During this difficult time, a lot of centers has been closed down. However, there are still some who managed to sit for the exam and provide us with past recalls. As for those who got their exam postponed, we believe that this is the best opportunity to practice more recalls. By doing recalls is one of the best way to tackle AMC Part I. Pilot questions may have tendency to be repeated in the AMC MCQ actual exam. We hope everyone is doing fine. Stay home, stay safe.
Australian Medical Council (AMC) MCQ Recalls SEPTEMBER 2020 compilation
- Crescendo decrescendo murmur increases with valsalva. No family history.
A.Mvp
B.hocm - ataxia 6 years. height and weight at the 50th percentile. serum and red-cell lipid profiles are abnormal, mutation in which gene?
a/ microsomal triglyceride transfer protein
b/ huntingtin - old man in coma. shaking and abnormal breathing sounds. unable to wake him. he is in status epilepticus, what’s next?
A intraventricular drain to monitor intracranial pressure
B lorazepam for intravenous administration - Post partum bleeding, afebrile. Uneventful labor but with Superficial Laceration, bleeding controlled but not sutured. Thin vaginal mucosa. Diagnosis?
A.bleeding laceration
B.retained products of conception
C.atrophic vaginitis - Asymp bacteuria in elderly and infant, no treatment needed.
- Uti intermittent abdominal pain, clear ua. Management?
A.Oral nitrofurantoin
B.nitrofurantoin and cefalexin
C.trimethroprim - 75 yo woman evaluate of a tremor. right hand worsening past 18 months. resting tremor of the right upper extremity. best medication?
a. alteplase
b. carbidopa-levodopa - Sle case, joint and skin involved. already on nsaid. Treatment?
Add hydroxychloroquine - RA for 10 yrs AND dvt 3 yrs ago. Investigation?
A. Anca
B. ana
C. anti cardiolipin
D. anti topoisomerase - student was found walking around his dormitory naked. He is disoriented, inattentive, and shows poor comprehension, fever of 38.8° The emergency room physician orders a brain MRI and then decides to perform a lumbar puncture. Neuroimaging of the brain before attempting a lumbar puncture is advisable in cases of acute encephalitis for which one of the following reasons?
a) massive edema causing herniation
b) determine whether a brain biopsy should be obtained
c) shunting of the ventricles is usually indicated, and the imaging studies are needed to direct the placement of the shunt. (exact same word) - Pregnant no symptoms, labs: low hgb, slight inc wbc, low plt, inc esr. Diagnosis?
A.Post partum bone marrow biopsy
B.anti platelet Abs
C.fbc during labor - Child recent fall. Now febrile with marked focal tenderness on medial upper tibia. Soft 3/6 systolic murmur and bruises. Diagnosis?
A.Osteomyelitis
B.septic arthitis
C.endocarditis
D.acute RF - Child recent fall, febrile, recent urti. Investigation?
A.Joint aspirate
B.throat swab - Jellyfish northern australia. No picture or description of jellyfish. Management?
A.hot water
B.vinegar - Child in park, Snake bite with vomiting. Management?
A.Give polyvalent anti venom
B.take picture of the snake to identify type of snake
C.call authority of park to identify type of snake
D.give anti-venom of common type of snake in that area - Famous pic of Cerebral tumor vs abscess. No edema around it, so i picked tumor.
- significant head trauma, CT scan shows bilateral frontal lobe contusions of the brain. no midline shift. statements cerebral contusions is true?
A. they occur most frequently in the occipital lobes.
B. they may occur opposite the point of skull impact. - Recall of Child Head trauma from sports, gcs 10/15, rural hosp. Tertiary hosp 1 hour away. Next?
A.IV manitol
B.ct scan
C.transfer to neuro unit
D.burr hole - 15 yo girl complain blood in her urine. asymptomatic and not menstruating. urinalysis reveals grossly pink urine. cause?
a. spinach
b. strawberries - rape victim. sleep has improved. developed new friendships. be in control of her life. best recommendation for the recovery of this patient?
a. continue counseling
b. face her attacker to bring closure to this event. - You are a GP and you were approached for prescribing New drug. What to ask?
