AMC MCQ Recalls OCTOBER 2023

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In 2022, COVID-19 ranked among the top causes of death in Australia, following heart disease and dementia.

On 14th October 2023, Pfizer Australia and BioNTech SE announced that the Therapeutic Goods Administration (TGA) have authorized the companies’ XBB.1.5-adapted monovalent COVID-19 vaccine (COMIRNATY® Omicron XBB.1.5) in individuals 5 years and older.

This decision paves the way for the imminent availability of an updated vaccine designed to target various sublineages related to Omicron XBB, which currently constitute the primary source of COVID-19 cases on a global scale.

Omicron XBB sublineages account for the majority of COVID-19 cases globally. Although Omicron BA.4/BA.5-adapted bivalent COVID-19 vaccines provide some protection against a range of outcomes from XBB-related COVID-19, evidence suggests that vaccines better matched to currently circulating strains can help further improve protection against symptomatic and severe COVID-19.

On the side note, we would like to extend a huge thank you to those who have provided us with these recalls. It is now our turn to do our part and help solve them for you. You can obtain them from here.  

Australian Medical Council (AMC) MCQ Recalls OCTOBER 2023 compilation

Liver CT scan picture with irregular big mass inside the liver…

Half of liver is occupied. Dx…

a) Intrahepatic Ca

b) Secondary metastasis

c) Hydatid cyst

Liver CT – inside the liver I could see like hemorrhages. Its big area

a) Intrahepatic hemorrhage

b) Spleen hemorrhage

c) Spleen laceration

Child fallen and started vomiting and is drowsy after fall. Small swelling over scalp in right side. Child is okay after few hours. Ask what to do next. Vitals are okay

a) Send home

b) Ct scan

c) Mri

So many questions on carotid artery stenosis              

75y/o female, present with left arm weakness. Cartoid artery studies shows some degree stenosis.50% asked what to do next for diagnosis the condition

a) Mri

b) Ct

c) Ecg

d) echo

Acute upper gastric pain over one hour. Settled after vomiting. No abnormalities on clinical examination. How to diagnose?

A Upper GI endoscopy… gastric ulcer

B S/Lipase

C USS Abdomen

D CT Abdomen

10 year old, history of retrosternal chest pain. Relieved with antacids. What to do next?

A Endoscopy

B USS Abdomen

C CT Abdomen

May be GERD… initial 24 hour PH monitoring….. any red flag point then endoscopy

GERD… trial PPI > endoscopy

Nephrotic Xn scenario: Teenage boy, BP mildly high. Protein ++, RBC ++. What’s the BEST finding to come to a diagnoasis?

A Low S/Albumin

B C3 levels

C Blood culture

D Urine analysis & Urine culture

E Acute post streptococcal glomerular nephritis APSGN— common in kids

Man travel to Jakarta 5 days ago , now present with fever , myalgia, rash and eye soreness. No splenomegaly . No fever

a- malaria

b- dengue

c – flavivius

d – Japanese encephalitis

25 year old woman with menorragia , irregular cycle between 3 – 6 months. She got promoted and need to travel a lot and this become trouble for her. She didn’t want to get any contraception.

a – merina .. best contraceptive

b – COC pill

c – tranaxemic acid because she did not want

In aged care , caregiver notice blood stained pantie of a old lady

On examination, nearly 3 or 5 cm laceration at vagina. Dx

a – ca endometrium

b – lichen sclerosis

c – assault

d- candidiasis

3 or 5 year old boy present with diarrhoea and later he’s scratching his anus. On examination , there’s fissure and mucous discharge from anus.

What’s the cause?

a – E. coli

b – Giadia

c – Candida

d – Entero worm—- enterobius vermicularis

A new drug is found to have 25% reduction of prostate cancer. Incidence  of prostate cancer in the population is 8/100 ,How many people we need to treat to reduce the prostate cancer in 1 person?

