Australian Medical Council (AMC) MCQ Recalls NOVEMBER 2024 compilation
80yo woman who lives in nursing home admitted for uncomplicated colles fracture, upon admission had incontinence so cbd inserted, & taken urine sample, upon discharge result came out: e coli in urine, nitrites & others negative. Pt denies dysuria. Next step?
A. Allow discharge without any abx
B. Give oral abx and discharge
C. Stay admitted in hosp to commence iv abx
D. Repeat urine culture
32yo Woman referred to specialist for permanent contraception. Has 3 kids. Doesnt want anymore children. Currently using condom. Husband doesn’t want to get sterilised but supports her decision. What to do?
A. Bilateral salpingectomy
B. Hysterectomy
C. Depo provera
D.refuse any intervention
E.advise to come back at 35yo
Foreign body magnet scenario in 6yo. Toy magnet was seen ingested by child, at ed Xray shows its at small bowel area, serial xray after 6 and 12 hours shows battery has not moved, both magnet are seen close to each other, child is asymptomatic. Next step?
A.Reassure and send home
B.Surgical removal
D.Cont. Serial X-ray
First-time mum brings 4wk-old baby w/ firm, non-tender neck lump on R side below mandibular angle. No erythema, baby appears well. What’s the next step for diagnosis?
a/ Ultrasound of the neck
b/ Fine needle biopsy
62M w/ COPD presents w/ worsening cough, purulent sputum, fever, and increasing breathlessness. R on 6 puffs salbutamol q4hrs but no improvement. What abx regimen for COPD exacerbation?
a/ Prednisolone 50mg daily for 5 days & amoxycillin 500mg 8hrly for 5 days
b/ Prednisolone 75mg daily w/ taper & amoxycillin 1g 12hrly for 5 days
52F w/ vomiting (no nausea/pain), hx of chronic back pain, AF, iron deficiency, HTN, depression, and melanoma excised 10yrs ago. What’s the most likely differential?
a/ Cerebral metastases
b/ Alcohol use
c/ Antidepressant adverse effect
29M w/ sub-fertility, sperm results: FSH 30, LH 35, T 4, prolactin normal. What’s the most likely cause of sub-fertility?
a/ Testicular failure
b/ Eating disorder
c/ Abnormal spermatogenesis
33F in QLD, fair skin, limited sun exposure, uses sunscreen daily. What UV index level requires sun protection?
a/ UV Index ≥ 3
b/ UV Index ≥ 1
c/ UV Index ≥ 2
Colleague smoking marijuana between patient consults as he is stressed
What to do?
a/Report to ahpra
b/Talk to colleague before and see what his response is
c/Report to clinical director
d/Report to hospital head
you are a Medical officer on duty, patient having surgery for fracture on the 2nd day while you are attending him was requested you to sign the will for him.What should you do?
a/Refuse
b/Be the witness
c/Ask the senior
d/Check mental capacity
e/Ask him will let you know after discussing with admin
A man having joint arthritis for last 1 year and having the treatment. He had loose his job due to health issues.He isolated himself from club and social activities,wake up at morning, loose weight,decrease sleep,speak less,during consultation he asked he is searching for job and it is tough to adjust with all of the thing. diagnosis?
a/Adjustment disorder (<3months) b/MDD(> 6months)
c/Schizophrenia
d/Anxiety disorder
AF Ecg, stable patient asking management.
a/Metroprolol (rate control)
b/Younger people- Rhytm control digoxin, unstable (shock)
Stab injury to back of the chest, inability to move hand and finger.which nerve involved?
a/Radial
b/Median
c/Posterior interosseous
d/Common peroneal
40 wks pg primi with vaginal bleeding after intercourse BP 80/56, uterus tender hard.
What is the initial management
a/UsG
b/Speculam examination
c/Induction
d/I/v fluid
e/Blood transfusion (best next, as soon)
70M w/ metastatic prostate cancer, worsening pain despite paracetamol. What opioid to prescribe for pain management?
a/ Morphine
b/ Fentanyl
c/ Hydromorphone
30M factory worker w/ dry cough, wheeze, hayfever, and smoking. Symptoms improved on holiday, but returned. advice?
a/ Best prognosis if avoids sensitising agent
b/ Wear mask at work to reduce exposure
6F collapses, unresponsive, abnormal breathing. What’s the recommended compression-to-ventilation ratio in Paediatric Advanced Life Support?
a/ 15:2
b/ 30:2
c/ 30:3
Old lady after fracture femur surgery upon discharge, urine R/M/E – RBC and E coli found more than normal range — she had catheter during surgery.