A. Common side effect - No lytic lesions, BM plasma cells 6%, a.Dexamethasone and thalidomide
A.repeat BM biopsy
B.review in 3 mos - complain intense pruritic rash all over her body, abdominal cramping, and chest tightness. accidentally ate some shrimp. known anaphylactic allergy to shrimp. next step?
A, IV epinephrine
B, SC epinephrine
C, IM epinephrine
D, neb epinephrine - history of malignant melanoma presents with a new type of headache. multiple small brain hemorrhages. metastatic lesions to the brain often appear in which location?
a. at the gray-white junction
b. in the thalamus - Barrets case
A.Review after 3 years
B.review after 6mos - 35 yo woman anxious every day for 7 months. difficult concentrate. trouble falling asleep at night despite tired. denies substance or alcohol abuse. likely diagnosis?
a. hyperparathyroidism
b. generalized anxiety disorder - Child with seizure. Febrile. No mention of sunlight exposure/ethnicity/diet. Investigation?
A.Analgesic and observe
B.blood culture
C.serum calcium and vitamin D - tonic-clonic seizure which in her left lower extremity. small arteriovenous malformation near the motor cortex.
a. intracerebral hemorrhage
b. subarachnoid hemorrhage - uterine bleeding at 7 weeks gestation without any cervical dilation. abortion type?
a. incomplete abortion
b. threatened abortion - Child with diarrhea. Afebrile and rest of VS is stable, not dehydrated. Causative agent?
A.Norovirus
B.Enterovirus
C.giardia
D.staph aureus - Pneumonia case. Stable, no comorbids. O2 sat 92%
A.Penicillin
B.flucloxacillin
C.azithromycin - Pic of ateletasis 3 months old, runny nose, wheezes and crackles. O2 sat 90%. Management?
A. Bronchoscopy
B.abg - Mva with flail chest. Urgent Management?
A.chest xray
B.chest strapping
C.needle thora
d.insert intercostal catheter - Man who loves to pet cat, swelling of arm with palpable nontender lymph nodes. Diagnosis?
A.cellulitis
B.Cat scratch disease - vaginal spotting. occasional abdominal cramping with bleeding. her first trimester. previous pregnancy was uncomplicated. vitals are normal. closed cervical os. diagnosis?
a. septic abortion
b. complete abortion - Sjogren case, occasional pain on mandible, dry eyes and mucosa. Fnac doesnt show much. Investigation?
A.Salivary gland biopsy - Drug B is more effective than drug A with P < 0.01
A.Drug A is less effective than drug B by less than 1%
B.drug A is less effective by <0.01%
C.drug B is preferrable than drug A - eye blinking or throat-clearing noises for healthy 8-year-old boy. diagnosis?
a. transient tic disorder of childhood
b. tourette syndrome - weakness in the legs. bilateral foot drop and atrophy; mild wrist weakness. blood smear shows basophilic stippling. cause?
a. amyotrophic lateral sclerosis
b. lead poisoning - blurry vision. feels great in morning, her eyelids look droopy in the evening. her cranial nerves are intact, notice slight ptosis. diagnosis?
A, guillain-barré syndrome
B, myasthenia gravis - 20 yo woman obese and facial acne and hirsutism on face. do not wish to conceive at this time. appropriate treatment?
a. oral contraceptives
b. corticosteroids - Pic of bullae, itchy, scratch marks, no mention fever.
A.Prednisone
B.skin scrape
C.skin sample for VZV
D.flucloxacillin - old woman pain right shoulder. treated with analgesics without relief. a mass in the apex of the right chest. clinical features?
A, atelectasis of the involved apical segment
B, horner syndrome - Newborn with TTN. Now with progressive dyspnea and deceasing O2 sat. Cause?
A.Pneumothorax
B.Hypoglycemia - yo Precocious breast development. The rest normal smr.
A.Review in 3 months
B.bone age - 51 yo man complain chest pain. ecg is abnormal, should have a cardiac catheterization. he refuses the intervention. response?
a. respect the patient’s choice and continue to explore his reasons for refusing treatment.
b. explain to him that you think he is making a bad decision, and try to convince him to change his mind. - Painful swallowing, weight loss with ear pain. Investigation?