A) 10  
B) 50  

C) 100   

D) 200

A 57 yo new patient, on sertraline 50mg, aspirin 100mg, history of MDD, SVT (ablated), family history of diabetes in parents. Why taking aspirin?

a) Low-dose aspirin has been shown to reduce risk of colon cancer in those aged 50 – 74 years

b) Low-dose aspirin has been proven to reduce episode severity in depression, related to the neuro-inflammation hypothesis

A 35yo with C677T MTHFR gene variant. Ordered by naturopath. No symptoms, 2 healthy children. Appropriate step?

a) Refer her to a clinical genetics unit to discuss cascade testing for other family members

b) Reassure her that MTHFR gene variants are common and do not increase the risk of particular health problems

Elderly woman living by herself, her siblings live close to her and help her in her daily life. She suffered a fracture and was admitted.  before discharging her, you need to be sure that ?

a) prepare meal by herself.

b) Take medication by herself,

c) able to walk with or without assistance

24 lady, SOB, wheeze, worse with exercise, used boyfriend’s inhaler, bilateral expiratory wheeze, raised FEV1 post-bronchodilator. What’s correct?

a) She should be commenced on a PRN short acting beta-agonist, a regular low dose inhaled corticosteroid and a short course of oral prednisolone.

b) A family history of asthma is not considered a risk factor for the development of asthma.

35 lady, progressive lower back pain, worse in mornings, HLA-B27 positive. Consistent feature with ankylosing spondylitis?

a/ Back pain which improves with rest

b/ Morning stiffness which lasts for more than 45 minutes

14yo guy, tackled in rugby, no head hit, mild pressure headache, no LOC, no vomiting, normal neuro exam. Wants to return to sport for final in 4 days. Advice?

a) Advise him that as long as his headache resolves by the time of the grand final, he will be able to play in the match.

b) Advise him that he will not be able to return to full play prior to the grand final.

Old lady in dialysis for 5 years. Come to see you with her son. He states that she is tired about the dialysis and would like to stop. She understands that without the treatment she is going to die. What to do?

A) ask for psychiatric evaluation

b) family court

c) speak with her alone

d) palliative care.

4yo boy, fall from local reserve, head injury, ‘passed out,’ tonic-clonic seizure 20s still ongoing. Next management step?

a) Phone his parents to gain consent prior to commencing any active treatment.

b) Immediate active treatment, administration of oxygen, gaining IV access, check sugar, administer midazolam (IV, IM or buccal)
c) referral to tertiary

21 lady, G1P1, 6wks post-partum, glucose intolerance in pregnancy, breastfeeding. Advice on diabetes and breastfeeding.

a) She should check her blood glucose levels, by fingerprick, prior to each breastfeed to ensure she is not at risk of an acute hypoglycaemic episode

b) Breastfeeding post-partum has been shown to reduce diabetes risk post gestational diabetes

Young adult male with multiple male partners always uses condoms, came for routine review. Most appropriate test?

A. HIV,  

B. hepatitis C

C. HPV  

D. chlamydia,

37 lady, left periorbital swelling, mosquito bite, pain, fatigue, muscle aches, swollen left eye (given photo), conjunctival injection, reduced upwards gaze, diplopia. Known complication?

a) Maxillary sinusitis

b) Venous sinus thrombosis

c) Dental pulpitis

16 male, sudden intense right testicular pain, vomiting, nausea, no trauma, sexually active. Right teste elevated, absent cremasteric reflex, pain persists. Testicular torsion??? Correct statement?

a) Regardless of time to presentation, this condition needs to be referred for urgent surgery

b) This patient should undergo immediate manual detorsion

59 lady increasing vulval itch, post-menopausal, on oral terbinafine, erythema, no vaginitis/discharge, no satellite lesions, diagnosis?

a) Psoriasis

b) Lichen sclerosis

c) Lichen planus

66 male, rapid 1cm dome-shaped nodule w/ central keratin plug on L forearm. Likely keratoacanthoma. Management? 

a) There is no need for any treatment

b) Excisional biopsy of the whole lesion

32 male, itchy, tender glans penis, multiple erythematous scaly lesions, not circumcised, poorly controlled type 1 diabetes. Next management step?

a) Refer him to a surgeon for consideration of a circumcision

b) Commence hydrocortisone + clotrimazole 1% cream topically twice daily until 2 weeks after the skin is clear

42 lady, strong family history of heart disease, smoker, BMI 38kg/m2, coronary artery calcium score 150 AU, no fasting bloods yet. Recommended treatment?

a) Recommend statin therapy for primary prevention of myocardial infarction

b) Recommend both aspirin and statin therapy for primary prevention of myocardial infarction

32YO man brought to emergency room after report by people in shop area, singing loud songs, changing tunes and lyrics. says he’s the best singer, unkempt, foul odour, makes eye contact and animated.