What antibiotic should give during discharge?
a/Ceftriaxon
b/Cefalexin
c/Trymethoprim (first line, empirical therapy)
d/Sulfonyle urea
48 years F , mother had breast carcinoma at 60 years.she is having pain and greenish discharge from multiple duct.diagnosis?
a/Carcinoma in situ
b/Ductal cell carcinoma
c/Duct ectasia
d/inflammatory breast disease
Husband and wife came to clinic complaining that their neighbour is keeping eye on them,they think neighbours wants them to move out. Husband unable to sleep at night, with obsession to check on neighbours through window regularly.
They even talk about sex life of their neighbours with other society members.
Diagnosis?
OCD
Delusional disorder
Paranoid personality
Borderline personality
Schizophrenia
8F w/ bluebottle sting, pain, linear raised marks on R hand, no swelling or breathing issues. What’s the first aid management?
a/ Soak hand in hot water until pain resolves
b/ Soak hand in vinegar for 20 mins
19M w/ left foot injury, swelling and tenderness over calcaneus, antalgic gait, able to weight bear. correct statement?
a/ Ottawa ankle rules recommend foot x-ray in all ankle pain pts
b/ Ottawa ankle rules don’t apply to calcaneal injuries
43F w/ R foot pain, burning sensation, tingling in 3rd/4th toes. No trauma or pain at night. Next step in management?
a/ Refer to podiatrist for wide shoes, firm sole, metatarsal pads
b/ Initial treatment is surgical; refer to ortho foot surgeon
67F in rural clinic, gardening, saw brown snake nearby but no bite sensation. Scratches on hands. Management for possible snakebite?
a/ Apply pressure immobilisation & transfer urgently to regional hospital
b/ Check normal vitals & reassure, 4hrs since possible bite
8 year boy face and periorbital swelling, BP increased, urine- protein 4 +
Asking what is the most appropriate initial management?
a/Low protein
b/High protein
c/Protein and water limit
d/Prednisolone
Moluscum contageam long scenario and pic then ask diagnosis.
VT ECG unstable patient asking management
Lacerated wound in back,
Tetanus vaccine completed 7 years back. Appropiate management.
a/I/v ceftriaxon
b/Debrightment
c/Immunoglobulin
d/Tetanus vaccine
e/Both vaccine and immunoglobulin
Female presented with complain of prolonged menstrual
period and heavy blood loss . What is most appropriate treatment?
a.Cocp
b.IUCD
c.Mefanemic acid
d.Transemic acid
e.Northisteronq
28F w/ smooth, fluid-filled lump on buccal mucosa, present for 4wks, no pain. Type 1 DM well controlled. Management plan?
a/ Refer to oral/maxillofacial surgeon for further assessment
b/ No further treatment; lesion is benign
10F w/ 3-day fever, painful sore throat, enlarged L tonsil, uvula displaced to R, muffled voice, pooling saliva. First-line treatment?
a/ Urgent referral to ED for ENT review
b/ Phenoxymethylpenicillin 250mg bid for 10 days
Tardive Dyskinesia patient on haloperidol.
- Switch to quetiapine
- Reduce haloperidol
- Benztropine
- Propranolol
44F w/ pain/swelling over radial styloid, aggravated by writing/grasping, positive Finkelstein’s test. Likely diagnosis?
a/ DeQuervain’s tenosynovitis
b/ Carpal Tunnel syndrome
c/ Trigger thumb
33F fair skin, blue eyes, concerned about Vitamin D deficiency due to family hx of osteoporosis. Risk factor for which condition?
a/ Bowel cancer
b/ Coeliac disease
c/ Age-related cataracts
60F w/ 6-day rhinorrhea, blocked ears, non-productive cough, progressive R ear hearing loss. Exam normal except for tympanic membrane. Diagnosis?
a/ Cholesteatoma
b/ Acute Otitis Media
c/ Tympanic Perforation
67F w/ tinnitus and L ear hearing loss for 2wks, no pain/vertigo, normal exam. Weber test lateralizes R. Type of hearing loss?
a/ Left-sided sensorineural hearing loss
b/ Left-sided conductive hearing loss
23M new job at cattle farm, needs Q Fever vaccination. No prior vaccination, but up-to-date on childhood shots. Advice for Q Fever vax?
a/ Pre-vaccination screening required (skin & blood tests)
b/ No pre-screening needed; GP can administer Q Fever vax
RTA patient BP 80/50, GCS 12, spo2 95, breathless, all others vitals normal. what is the immediate next management?
