. Ovarian cyst torsion

203) BMI plotting in the chart and asked for where was the person sitting:

obessed,
normal
Morbidly obese

204) One xray of kidney stone there was a small sort of oval very opaque thing on the left side of the abdomen the que that asked what is most investigation to do?

CT
MRI
USG
Some other irrelevant option

205) Another X-ray about a 3year child presenting with sign symptom of pneumonia but when you checked the chest was normal but the X-ray was positive for pneumonia, they asked about the causative organism. The child didn’t have any abdominal symptoms only respiratory.

S. Pneumonea
S. Aureus
H. Influenzae
Some other options forgot

Australian Medical Council (AMC) MCQ Recalls JULY 2021 compilation

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