AMC MCQ Recalls JUNE 2024

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In the first 10 months of this financial year 2024, over 22,797 trained health professionals, including 4,699 overseas doctors, have relocated to Australia, significantly strengthening the country’s healthcare system.

New figures released on Sunday indicate that the number of healthcare workers, such as nurses and midwives, who have registered to practice in Australia for the 2023-24 financial year is more than double the pre-Covid figures from 2018-19.

For doctors, this marks an increase of just over 55 percent compared to 2018-19, when 2,991 foreign-trained doctors registered to practice in Australia.

The data revealed that 60 percent of the doctors who relocated to Australia between July 2023 and April 2024 came from the United Kingdom, Ireland, India, and the Philippines.

Most of these doctors have settled in regional, rural, or remote communities, following guidelines that require foreign doctors to practice outside major cities for their first 10 years in Australia if they wish to provide Medicare services.

Australian Medical Council (AMC) MCQ Recalls JUNE 2024 compilation

59gentleman with T2DM, on insulin glargine, presents with lethargy & diarrhea. Recent bloods: HbA1c 10.1%, eGFR 40, creatinine 235. Previous creatinine 105, eGFR 80. Next step?
a) Urgently repeat blood tests, refer to ED if creatinine >235 μmol/l.
b) Withhold insulin, recheck eGFR today.

45yo man sudden severe pain and popping sensation of right upper arm after lifting heavy object. Image given (swelling, with visible bulge at lower part of upper arm). Dx?
a rotator cuff tear
b bicep tendon rupture

32 yo presented with conjunctival injection, corneal dendritic ulcers, and reduced visual acuity in the affected eye. (herpes eye)
A oral acyclovir
B topical antiviral

Questions about statistics , one graph in the handbook (maybe)

65 lady underlying T2DM, lost 10% weight, walks daily. On perindopril for HTN, BP still 170/90. Non-smoker, non-drinker, healthy diet. Manage BP now?
a) Add amlodipine 5mg daily.
b/ Add Irbesartan 150mg daily.

28F, 37 wks pregnant, rash on abdomen spreading to thighs. 2yo daughter at childcare, recent chickenpox case. Feels well, no fever/urine/bowel changes. Rash management?
a) Reassure no adverse pregnancy outcomes.
b) Refer to dermatologist.

65 lady with enlarging papule on R neck, non-pigmented, raised w/ central keratotic horn, 8mm diameter. Suspect keratinocytic tumor. Max dose of lignocaine 1% w/ adrenaline for biopsy?
a) 490 mg
b) 140 mg
c) 210 mg

GERD given ppi and patient improved asked about further management
A increase dose
B arrange for ogds

28yo easy brusing petechiae prolonged bleed (ITP) treatment?
A ivig
B splenectomy
C oral corticosteroid
D platelet infusion

patient on warfarin has dental checkup in one week – asked about further management

79 lady overweight with worsening L knee pain, x-ray shows OA. Awaiting ortho opinion, paracetamol helps. Asks about glucosamine, advised low evidence. Recommend non-pharmacological management?
a) Referral for CBT for pain management.
b) Knee brace in valgus position.

4mo boy with asymmetric red reflex in eyes during well-child check. Statements about this condition?
a) Retinoblastoma, cataracts, and refractive errors can cause abnormal red reflex.
b) Retinoblastoma is never fatal.

36lady with L breast lump, tender, diagnosed as benign cyst 2 mos ago. Lump feels bigger, ongoing pain. No significant family history. Next step?
a) Referral for ultrasound-guided FNA of the cyst.
b) Referral to breast surgeon for review.

24yo male swimmer presents to the emergency department with intense pain, redness, and welts on his left arm after being stung by a bluebottle while swimming in the ocean. He reports severe burning pain and local swelling. Mx?
A apply vinegar
B apply ice
C rinse with seawater and remove tentacles
D rub with sand
E oral abx

28yo first trimester presented with nausea vomiting (hyperemesis gravidarum). Ix?
B urinalysis
C abd ultrasound
D serum electrolytes

50M, never smoked, asks about coronary calcium scoring. Brings article, regular patient. Scenarios for ordering Coronary Calcium Score?
a) If his father died of cardiovascular disease at age 40
b) If he had Familial Hypercholesterolaemia

48gentleman with fatigue, consults naturopath, brings pathology order form w/ various tests. Thinks fatigue due to lack of sleep. Naturopath wants test results. Next step?
a/ Take thorough history, physical exam for fatigue, then investigate if needed.
b) Explain inappropriate ordering, can’t sign form.

Motor vehicle accident for pregnant women on 30 week gestation age , no leakage of water but symphysio fundal height shows 34 weeks asked about diagnosis?

Travelling to Thailand, returned to Australia 10 days back M-P rash & bilateral conjunctivitis, fever & cough (asked Diagnosis) and some of the similar question asked for investigation to get the Diagnosis.