A acute mania,  

B, schizophrenia 

C, Methamphetamine abuse ,

D. schizoid effect.

72 old man, 6-month lesion, previously had basal cell carcinoma on the face. 6mm pink papule, well-circumscribed, arborizing vessels, central ulceration. Suspected basal cell carcinoma. Most appropriate removal method?

a) Elliptical excision measuring 16 x 48mm

b) Elliptical excision measuring 12 x 36 mm

78 old lady, difficulty reading in dim light, central vision problems. PMH: Ischaemic heart disease, hypertension, type 2 diabetes, osteoarthritis. Most likely diagnosis?

a) Age-related macular degeneration

b) Chronic glaucoma

78 old man collapses, unresponsive, abnormal breathing. What’s the chest compressions to breaths ratio in Basic Life Support? 

a/ 30 compressions : 2 breaths

b/ 15 compressions : 1 breaths

c/ 30 compressions : 1 breath

21mo boy, worried about development. What developmental expectations at this age?

a) Speak six or more words

b) Able to put on his clothing

c) Jump on the spot

6yo with headache, drowsy, what exam finding suggests raised intracranial pressure?

a) Widened pulse pressure

b) Tachycardia

c) Hypotension

49gentleman, smokes 20/day, wants to quit. Seizure history, carbamazepine, sodium valproate. Effective smoking cessation med?

a) Nicotine 21mg/24 hour patch daily with Nicotine lozenge 2mg as needed

b) Nortriptyline 10mg orally daily

Aboriginal with 4 month kid . Want to get  kid immunised quickly, not making eye contact. What will be the most appropriate?

A .motivate to bring someone next visit.

B .observe in next visit.

C. report to CPS.

68 gentleman, asymptomatic, wants osteoporosis test but for Medicare rebate. What conditions qualify for DXA rebate?

a) Multiple falls, low body weight, parental history of fracture

b) Coeliac disease, hyperthyroidism, hypogonadism

64 lady acute epigastric pain, vomiting, fever, tachycardia. Elevated WBC, GGT, AST, ALT, LDH. Lipase normal. Next investigation?

a) Abdominal X-ray

b) Upper abdominal ultrasound

42 lady w non-specific pelvic pain, CA125 48U/mL. Possible cause?

a) Corpus luteum cyst

b) Uterine Prolapse

c) Uterine fibroids

Research paper, new oral hypoglycaemic agent, mentions 95% confidence intervals. Describe confidence intervals?

a) The 95% CI means that there is 95% certainty of the efficacy of a treatment

b) A 955% CI means that it is 95% certain that the true value lies in the given range.

17 year old boy present with headache, which got as post sport injury ( halmet to halmet injury ) 5 days ago. No LOC at that time . No neurological S/S except headaches. There’s tender point at temporal region but no swelling seen . He asked for to do Head X ray as his headache may be from fractures of skull bone. What will you do ?

a- CT brain

b – MRI brain

c – skull X ray

d – no investigation required

Woman 27 years old with Crohn disease. She’s taking azathioprine , sulphur or something I didn’t remember. Her blood test is


WBC – reduced

Platelet – reduced

What will you proceed ?

a – stop sulphurlazine

b – stop azathioprine

c – check creatinine

Renal – giving some analgesic and now present with high BP , red cell cast , what’s the cause ?

a- interstitial nephritis drug induced

b- glomerular nephritis .. because of red cast

c – Ig A nephropathy

A man in prison presented with swallowed razors blades. On examination, abdominal tenderness present . Abdominal x ray given ,

What’s your treatment?

a – admit for observation

b – colonoscopy

c – endoscopy blade ubove pyloric sphinter

d – laparoscopy .. if gas under diaphragm

You are counselling about Down syndrome baby to mother . In counselling section, what complications can this baby suffer ?

a- leukaemia

b – medulloblustoma

c – retinoblastoma

d – Wilms tumour

Prisoner with swallowing foreign bodies and he’s saying he gonna die very soon .