A.ct scan of neck and chest
B.indirect laryngoscopy
C.upper endoscopy
D.barium swallow - Ocd case, given a task in work which requires group interaction.
- 21 mo child at ED because of fever and refusal to move his right lower extremity. swollen and tender right knee that resists passive motion. diagnosis?
a. examination of joint fluid
b. x-ray of the knee - 4 yo girl vaginal itching and irritation. denies of inappropriate contact. notice some erythema of the vulvar area but no evidence of trauma. next action?
a. refer to pediatric gynecology for removal under anesthesia of a suspected foreign body in the vagina
b. counsel mother to stop giving the girl bubble baths, have the girl wear only cotton underwear, and improve hygiene. - Child aggressiveness. Treatment?
A. Risperidone
B. haloperidol - old man epigastric pain radiates to his back. drinks 6 pack of beer daily. suspect pancreatitis. laboratory values specific for pancreatitis?
a. elevated amylase
b. hyperglycemia - patients with duchenne dystrophy, which is true?
a. pseudohypertrophy routinely does not occur
b. pseudohypertrophy routinely is limited to the shoulder girdle - substances to stimulate the appetite?
a. neuropeptide y
b. gaba - Recall of Immigrant with paranoid (spies), what to look for in collateral?
A.Immigrant visa status - old man intermittent right upper quadrant abdominal pain. pain lasts 1 to 2 hours. no leukocytosis and normal bilirubin. normal gallbladder wall thickness. diagnosis?
a. symptomatic cholelithiasis
b. acute cholecystitis - 7 yo boy respiratory distress. become progressively tired and pale. hemoglobin concentration in the ER is 3.1 mg/dL. common cause?
a/ roseola
b/ parvovirus b19 - Dependent personality disorder wife in clinic. Irritable with kids. What to look for in history?
A.Hx of trauma
B.previous still birth
C.fhx of schizophrenia
D. recent loss of loved one - 38 yo man alcohol use. you ask the CAGE questions as an initial screen.
a. concern expressed by family
b. previous alcoholics anonymous contact - 46 yo severe menorrhagia when she menstruates, cannot leave the house. current hematocrit is 25.0. refuses to have a blood transfusion, ethical concern?
a. legal issues
b. patient preferences - 24 yo woman recently sexually active. painful coitus, pain located at the vaginal introitus. painful involuntary contraction of the pelvic muscles. common cause?
a. endometriosis
b. psychogenic causes - 8 yo boy drooping left side of his mouth, unable to completely shut his left eye. . diagnosis?
a/ brainstem tumor
b/ bell palsy - 38yo man uric acid level of 9 mg/dL. no history of chronic or malignant disease. best approach?
a. the risk of urolithiasis requires the institution of prophylactic therapy such as allopurinol.
b. asymptomatic hyperuricemia is associated with an increased risk of gouty arthritis, but benefits of prophylaxis do not outweigh risks in this patient. - old man constipation. no history of prior gastrectomy or of upper GI symptoms. next step?
a. serum lead level
b. colonoscopy - first pregnancy was delivered 10 years ago. normal vaginal delivery at 40 weeks and the baby weighed 4kg.blood pressure range has been 100 to 120/60 to 70. explanation for decreased fundal height?
a. multiple gestation
b. hydramnios - 11 weeks pregnant. first pregnancy for this 36 yo woman. her uterus is palpable midway. no fetal heart tones are audible. next step?
a. dilation and curettage since her uterus is too large and the fetal heart tones are not audible.
b. ultrasound determine the gestational age and viability of the fetus. - woman evaluated for gait difficulties. she is able to walk along a straight line touching the heel of one foot to the toe of the other is impaired.
a. cerebellar dysfunction
b. parietal lobe damage - old woman diagnosed with lung cancer. which small-cell lung carcinoma is true?
a. it is slow growing and rarely metastasizes
b. most are treated with chemotherapy and radiation instead of surgery - substernal discomfort. worse after heavy meals. gained 20 lb in the past 2 years. approach?
a. therapeutic trial of ranitidine
b. exercise test with thallium imaging - lesbian woman. left a 10-year monogamous relationship, concerned her risk for vaginal infections
a. sexually transmitted infections among lesbians is less than the rate in heterosexual women
b. genital warts is higher in lesbians than in heterosexual women - laparotomy 9-cm right ovarian mass. pathology report shows glial tissue and immature cerebellar and cortical tissue. most likely ovarian tumor?
a. granulosa tumor
b. immature teratoma - young girl , takin ocp, her 2 month ago pap was normal , now come with vaginal bleeding, treatment
A-Do pap
B-Coploscopy
C-No test
D-Smear - 28-year-old lady with post coital bleeding one-two separate occasions. Pap smear normal 2 months ago. What next?