Intubation
O2 (following ATLS order)
o negative blood
1L Normal Saline
Note: (breathlessness can be mechanic)
36,F, obese, heavy drinker and smoker,BMI 32, ca breast,
Asking contraception. which should be considere prior prescription?
a/Alcohol
b/Smoking
c/Obesity
d/Ca breast
Traveller going climbing having high altitude syndrome
What to do?
a/Dexa
b/Prednisolone
c/Acetazolamide
d/Advice not to go
Hemolytic anamia senario asking diagnosis
16 year pale, unconjugated bilirubin, others vitals normal
Long senario with lab. Asking diagnosis?
a/Hepatitis
b/Hemolytic jaundice
c/Gilbert syndrome
Gp with forgetfulness, share one patient history with another, going through family problem. What to do
a/Console
b/Ask to take leave
c/Advice to take psychiatrist counselling
d/Inform APRHA
e/Inform medical board.
7 d,F, baby birth weight 2.2 kg delivered at 36 weeks bring by mother to GP for routine checkup and asking the time of starting vaccination.
a/According to chronological age
b/As per standard
c/When the weight gain
d/When mother wish
1 state. question about negative predictive value
breast and colon cancer screening questions.
3/4 jaundice related question.
Hyperthyroid in pg .ix
Thyroid nodule management
2 year boy, cough, irritating, not eating properly, wheeze, grunting, intercostal retractions, spo2 – N. which test will help to reach the diagnosis?
a/CXR???
b/CBC
c/Blood culture
d/ABG
e/Spirometry
white tail spider bite after giving analgesic and antihistamine still there is severe pain and patients conditions is deteriorating. What is the next best management?
a/Transfer to ICU
b/Antivenom
c/Repeat analgesic
d/Antibiotic
picture of Basal cell carcinoma asking management.
a/Excision
b/Punch biopsy
c/Cautery
d/Observe
Pancreatitis long scenario PT was admitted in hospital. asking what is the condition of doing CT?
a/After 24 hour
b/When condition deteriorate (in severe, after 48-72hrs)
c/No need (in early stage)
d/When spo2 fall
Women with 4 children requests for permanent contraception. Husband supports her. He is not keen for vasectomy.
A.Bilateral Salphingoopherectomy
B. IUCD
NG tube placement. Method to confirm?
A. Bubbling sound.
B. CXR
Pregnant lady at 18 weeks/52 with persistent nausea not resolving with Metochlopromide. Sudden onset of RIF pain. Likely diagnosis ?
A. Red degeneration.
B. Acute appendicitis.
Baby 10 months/10 weeks, presented with low feeding, no cyanosis, had bibasal crepts with systolic murmur and splenomegaly. Dx ? CCF
How to know the orbital floor fracture?
a/Epistasis
b/Facial muscle weakness
c/Cranial fluid leak from ear
d/Diplopia
e/Some discharge from eyes option
Note:
Pic for firm immobile swelling on eyebrow (sebaceous syst, dermoid)
I think osteoma of frontal bone (hard)
Patient presents with acute anxiety attack. What is the expected ABG findings? (Each ABG value was given, to pick the value)
Normal PO2 levels, reduce PCO2 level, increase Ph. (hyperventilation)
Scenario with Wagerners/Good pastures syndrome
Anemia (A lot of blood IDA/MCHC anaemia interpretation MCH low MCV low microcitic microchromic anemia)
Young lady NKMI, presented with thin whitish vaginal discharge post Mirena insertion. No fever and not foul smelling.
A. Candidiasis
B. Foreign body cervitis
Teacher 34 weeks pregnant, felt fluid trickling down. No fever, vital signs stable, abdomen soft, FH 140bpm. Which of the following will be the indicator to transfer her to a tertiary center ?
A. Fetal fibronectin
B. ….
Farmer fell backwards from horse, GSC 4 with right pupil dilated. Intubated patient and neurosurgical center is 1 hour away by air. What is the next management ?
A. IV Mannitol 20%
B. Send to Neurosurgical doctor with a flying doctor.
C. IV Dexamethasone
Young man with a midline swelling which moves with tongue protrusion. What is the next management ?