X ray is given and I see.. some white cross mark . I dun know what are those .

What’s this disorder?

a – bipolar disorder

b – factitious disorder

18 years Aboriginal girl present  with chronic otitis media. She’s not immunised since her 18 months as her mother dun believe in immunisation. After give oral antibiotics , what will you do next ?

a – start her  all immunisation

b- give HPV vaccine

c – give pneumococcal/ Hib B vaccination

d – start immunisation as her age

6 months old baby present with diarrhoea and resolved after some days .He’s bottle feeding and now present with loose diarrhoea again. What will you advise?

a – hypo allergic milk

b – lactose free milk

c – pure water

d – stop bottle feeding

Mother complaints about her 3 years old boy who is falling ( what she thinks he’s just falling as his sister chasing him )he’s sweating and pale at that time but no tonic clonic… after that he’s ok and no drowsy.

What inv you want to do ?

a – EEG

b – CT brain

c – echo.. may be cardiac cause

d – electrolytes

c – blood sugar

Case about Biliary Colic ( No fever / Jaundice) just intermittent pain in RUQ  severe pain with respiration cholicystitis

> 53 years woman complaint with LOW 10 kg and lymph node on upper Left clavicle.

What’s diagnosis?

a – ca lung

b – ca stomach more common

c – ca colon less common

Fail chest Management

In AN care , woman ask for epidural anaesthesia for pain management during labour. What investigation need to do more ?

a- coagulation profile

b – platelet count

13 years old woman present with menorrhogia. She starts her period 3 months ago. What’ll be the diagnosis?

a – V-W disease

b – haemophilia

c – ITP

cousin is living with him and he heard that his cousin has regular transfusion .

What disease will you consider first ?

a – Haemophilia

b – thalassaemia

c – ITP

35 years old woman presents with loss of consciousness for 3 times . It lasts several seconds and resolves. She stay in the bed the whole day. What investigation will you consider first ?

a – CT brain

b – MRI brain

c – Echo

d- electrolytes

Patient presents with features of closed angle glaucoma. What investigation will you do ? Fundoscopy done in examinations , no gonisoscopy given in answer

a – Tonometry

Herpes keratitis and ask for treatment.  acyclovir

Neonatal jaundice present with 24 hours after birth but no abnormal in mother in AN care visit. What’s the cause ?

a – ABO incompitability

b – Rh

c – congenital

20 years old boy present with features of pneumonia., he’s using vape.

CXR show bilateral infiltration.

What’s diagnosis?

a – vape induced lung injury

b – asthma

c – mycoplasma pneumonia

d- eosinophilic pneumonitis

26 lady breastfeeding, 4wk baby. Left breast pain, red, hard, tender. Temp 38.2C. Correct management?

a) First line treatment for this condition is oral clindamycin

b) The patient will require review within 24 – 48 hours

Athelete with angle twisting unable to change direction. What is important to diagnose?

A .edema in hindfoot.  
B tenderness in lateral ligaments.
C loss of reflux.
D bony tenderness fibula .

65 male, CKD stable at 50mL/min/1.73m2. Now eGFR 34mL/min/1.73m2. When referral to Nephrologist indication?

a) eGFR <50mL/min/1.73m2

b) A sustained drop of EGFR of 25% or more within 12 months

28 male, 2 mo abd pain, diarrhea w/ blood, mucous, reduced appetite, fatigue, no travel, family Crohn’s and UC, smoking hx, correct statement?

a) Smoking is a risk factor for UC but is not associated with more severe disease

b) Smoking is a risk factor for Crohn’s disease and is associated with more severe disease

57 lady, 3 days heavy vaginal bleeding, resolved, spotting yesterday, postmenopausal, normal cervical screening 6 mo ago, 5mm endometrium. Important investigation?

a/ Diagnostic laparoscopy

b/ Endometrial biopsy

c/ Pelvic CT scan

Long stem, cardiac patient. Elderly taking amlodipine. Diabetic presence with LVF  ,shortness of breath ,crepts. Labs-  mild raised  sodium, potassium  5.8, chloride mild low, rest is  normal. What to give?