35yo high risk behavior with multiple sexual partners. Request for initial hiv testing.
A cd4 count
B hiv rna pcr
c hiv-1/hiv-2 ab
d western blot

PTSD / Panic Disorder and Adjustment Disorder related question.

JMO has needle stick injury from a patient who is in comatose, don’t know whether the patient is HIV positive or not. What to do next?
A Start PEEP
B screen patient HIV status and decide

3 weeks baby born to Hep-C positive mother, is now jaundice. What is the diagnosis?

51male ex-smoker with COPD, diagnosed via spirometry, FEV1 70%. On ipratropium, not controlling symptoms of cough/breathlessness. Next medication?
a) Add formoterol 12mcg 1 inhalation twice daily
b) Add tiotropium 18mcg 1 inhalation once daily

82 lady with severe Alzheimer’s, disruptive behavior, assaulted staff/resident. Tried non-pharmacological strategies. Nurse asks for medication order. Most appropriate management?
a/ Obtain consent from medical POA, order low dose antipsychotic, review tomorrow.
b) Order temazepam 20mg nocte, review next week.

27 lady w/ rash on legs for a wk, initially thought from netball, now painful lumps. Feels tired and achy. Meds that could cause this?
a) Trimethoprim
b) Cephalexin
c) Frusemide

18 months baby has jaundice, what is the investigation to find the diagnosis?

12 month baby has symptoms of cough, fever & X-ray shows right upper lobe opacities, treatment –

Elderly patient is on many drugs, he is feeling light-headedness (This is repeat question) say -> review medication.

Patient has started using some skin products & had developed scaly, erythematous papules. What to do?

  • Atopic eczema
  • Guttate psoriasis

Woman come for psychiatric check-up and found melanoma excision but she refused. AS -> We need to ask her why she refused.

Woman come for check-up & complained about another physician & asked what is the suggestion you will give as the general practitioner (Also some change in the scenario)

A school-aged girl is on risperidone for 12 months and there is discharge from the breast. She is embarrassed for going to school. She says that she wants to withdraw the drugs as the symptoms relieved.
A. Cease risperidone
B. Add bromocriptine
C. Change to quetiapine.

10 cm anal verge asked for treatment (This is yesterday’s question)

  • Radiotherapy
  • Chemotherapy
  • Radio & Chemo combined.

21 male, teeth discoloration, recently tired, diarrhea at times. Dentist suggested GP check-up. Test for diagnosis?
a) Serum transglutaminase-IgA (tTG-IgA) and deamidated gliadin peptide-IgG (DGP-IgG)
b) Serum ferritin
c) Hydrogen breath test

6wk baby girl, family going to Uganda, concerned about malaria. Only child, breastfed, good health, no travel history. Advice on preventing mosquito bites?
a) No insect repellent for baby; use pram netting, light-colored long-sleeved clothes.
b) Use roll-on mosquito repellent with 10% DEET for baby.

53F w/ hot flushes, periods ceased at 51, interested in MHT. Discussed benefits/risks, screened for contraindications. Possible contraindication to MHT?
a/ Established cardiovascular disease
b/ Treated hypertension

92 lady, frail, bed bound, no appetite, difficult swallowing meds. End-of-life care planned, comfort-focused. Nurse reports distress, SOB, no pain, midazolam given, cooling room. Advise staff?
a/ Give morphine for dyspnoea, 1-2.5mg subcut 1 hourly as needed.
b) Apply 2L oxygen via nasal specs to reduce dyspnoea sensation.

58 lady w/ palpitations, tremor, heat intolerance, tachycardic, irregular HR. R-sided thyroid nodule, brisk reflexes, AF on ECG. TSH <0.05, free T4 48. Next step for thyroid nodule?
a/ Perform radionuclide imaging, refer to endocrinologist.
b) Order CT scan of neck.

Patient family history father had melanoma, now patient is having small intra-dermal nevus asked for risk factor.

Patient has HIV and as GP, what will you advise the patient to prevent HIV to his partner.

35 guy w/ R heel pain post-half marathon, diagnosed Achilles tendinopathy via US. Advised rest, returns w/ ongoing pain. Further management today?
a) Refer to physiotherapist for further management.
b) Advise strict bed rest until pain resolves.

66 male w/ L eye pain, intermittent double vision, dull frontal headache. Poorly controlled T2DM, HTN. L ptosis, normal pupil, eye movement paralysis. Most likely cause?
a/ Microvascular ischaemia
b) Microvascular embolus
c) Infection

64 male w/ LLQ pain, diarrhea for 3 days, increasing pain, feels unwell. Tender LLQ, fever 38.4C, HR 112, BP 100/64. Appropriate management?
a) Admit to hospital for IV antibiotics, rehydration.
b) Urgent outpatient CT abdomen.