A. Simple excision
B.Extended excision
C.Ultrasound
Dx: thyroglossal cyst
Psychiatry questions (OCD in cldren/Delusion/Borderline Personality Disorder/Anti-social Personality Disorder)
High impact MVA with ankle deformity , no chest injuries. ON examination, sudden tachypnoea with raised JVP. Next management ?
A. ICT
B. Needle Thoracocentesis
C. ECHO (pericardiocentesis)
Dx: cardiac tamponate.
Post MI last week, presented with sudden collapse. Next investigation ?
A. Urgent ECHO (Complication post MI rupture)
B. CT Coronary
Young guy, went to Thailand for 6 weeks after 4 weeks came back with fever/myalgia. Options :
A. Malaria (1-3 weeks incubation period)
b. Dengue
c. Thyphoid (GI symptons)
57F w/ Type 2 DM, elevated fasting blood sugar. What lifestyle management goals based on SNAP guidelines?
a/ Smoking: 0 cigs/day; Nutrition: healthy; Alcohol: ≤2 drinks/day; PA: 150min aerobic + 2-3 resistance/wk
b/ Smoking: 0 cigs/day; Nutrition: healthy; Alcohol: ≤2 drinks/day (men), ≤1 drink/day (women); PA: 150min aerobic + 2-3 resistance/wk
Patient on multiple drugs Thiazide, celecoxib, paracetamol, perindropil. Gfr went down to 20 from 30 something.
What drug combination is the cause?
- Celecoxib and Thiazide
- Perindopril and Thiazide
- Celecoxib and Paracetamol
4yo boy w/ clear rhinorrhea, hit head on rock, briefly passed out but fine since. Tympanic membrane looks unusual. Concerned diagnosis?
a/ Fracture involving the floor of the cranial vault
b/ Meningitis
c/ Epidural Haematoma
20F w/ sexual assault hx, follow-up visits for support & investigations. Police request for statement. Best course of action?
a/ Provide written statement after obtaining consent
b/ Provide verbal statement to police station
80F w/ weight loss, anxiety, poor hygiene, bruise on L cheek, vague about incident. Most important differential?
a/ Elder abuse
b/ New diagnosis of depression
c/ New diagnosis of dementia
27F w/ easy bruising, epistaxis, menorrhagia, petechiae. Normal prothrombin & PTT. Likely diagnosis?
a/ Von Willebrand disease
b/ Acute immune thrombocytopenic purpura
c/ Aplastic anaemia
Scenario of obese man with daytime somnolence.
Girl with headache and fever for 1/52. Mother has similar hx of recurrent headache. Next investigation
a/LP
b/MRI
URTI with greenish sputum. Options Klebsiella/S.Pneumonia/ Legionella
Patient NKMI with FBS 5.8. Options -Repeat OGTT in 3 months.
Young lady with sore throat and fever was given amoxicillin. Presented a few days later with diffused rash over torso. Still had persistent fever and sore throat. What investigation to confirm diagnosis?
a/Throat swab
b/Blood C&S
c/Specific Ig E for Penicillin
DD: amoxicillin rash, rheumatic fever, mononucleosis?
Indication for LSCS
Lady with breast ca + lytic lesion on femur Next management ? Options : A. Surgery B external radiation c. chemotherapy
Question on a lady who went to a party had a minor accident and required admission Was given Iv Metochlorpromide. Developed Eye signs- looking upwards (I think it was Occulogyric crisis). Asking about treatment
A/Benztropine
B/Naloxone
Gilbert/G6PD/Primary Billiary Cholangitis (Separate questions with blood parameters)
Post Local anaesthesia had tongue tingling What to give to reverse it ?
A. Midazolam
B. Intralipid
Lady in labour, as soon as delivered baby, BP drop and profused per vaginal bleeding. Dx ?
A. Amniotic fluid embolism
B. Pulmonary Embolism
C. DIVC
9yo boy w/ asthma, uses reliever 2-3x/wk, night symptoms 1x/6wks. Indicator of poor asthma control?
a/ Daytime symptoms >2 days/wk, lasting min to hrs
b/ Nighttime symptoms >once every 6wks
20M w/ burning, itchy lesion on 3rd R toe after hiking, similar past lesion on fingers. Prevention advice?
a/ Cease smoking
b/ Apply topical corticosteroids to the fingers and toes daily
72M w/ 4-month history of painful swallowing, gravelly voice, L ear pain, 20 pack-year smoking, excessive alcohol use. Likely diagnosis?
