2020 has really been a tough pill to swallow in, we hope you have been staying positive and testing negative. If you’re struggling with AMC preparation, you are not alone. We wish we had all the answers, but don’t lose hope. We are humbled to work with some of the best candidates during this uncertain times. They have shared their recalls and we quickly compile them to share with all of you. We believe that this is the perfect timing to get prepared for the AMC MCQ exam. Finally, we would like to give a big shout out and congratulations to those who had passed their exam! We wish you all the best!
Australian Medical Council (AMC) MCQ Recalls OCTOBER 2020 compilation
- pregnant 20w ,her 1st trimester screening shows low risk for 21, 13 & 18 triaomy ,presented with low level of PAPPA ,no other screening mention about bhcg , has no family h/o. What to do for follow up?
1) refer for routine non invasive antenatal screening
2) nunataltranclucency us
3)evaluation for growth screening
4) reaassure and stop screening
5) termination of pregnancy - young boy repeat every sentence twice and count to 20 before answering any question. medications?
a) Alprazolam
b) Sertraline - 200 people town, 5 children found Trachoma , contact trace found 24 household. Except treat index cases, What to do?
A.Treat the whole community
B.Treat for contact *
C.Prophylactic Antibiotics for contact
D.Prophylactic antibiotics for the whole community - statements true about the Glasgow coma scale?
a/ includes measurement of pupillary reflexes.
b/ includes measurement of verbal response. - a 5 Year old came with symptoms of Asthma attack. He was given inhaled salbutamol and the symptoms were relieved. Now he has to be discharged. What to give to prevent future attacks?
a. Oral Prednisolone
b. Fluticasone
c. Montelukast
d. Salmeterol - 13-year-old develops fever, malaise, sore throat, and a dry, hacking cough over several days. Appear well, chest examination has diffuse rales and rhonchi. What is the most likely pathogen
a/ H infleunza
b/ M. Tuberculosis
c/ M. pneumonaie
d/ S. pneumonaie
e/ S. Aurues - A 25 yr old woman developed chicken pox at 14 weeks gestation. Blood test shows IgM for varicella as positive. What is your management?
A. Repeat serology in 1 week
B. Give antibiotics.
C. No action needed.
D. Varicella zoster immunoglobulin. E. Pelvic U/S. - man sexually active with multiple partners. right scrotum is swollen, tender, and firm. next step?
a/ Treat the patient for epididymitis and have him return if symptoms persist.
b/ Order a statim (STAT) color Doppler ultrasound and urologic consultation. - premenstrual fatigue, breast tenderness, and bloating. pills alleviated PMS symptoms except depression and emotional. next step?
a/ Spironolactone
b/ Fluoxetine - a 25 y old girl who had right hemicolectomy due to crohn last year,her BMI is 15 and is admitted for nasogastric nutrition but does not allow for NG tube, complaining that why she is in ER and hasnt been visited by her doctor because just her doctor know her problem.what is underlying cause of her behavior?
A- anorexia nervosa
B- borderline
C- relapse of crohn
D- depression - woman with severe seasonal allergies, attempts to avoid potential antigens proven unsuccessful. advise?
a/ Immunotherapy against respiratory organisms can decrease the incidence of bacterial sinusitis.
b/ Immunotherapy requires the identification of specific antigen by dermal or serum testing.
(Exact Same Words) - 2nd day jaundice – mother AB negative. Feeding well. But little vomiting. Liver 3cm below. Bilirubin 300. Conjugated 10 . Cause?
A. Biliary atresia
B.ABO incompatibility
C.Brest milk jaundice
D.Rh incompatibility - man with hypertension and COPD, cramps in his calf muscles upon walking one block. diminished popliteal and pedal pulses. medication to avoid an adverse effect on a comorbid condition.
a/ Angiotensin-converting enzyme inhibitor
b/ Beta-blocker, noncardioselective - woman with cardiac artery stenting, develops episodes of transient visual loss to her left eye. wision returns within 30 minutes. 10 of these events within the past 3 months. symptoms?
a/ Retinal vein thrombosis
b/ Central retinal artery ischemia - A five-day-old infant having a mild purulent eyes discharge from previous day is brought to the clinic. In Ph/Ex, there is a mild crusted yellowish discharge in both eyes without a prominent swelling and inflammation of eyelids.
a) Staph
b) Strept
c) Gonorrhea
d) Clamidia - 20-year-old G1P0 on her first OB visit at 10 weeks gestational age. no significant medical history . not recommended first trimester blood testing ?
a/ CBC
b/ Hepatitis B surface antigen - infant less than 2500g shows edema over her hands and feet. diagnosis of Turner syndrome?
a/ A liver palpable 2 cm
b/ Redundant skin folds at the nape of the neck - An Rh –ve woman who is a Jehovah’s Witness, is refusing to take anti-D immunoglobulin. Her baby is found to be Rh +ve. What will you do next?