84 lady w/ diarrhea, now confused, on valsartan, ibuprofen, alendronate. Admitted for viral gastroenteritis, 4 loose stools last 24 hrs, diffuse tenderness. Investigation for next step?
a) Renal function test
b) Abdominal XR (erect and supine)
c) Pulse oximetry

58 male w/ severe chest pain at rest, 2 wks exertional chest pain, T2DM, HTN, ex-smoker. ST elevation in leads II, III, aVF. Coronary artery likely occluded?
a) Right coronary artery
b) Left anterior descending
c) Left circumflex artery

50 male w/ erectile dysfunction, otherwise well, normal exam. Common condition to exclude?
a) Diabetes Mellitus
b) Peyronie’s disease
c) Hypothyroidism

30yo couple planning pregnancy, concerned about cystic fibrosis due to wife’s brother’s diagnosis. Advice to couple?
a) Organize blood test for cystic fibrosis carrier status.
b) Chances of having baby with cystic fibrosis is 25%.

5yo w/ knock knees, mother concerned due to family history. Intermalleolar distance 9 cm, no limp, 75th percentile for weight)height. Next step?
a) Refer for a paediatric orthopaedic opinion
b) Refer to a paediatric physiotherapist for exercises

35F returns from Thailand w/ persistent diarrhea, started on day 4 of holiday, 2 wks duration. Azithromycin ineffective, uses rehydration solution. No night sweats, fever, or blood. Correct statement?
a/ Protozoan infections most common cause of prolonged diarrhea (>14 days) in returned traveler.
b) Viral infections most common cause of prolonged diarrhea (>14 days) in returned traveler.

55M w/ new gynaecomastia, past BPH, CHF, AF. Not seen for 12 mos, brings meds. Medication causing gynaecomastia?
a) Amiodarone
b/ Prazosin
c) Apixaban

58M w) erectile dysfunction, past HTN, T2DM. Review medications. Med likely contributing to problem?
a/ Indapamide
b) Gliclazide

4yo with L arm pain after being spun by arms, refuses to use arm. Correct statement about diagnosis?
a) Apply pressure over radial head, fully pronate forearm while elbow is flexed.
b) X-ray needed to diagnose pulled elbow.

34M new patient w/ R ankle issues, antalgic gait, recent ORIF, uses oxycodone. Correct statement?
a) Drugs of dependence most likely prescription drugs to be abused.
b) Oxycodone least common opioid prescribed based on PBS data.

42F w/ 1-day severe epigastric pain, vomiting, fever. RUQ tenderness, positive Murphy’s sign. Likely diagnosis?
a) Acute cholecystitis
b) Gallbladder polyps

22M at rural ER, took unknown drug at party, agitated, tremor, diaphoretic, flushed. High HR, RR, uncooperative. Next step?
a/ Sedate, then check electrolytes, glucose, ECG, creatine kinase, blood lactate.
b) Sedate, then start IV hypertonic saline infusion.

6-mo girl, elective C-section, 4.1kg, gestational diabetes. Babbling, transfers objects, sits unsupported. Even leg lengths, deep uneven buttock creases. Next step?
a/ Arrange a plain x-ray of the hips
b) Arrange an ultrasound of the hips

35 lady w/ fever, runny nose, sore throat, cough, joint pain, non-itchy rash. On carbamazepine for trigeminal neuralgia. Rash on face, forearms, trunk, painful mouth ulcers. Important diagnosis?
a) Stevens-Johnson syndrome
b) Erythema multiforme

24 lady pregnant, worried about cystic fibrosis due to family history. Brother’s newborn diagnosed. True statement about CF testing?
a) Positive newborn CF screen, do sweat test at 6 wks.
b) No carrier screening, already pregnant.

58 lady w/ Hodgkins lymphoma, back home after chemo, short of breath, headache, dizziness, facial swelling, hoarse voice, cyanosed. Immediate management?
a) Emergency air retrieval, 2L O2 via nasal cannula, IV line, stat morphine and dexamethasone.
b) Call 000 for emergency road transfer, urgent chest)neck/head x-rays, 2L O2, oral paracetamol, oral prednisolone.

28 male w) 3-mo irritating cough, worse at night, slightly productive, no SOB or wheeze. Non-smoker, recent hayfever, clear chest exam. Likely cause?
a) Allergic rhinosinusitis
b) Bronchitis
c) Malignancy

45 male indigenous, poorly controlled diabetes, ischaemic heart disease, fevers, productive cough, night sweats, hemoptysis. Suspect TB. First-line investigation?
a) Chest x-ray, sputum microscopy, culture, sensitivity for acid-fast bacilli.
b) Chest x-ray, tuberculin skin prick test.

44M discussing smoking cessation, thinks can quit anytime. Reliable indicator of nicotine dependence?
a/ Time to first cigarette after waking (<30 mins).
b/ Number of cigarettes smoked per day.

68F w/ mild-moderate Alzheimer’s, on Donepezil, aspirin, perindopril. Daughter asks about gingko biloba. Correct statement?
a) Gingko biloba linked to anti-platelet effects, bleeding risk with other drugs.
b) Gingko biloba increases MI risk with aspirin.

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