a/ Carcinoma of the oropharynx
b/ Reinke’s oedema
c/ Parkinson’s disease
74F w/ early mild dementia, daughter wants to suspend her license due to driving concerns. True statement about dementia & driving?
a/ Dementia drivers at higher risk for accidents
b/ Driving co-pilot reduces risk in dementia
31F w/ 3yo daughter, struggling w/ tantrums, food throwing, hitting, and other challenging behaviors. Best way to manage?
a/ Praise behaviour more than the child
b/ Children need clear explanations of wrong behaviour
7yo boy w/ widespread bruising, leg/abdominal pain, purpura on buttocks & legs, +blood/protein on urine dipstick. Most likely diagnosis?
a/ Henoch-schonlein purpura
b/ Leukaemia
55M w/ L jaw pain, sharp, shooting, worse w/ chewing & hot/cold drinks, no trauma or swelling. Likely diagnosis?
a/ Trigeminal neuralgia
b/ Cluster headache
c/ Temporal arteritis
28F w/ major depressive disorder, on sertraline, wants counselling to wean off meds. Best psychological therapy for moderate depression?
a/ Interpersonal psychotherapy
b/ Cognitive remediation therapy
39F w/ hx of migraines w/ aura, stopped combined pill, considering progesterone-only pill. Absolute contraindication for it?
a/ Current breast cancer
b/ Past history of ischaemic heart disease
24M w/ gender incongruence, starting feminising hormones (oestradiol, spironolactone). Correct statement about feminising hormones?
a/ Fertility reduces soon after starting oestrogen
b/ Over 6-12 months, oestradiol reduces muscle mass, testicular volume, & causes voice feminisation
32M w/ alcohol dependence, drinks half bottle whiskey/day, no withdrawal symptoms, GGT mildly elevated. Next step in management?
a/ Refer for inpatient detox via local Drug & Alcohol service
b/ Start naltrexone 50mg daily
68F w/ blurred vision, T2DM, HTN, inconsistent meds. Likely cause of vision deterioration?
a/ Hypertensive retinopathy
b/ Diabetic retinopathy
c/ Age-related macular degeneration
34M w/ chest pain, SOB, fever, diagnosed w/ pericarditis on ECG. What to expect on ECG?
a/ PR depression & diffuse ST elevation, then T wave changes
b/ Loss of P wave & tall T waves
12mo boy, well, up-to-date on vaccines, routine immunisations. Recommended vaccine combo?
a/ MMR, Pneumococcal, Meningococcal ACWY
b/ MMRV, Hib, Meningococcal ACWY
4yo Aboriginal girl, up-to-date immunisations, next preventative health check based on Australian guidelines?
a/ Check visual acuity, hearing, oral health, growth, behaviour, developmental milestones, & child maltreatment risk
b/ Check haemoglobin, visual acuity, hearing, & child maltreatment risk
76F w/ COPD, breathless, productive cough, needs prednisolone for illnesses. Expected FEV1 on spirometry?
a/ 50%
b/ 30%
c/ 65%
–years old lady, NKMI Breast lump at areolar with itchiness/redness Preductal mastitis
Greenish discharge from breast Options : Duct ectasia
Boy presented post white spider bite vitally stable. Reached hospital in 2 hours and had itchiness with erythema at bite site . What is the next step?
A. Cephalexin
B. Polyvenom
C. Swab
D. Antihistamics
Patient after dialysis developed hyponatremia, drowsy, wheezing. Admitted to ED. What next investigation to do:
a/CXR
b/CT
c/ABG
d/FBE
Foster parents brought a 6Y girl for examination due to she demonstrated sexual acts towards a boy. What should we do first:
a/Notify child WELLBEING service (exact wording)
b/Psych assessment
c/Drug screen
d/Something else don’t remember
The woman after hip surgery developed confusion, fall down but did not injury herself she agitated and shouted at nurses that it is their fault and she will go to court (something like this)
a/Ct
b/Frontal lobe testing
c/CXR
d/Drug and alcohol assessment
CXR given with the man coming with SOB. Everything else is normal. Diagnosis:
a/Cancer (no opacity anywhere)
b/PE
c/Pneumonia (no other symptoms, no consolidation or perhilar, so chose PE, however not sure)
The traveler was in Colorado developed mountain sickness and now want to travel to Peru
a/Acetazolamide
b/Advise
Bat bite (clear wound, person was previously immunized)
a/Reassure
b/Vaccinate (this is the correct)
c/Ig