A.IV furosemide.

B. spironolactone.

C. steroids.

D salbutamol

49 male, new symptoms past 6 mo, consider androgen deficiency. What symptom constellation?

a/ Reduced libido, breast discomfort, reduced shaving

b/ Reduced libido, voice changes, hot flushes

6yo boy, 6 mo constipation, faecal soiling, withholding. Bristol type 1-2 stools, no blood. Born term, normal development. Exam & investigation?

a/ Abdominal x-ray

b/ Examination of the spine and sacrum

c/ Barium enema

88 lady, low-level aged care, unconscious. Recently started insulin, BS 2.2mmol/L. Immediate treatment?

a/ Glucagon 1mg IM stat

b/ Oral glucose/sucrose

c/ 20mls of 50% Dextrose IV bolus

34 lady, pre-conception check, well-controlled HTN on perindopril. Advice on perindopril during conception?

a/ Advise her it is safe to continue on perindopril throughout her pregnancy and she should continue taking it

b/ Advise her to cease her perindopril now and commence her on either labetalol or methyldopa

19 lady unprotected sex 2 days ago, regular 29-day cycle, day 10. No regular contraceptives. BMI 32, BP 110/70 mmHg. Counseling on oral emergency contraception. True statement about oral EC?

a) Levonorgestrel is more effective in preventing pregnancy compared with ulipristal acetate

b) After using ulipristal acetate, women should not be started on a hormonal contraceptive method for at least five days and should be advised to use barrier methods or abstain from sex until effective hormonal contraception has been achieved

Patient brought  by husband; she saw her kid rolled over by a car few weeks ago. She feels guilty, thinks police will arrest her. Hears voices saying her it’s her fault.

A. schizophrenia   


C. brief psychosis     

D. major depression.

Aboriginal female child 12-year-old had not taken any immunisation after one year. What is best now?

A ask to come at 13.

B begin immunisation from starting again.

C catch up with immunizations now.

10mo baby, widespread fine red rash on limbs. 4 days of high fevers up to 40oC, managed with paracetamol and ibuprofen. No family illness. Likely diagnosis?

a) Roseola infantum

b) Kawasaki Disease

c) Rubella

43 lady, tooth extraction 2 days ago, increasing pain, no facial swelling, allergic to penicillin. Pus in socket. Initial management?

a) Advise regular analgesia with paracetamol 1g orally 6 hourly; prescribe clindamycin 300mg 8 hourly 5 days; advise her to call the dentist first thing Monday morning to arrange further treatment.

b) Advise regular analgesia with paracetamol 1g orally 6 hourly; refer for a CT scan to check for collections that may need surgical drainage; review her with CT results first thing Monday morning.

2mo baby girl, breech birth, equivocal Ortolani and Barlow tests. Next step in management?

a/ Advise that she requires a bilateral hip magnetic resonance imaging (MRI) scan

b/ Advise that she needs a referral for a bilateral hip ultrasound

62 lady, postmenopausal, wrist fracture, T score 1.0. Next stage in management?

a/ Consider specialist endocrinology referral

b/ Commence oral alendronate 70mg weekly

Pregnant female with ankle pain question was there similar with compression bandage and advised elevation. What else ?  with different options

A rest    

B. topical diclofenac .

C. Ice pack.

19 lady, pain post-intercourse, pain urination, unwell. Cervical redness, inflammation, ulceration. Vulvar ulcerations. Initial investigation for suspected diagnosis?

a/ Swab for herpes simplex virus NAAT

b/ Herpes simplex serology

60 male painful perianal lump x2 days, no rectal bleeding, normal bowel habit. Tender skin-colored lump at 3 o’clock. No rectal lumps or blood. Advice on condition?

a/ Advise him to increase his fluid and fibre intake, avoid straining when using his bowels and consider the use of stool softeners if required.

b/ Refer him to a colorectal surgeon for rubber-band ligation of the lump.