A Tell her to discuss this matter with her priest B Try to convince her during review next week
C Tell her it’s essential
D Tell her she may not get pregnant again
E Let her sign a letter of refusal - 10 cm cyst two month after pancreatic , Patient come with epigastric pain. cyst is exactly posterior to stomach,best mx?
A.ERCP
B.endocopic gastrostomy
C.laparatomy
D.conservative management and re evaluation in 6 months
E. Precutaneus drainage of the cyst - A young pt has got often light headness, dizziness, his clinical features are normal, CXR, ECG normal, Holter monitor reveals ventricular ectopics:
1Reassure
2.ETT
3.Dobutamine indeced echo
4.plain echo - old female patient is abusing alcohol. laboratory test to confirm this?
a/ MCV
b/ ALT - Pt lawyer wants his medical records as he is going to appear in court. What do you do?
a/ give him the records
b/ tell him need court order
c/ need to do forensic assessment before giving records - Pt has to plead in court for shoplifting. Asking what is the most important factor that makes him able to plead in court
-perception
-memory
-judgement - Pt on multiple drugs including genta. Regular genta levels are measured and are normal. However pt came with dizziness even when lying down, and some other cerebellar symptoms. Asking cause
– genta ototoxicity
– cerebral lesion - Pt hit in the eye by a ball. How to tell that there is an orbital floor fracture
– diplopia on upward and outward haze
– diplopia on downward gaze
– pain on opening mouth - Usg of I think hydatid cyst with history of recent travel. Askimg what to do next
– hydatid serology
– percutaneous aspiration - Ovarian simple cyst with Iliac fossa pain. Size 1.8cm asking what next
– usg again in 3 week
– lap aspiration
– lap cystectomy - There was an MI ECG asking for dx
- There was an ecg that I wasn’t sure what it was but came with a case. Case was pt brought to Ed. Had an episode of muscle jerks for one min followed by total body spasm for 30s. Pt has no recollection of it happening. Now perfectly normal. He was in ed and ecg monitoring going on and his hand twitch and ecg monitor went off. Ask what to do
– urgent pacemaker
– TEE - There was a weird question about internet disorder (video gaming stuff)
- Another case on chronic fatigue post MI
- Patient came with generalized headache with neck discomfort. The symptoms got worsen at night. She has mild reaction to the lights. She is taking OC pill other than that no other history. What is the Dx?
(a) Tension Headache
(b) Migraine
(c) Cervical spondylosis
(d) Cluster headache - light bleeding at midcycle during her first month on the oral contraceptive pill. response?
a/ Stop pills and resume after 7 days.
b/ Continue pills as usual. - An overweight woman with FBS 6.2 , hyperlipidemia who suffer mild knee osteoarthritis and she doesn’t have physical activity has sedentary life style BMI 33. Management?
A. Exercise physiology assessment
B. 150 min exercise in a week
C. Metformin
D. Statin
E. Roux en Y - newborn in cyanotic attack is placed on a face mask with oxygen flowing at 10 L/min. pulse oximetry unchanged, PaO 2 is 23 mm Hg. next step?
a/ Indomethacin infusion
b/ Adenosine infusion - MVA case with pain during breathing , shortness of breath with this ct, he also has paradoxical breathing.what to do?
A.morphine
B.chest tube
C.Needle aspiration
d.intubation - sucidial divorced man he had a suicide attempt He wanted to get back to his wife and said I will show HER now
a.Call the police
b.Hospitalise
c.Call his wife - Pt got admitted with suicidal attempt . And he was accusing hospital staff . Claiming money . His wife got separated 3 months back . He says ‘ she will not get away with it ‘ what’s the dx ?