A– HPV serology
B– Chlamydia PCR
C– Pap smear
D– Thin Prep Pap test
E– Repeat Pap smear - 45 yrs old female c/o irregular menstrual bleeding. Had been treated for CIN 2 previously n PAP smear done 6 month ago was normal. Most appropriate inv?
A. Colposcopy
B. Usg to detect endometrial thickness
C. Endometrial curettage
D. Pap smear
E. Cone biopsy - 25-year-old on OCP with post coital bleeding, last pap 18 months ago was normal. what next
A. Assure
B. Colposcopy
C. Repeat Pap
D. Do Thin Prep
E. Check for HPV - 18yr girl started getting a boyfriend, go in to have sexual course soon, h/o some ovarian cancer in 2nd degree relatives.(very complicated question). what to do?
A. start regular screening
B. wait till 2 years
C. give HPV vaccine
D. talk with partner about safe sex - 75 y.o man with fever,cough, rigor…had chronic cough with greenish yellow sputum for 3 years, and persistent bilateral basal crepitation, now in his cxr has left lower lobe consolidation, what is the most app treatment option for him:
a Oral rohxithromycin
b Oral amoxiclav
c IV flucloxacilin
d IV ticarcilin-pipracilin
e IV meropenem - Irritable because he thinks he can do the work alone. What else in history?
A.Excessive care in spending
B.aggressiveness
C.social isolation
D.self harming - Child with classic symptoms of meningitis. Lab result as ff: increased lymphocyte
A.acyclovir
B.antibiotic - Pneumonia case. Stable, no comorbids. O2 sat 92%
A.Penicillin
B.coamoxiclav
C.azithromycin - Pic of ateletasis 3 months old, runny nose, wheezes and crackles. O2 sat 90%. Management?
A. Bronchoscopy
B.abg
C. Nasopharyngeal aspirate
D.sputum culture - CRACK in calf after sports injury. Tender on lower calf. No mention of bruising. On passive movement of ankle, no pain. Investigation?
A.mri
B.ct scan
C.doppler
No xray - Lethargy and malaise for 3 mos. Previously well. hypo micro anemia, inr slight increased. Investigation?
A.Tft
B.anti gliadin Abs - Giving away and locking days after sports injury.
A.mri
B.arthroscopy
C.arthrography - Urge incontinence initial tx bladder training
- Stress incontinence initial tx pelvic exercise
- Urge incontinence symptoms.Next ivx?
A.Urine CS
B.urodynamic studies - Schizophrenic patient to undergo non-psych related management. What in patient to determine if capable to consent?
A. Schizophrenia
B.alcohol intake
C.Inability to comprehend consequences - Pregnant lady with regular periods 35-45 days. Complains of breast tenderness and nausea. On speculum, noted of minimal spotting/bleeding. No mention of LMP. What will help in diagnosing non viable pregnancy?
A. LMP date
B.persistent bleeding
C. Low bcg
D.decrease breast tenderness and nausea
E.repeat tvs after 7 days - Jehovah pregnant, most likely for her not to agree on having?
A.Rubella post exposure proph
B.ani RhD
C.hpv vaccine - Aboriginal Smoker, ambivalent to quit smoking but aware that it affects his health. Management?
A.Motivational therapy
B.bupropion
C.hide his cigarettes
D.nicotine patch - Colon ca. Most likely complaint?
A.Recent change in bowel
B.lethary/malaise - 34 yo Abdominal pain, diarrhea, constipation. Pain exacerbated by eating and decreased bu defacating. What to do?
A.Colonoscopy
b. review in 3 mos
C.upper abd utz/endoscopy - Obese case. Already tried diet and exercise for 6 months. Still BMI 33. Starts becoming disappointed despite her efforts. What to do?