A man aged 32 years ,presented to his GP with a one month history of increasing bilateral breast swelling. He was distressed by the appearance and said there was some pain on breast palpation. He denied any other symptom and was usually healthy. What will you do next?


2.ultrasound of both breast.

3. ultrasound of the testes,

4.measure serum prolactin .

84 old lady in aged care, severe vit D deficiency effect on Ca & PTH levels?

a/ Calcium decreased, PTH decreased

b/ Calcium decreased, PTH increased

19 male, 2 wks lethargy, mild fever, sore throat, cervical LAD, tender liver. Likely dx?

a/ Influenza

b/ Infectious mononucleosis

CT scan abdomen given, showed a hematoma in liver


Intrahepatic hematoma

Intercapsular hematoma

Pancreatic hematoma

GB Stone

Q…5different ECGs were given.

(AF, Flutter, VT, VF, CHB)

Patient having chest tightness, recurrent syncope and sweating, vitals were given asked which ecg describes the scenario best

Q.Breast cancer question…Patient 42, aunt diagnosed with Ca Breast at 54,recently. How to proceed

-Annual mammogram

-USG only annually

-Monthly self breast exam

-mammogram bi annually

-both bi annually

Right answer is mammogram every 2 yearly after age 50

Q.Mother brings 19year old with self cut hx and says she is not inspired in life, no goal and is promiscuous and easily influenced. What in Hx helps in diagnosis?

-Childhood sex abuse

-Drug Abuse

-Suicidal intent

-Hx of Suicide attempt

-Family Hx of mental disorder

Person was bitten for a spider with red back (red back spider) in the arm which was swelling, sweaty and a target sing. Indications for antidote:

1)target sign in the arm

2)sweaty arm

3) positive test for venom

Pain arm is first indication

girl 7 years complain of red rash over rectum, painful defecation, blood sometimes in stool

1. Enterobium vermicularis

2. Streptococcus pyogenes

Child 8 years high fever apical opacity cough ask for treatment

1. Benzylpencillins

35years breast pic nipple inverted some secretion came out through nipple squeeze ask the diagnosis

1. Pager disease

2. Du tak carcinoma… Inverted nipple with discharge

3. Du tak ectasia

39weeks Bp decrease on examination fhs 146 head engaged 2/5 what to do cephalic presentation

1. Send home

2. Admit and observe

Loss of pincer grasp, difficulty to hold pen, loss of sensory of 4th and 5th finger. Asked the reason..

a) C5/C6 damage

b) Elbow nerve trap

c) Carpal tunnel syndrome

Picture of eye. Dx…


b) Retinal detachment

c) Hypertensive retinopathy

Same eye picture.. asked for Mx…

a) Oral Valacyclovir

b) Topical dexamethasone

c) Topical Acetazolamide

17 years old pregnant woman comes to AN care first time . What screening test you want to do ?

a – urine chlamydia test

b – CMV serology

c – HPV screening

JAK 2 mutation patient treatment?

a – splenectomy

b- rituzimub

c – plateletpheresis

JAK2 inhibitor, e.g., ruxolitinib

orbital cellulitis ask for investigation.

a – CT head

A girl come to your GP for asking insulin for her boyfriend as he’s busy.

a- call the patient to confirm the condition

b – make an appointment with patient

c – give her insulin for one week

d – explain her why you can’t do that

A woman come to GP for hitting her lip and got haematoma. She put ice on it. On examination you see some bruises on her cheek also . She didn’t give eye contact with you.

How will you investigate this?

a- take picture

b- counsel with her husband

c – admit her

d – counsel her about domestic abuse

A 37 years old ( I’m not sure age but middle age not more than 40 )

has 2 children…. done with clip sterilisation HPV 16/80 detect and colposcopy show dysplasia at cervix and extension upward dun see clearly. Treatment?

a – colposcopy 

b – excision of transitional zone

c – excision of cervix

d – biopsy

c – hysterectomy

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