A.Borderline
B.Persecutory delusion
C.Narcistic - HIV man, antiretroviral therapy is failing, CD4 count less than 65 lymphocytes/mm 3. Prophylaxis instituted?
a/ Mycobacterium avium complex
b/ Fungal infections - old woman on long-term glucocorticosteroid therapy for polymyalgia rheumatica. diagnosis?
a/ Dual photon absorptiometry
b/ DEXA scan - young male has been seen in the clinic for urethral discharge. treated with ceftriaxone, but the discharge has not resolved. etiologic agent to cause this infection?
a/ Ceftriaxone-resistant gonococci
b/ Chlamydia psittaci - woman with AMS, past history includes hypertension & stroke. On haloperidol 3 days ago. patient tremulous, diaphoretic and has marked muscular rigidity. diagnosis?
a/ Urinary tract infection
b/ Neuroleptic malignant syndrome - man complains of insomnia, has past history of alcohol dependence. most important to rule out which of the following medical problems before using the desired sleep aid?
a/ Mild COPD
b/ Kidney failure - young man swallow unknown substance during a drug bust. indication for laparotomy?
a/ Refusal to take high doses of laxatives
b/ Signs of toxicity from leaking drug packets - woman with Graves disease started on PTU. patient is agitated, confused, and has rales on auscultation bilaterally. diagnosis?
a/ Pheochromocytoma
b/ Thyroid storm - student on travelling took ciprofloxacin for 5 days for diarrhea. 2 to 3 weeks since coming home, sympton continued with no rectal bleeding. therapy treatment?
a/ Another course of ciprofloxacin
b/ Doxycycline - man hit by a car presents to the ER with hypotension. tenderness and bruising over his left lateral chest below the nipple. ultrasound examination reveals free fluid in the abdomen. organ injured?
a/ Kidney
b/ Spleen - woman develops fever, lower abdominal pain & uterine tenderness after vaginal delivery. Clostridia are seen in a smear of the cervix. which is most tied to a decision to proceed with hysterectomy?
a/ Close observation for renal failure or hemolysis
b/ Immediate radiographic examination for hydrosalpinx - fetus of 26-year-old G1P0 patient at 34 weeks gestation has evidence of IUGR on previous ultrasound examinations. Systolic to diastolic ratio is much higher than 3 weeks ago. Now reverse diastolic flow.
a/ The Doppler studies indicate that the fetus is doing well.
b/ With advancing gestational age the S/D ratio is supposed to rise (exact same words). - intoxicated man brought to the ED . chest radiograph shows infiltrates involving the right-lower lobe. initial antibiotic coverage ?
a/ Gram-negative coverage only
b/ Broad-spectrum with anaerobic coverage - patient with gallstones presents with right upper quadrant pain, fever, jaundice, and shaking chills. he is febrile. cholangitis is suspected. correct statements concerning cholangitis?
a/ The most common infecting organism is Staphylococcus aureus.
b/ The diagnosis is suggested by the Charcot triad. - Postcoital test for evaluation for infertility. she & spouse should have sexual intercourse on which day of her menstrual cycle as part of postcoital testing?
a/ Day 3
b/ Day 14 - woman with UTI prescribed trimethoprim-sulfamethoxazole (Bactrim) without asking her allergies. she returns with significant hives. principles of medical professionalism been violated is?
a/ The principle of primacy of patient welfare
b/ The principle of patient autonomy - 40-year-old woman with gradual onset of low back pain over several months. morning stiffness pain that improves throughout the day. no neurological deficits. caused by?
a/ Back strain
b/ Inflammatory arthropathy - mother develops an illness during pregnancy. diagnosis of CMV infection is made by serology. prenatal CMV infections may produce which retinal disturbance?
a/ Chorioretinitis
b/ Cherry red spot - man presents to the ED complaining of RLQ pain for 24 hours. no appetite, nauseated & vomited twice. his WBC is 14,000/μL. as you palpate the LLQ ,his RLQ is painful. sign?
a/ Blumberg sign
b/ Psoas sign - fall down, tenderness over the medial joint line of the knee. flexion and extension of the knee are painful. The Lachman test and the anterior drawer test are negative.dx?
a/ Chondromalacia patella
b/ medial meniscus injury - a gp is writin a referral letter for a pt who has syphilis to a surgeon, pt insists that u remove syphilis from her medical record and referral letter what would u do?
– do as her wish
– tell her doctors are bound with confidentiality
– ask her the reason why she wants the info to be removed
– ask ur defence manager - 28 year old lady presented with sx of UTI. Treated with Bactrim for 3 days, worsening sx. Otherwise, no fever or flank pain. On examination showed mild suprapubic tenderness. Which is best next step?
a/ IV pyelogram
b/ Urine culture
c/ cystoscopy
d/ CT scan - cholestatic pattern of jaundice after recievin mtx, flocluxacilline and prednisolone, the culprit drug?
– Mtx
– Flucloxa
– Pred - serum sickness like reaction photo-after recievin antibiotics non blanching purpura and arthralgia what to check?
– Eosinophilia
– Plt
– Bun cr - A 12 year old boy with craniopharyngioma after hypophysectomy take thyroxine, cortisone, GH. He had diarrhea without vomiting. Other members of the family get gastroenteritis too. What is the most appropriate management?