A.psychotherapy
B.SSSS some drug i forgot!! Im sorry 🙁 - Obese with hypertension and Gerd. Management?
B.roux en y
C.gastric banding - Child constipation despite diet and oral emulsion paraffin. His classmates are teasing him already. Teacher is worried. What next?
A.rectal suppo
B.manual extraction
C.oral osmotic laxative
D.senna - Copd with pulmo infection on 6 lpm. Abg showed respiratory acidosis. pO2 80, pCO2 60(?), ph 7.47. What next?
A.Peep
B. reduce to 2 lmp
C.paralyze and intubate - Tb case symptomatic with xray pic of cavitation upper right. Aside from sputum cytology, what is Next?
A.mantoux test
B.ct scan
C.bronchoscopy - 27 yo Colposcopy then pid. Etiology: chlamydia
- Gynecomastia. 16 yo male athlete, BA controlled by salbutamol and fluticasone
A. Normal adolescent
B.salbutamol
C.fluticasone
D.anabolic steroid use - Study of Relationship of Alzheimer worsening with exposure to drug. Researcher wants short course only
A. Rct
B. Cohort
C. Cross section - Man finished his exercise, now experiences itchiness all over while doing his lecture. He ate egg quiche with salad. Known hx of asthma. He took dolfenal too. Cause?
A.Nsaid
B.Sulphites
C.egg
D.exercise - Post op on Morphine 1g , now drowsy, what to do?
A.Give naloxone
B.reduce dose to 0.5g
C.increase o2 - Prev well 5 month old child, now with constipation for 6 weeks. He was breastfed for 3 months. Started eating cereals.
A. Insufficient oral intake
B.cow milk protein
C.cow milk intolerance
D. Solid food - Post colectomy, no UO for 8 hours. Next?
A.Trial with hydration
B.insert FC
C.serum crea/bun
D. Ultrasound - Recent urti now with petechia, bruises. Inx?
Fbc - Aboriginal man recent behavioral changes. Cause?
A.Petrol sniffing
B.amphetamine
C.cocaine - Girl Marijuana used once, feeling euphoric at that time. Now feels paranoid even without marijuana. Next invx?
A.Drug screen - Seizure at work. No focal deficits. Glucose normal, drug screen negative. Next?
A.Blood alcohol
B.eeg
C.Ct scan
D.mri - Uncontrolled hypertension on full maintenance. No kidney disease. Next?
A.Add ACEi - Man complains of weakness, he is on multiple drugs. Hypokalemia, normal bun/crea/serum K. cause?
A.Indapamide
B.siadh
C. dehydration - 3rd day post partum. She doesn’t want the baby to be separated from her. Doesnt sleep properly, aligns objects, prays a lot. Tachycardic, bp 130/80, febrile. Dx?
A.Milk fever
B.delirium
c. postpartum psychosis - Woman who underwent Normal spontaneous delivery. Uneventful labor. 12 hrs after became febrile. Cause?
Endometritis - Post op woman. Paranoid episodes but resolves when consoled by nurse. What to do next?
A.observe in quiet room
B.diazepam
C.haloperidol - Man complains of severe chest pain. No resolution despite glycerin. He is hypertensive maintained on unrecalled drugs. He is currently hypertensive at presentation, tachycardic, normal o2 sat. He was in a flight 2 weeks ago. Management?
A.ct pulmo angiogram
B.ct angiogram - Picture as below. dx
A.Simple cyst of liver
B.hemangioma
C.hydatid cyst
D.metastatic
- Pic like this.
Dx is PE
- 40s woman with history of chest trauma some years ago. Pic looked somewhat like this.
Asking what to do next? Fnac - Copd with pulmo infection on 6 lpm. Abg showed respiratory acidosis. pO2 80, pCO2 60(?), ph 7.47. What next?
A.Peep
B. reduce to 2 lmp
C.paralyze and intubate - Man finished his exercise, now experiences itchiness all over while doing his lecture. He ate egg quiche with salad. Known hx of asthma. He took dolfenal too. Cause?
A.Nsaid
B.Sulphites
C.egg
D.exercise
We will gather more SEPTEMBER recalls and add into this post. So do visit regularly for the latest update.
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