A. Triple dose of cortisone
B. Oral rehydration fluids
C. Cease thyroxine
D. Antibiotics - male admitted to ER following a motorcycle accident. skull films disclose a fracture of the left temporal bone. patient suddenly loses consciousness & dilation of the left pupil is noted. diagnosis?
a/ A ruptured berry aneurysm
b/ An acute subdural hematoma - 7 year old girl suspected sexual assault. Management?
a/ report to child protection service
b/ hospitalize the child until the offender has been apprehended. - young girl complains chronic abdominal pain. made many various vague complaints over the past year. examinations and lab tests are normal. workup by gastroenterologist also negative. next step?
a/ Initiate biofeedback therapy for chronic pain
b/ Order immediate psychiatric evaluation - infant after circumcision developed prolonged bleeding & bloody diarrhea. subsequently, still has occasional bloody diarrhea. admitted to hospital twice for pneumococcal bacteremia, platelet count low then. WBC count normal. diagnosis?
a/ Idiopathic thrombocytopenic purpura
b/ Wiskott-Aldrich syndrome - 10 year-old boy diagnosed with cerebral palsy, and the parents do not really understand what this means. explain.
a/ Cerebral palsy is a static encephalopathy because deficits do not appear after birth.
b/ Cerebral palsy is a static encephalopathy because the injury to the brain does not progress. - woman had three vaginal deliveries, the last was complicated by gestational diabetes & preeclampsia. Never done papsmear before. her dad has coronary artery disease, aunt ovarian cancer. Best screening for her?
a/ cervical screening test, cholesterol profile and fasting blood sugar
b/ cervical screening test, cholesterol profile, fasting blood sugar, mammography and serum ca-125
c/ cervical screening test, cholesterol profile, fasting blood sugar and serum ca-125 - a 33-year-old G3P2 at 30 weeks gestation has an infection in pregnancy. which is a reactivation & therefore not a risk to the fetus?
a/ Group B coxsackievirus
b/ Rubella virus - a 26-year-old male college graduate is concerned that he may have adult attention deficit hyperactivity disorder (ADHD). which is true regarding this condition?
a/ The symptoms are likely to be more pronounced in adults as compared with children
b/ Children diagnosed with ADHD commonly continue to have symptoms into adulthood - young boy have episodes of eye fluttering lasting several seconds. sometimes loses track of his thoughts in the middle of a sentence. episodes may occur up to 20 or more times per day. two head injuries as a young child: brief loss of consciousness. tests?
a/ Conners Rating Scale
b/ Brain MRI - young woman Pap smear showed high-grade squamous intraepithelial lesion (HGSIL). colposcopy confirms severe cervical dysplasia (CIN III). virus type?
a/ HPV type 6
b/ HPV type 11 - hypertensive 56-year-old woman complains of rapid & irregular heart rate. diagnosis?
a/ Atrial fibrillation
b/ Paroxysmal supraventricular tachycardia (PSVT) - 44-year-old man with painless, large volume intestinal hemorrhage. suspect Meckel diverticulum as possible cause. test to confirm diagnosis?
a/ Esophagogastroduodenoscopy
b/ Sigmoidoscopy - a 12-year-old has several weeks of abdominal pain and black stools. which study is most likely to be diagnostic?
a/ Esophageal manometry
b/ 24 hour pH probe - man complains of generalized crampy abdominal pain. vomits intermittently over the last 6 hours. gunshot surgery as a teenager. hyperactive bowel sounds & mild tenderness without rebound. next step?
a/ Begin fluid resuscitation, bowel decompression with a nasogastric tube, and request a surgical consult.
b/ the rest cant remember - young man has progressive pain in his knees. tenderness, swollen & prominent tibial tubercle. radiographs unremarkable. diagnosis?
a/ Osgood-Schlatter disease
b/ Popliteal cyst - young woman was told by roommate to be isolative, ‘odd’, paranoid & hearing ‘voices’. patient became agitated, screamed & start getting aggressive. treatment?
a/ Haloperidol and lorazepam IM
b/ Clozapine PO - man has a bowel resection for intestinal perforation . his cvp had been 12 to 14 but is now 6, in the face of diminished blood pressure and oliguria. most likely etiology of his hypotension?
a/ Pulmonary embolism
b/ Hypervolemia - Group of Aboriginal children’s treated for scabies with topical application of permetin, after 3 weeks persistent symptoms. What to do next?
1)Oral steriod
2)Topical sterios
3)Repeat same treatment
4)Oral antifungal
can u plz highlight the answers?
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