Australia Medical Council

PREPARATION GUIDE
Unsolved Recalls
September, 2023

Australian Medical Council (AMC)

AMCQ Recalls | Solved | Unsolved

The ultimate resource guide to excel in the AMC (Australian Medical
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Best Resource guide to Pass AMC Exam
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September 2023 Unsolved Recalls

63 yo lady sustained blackouts, 15-30s duration, spontaneous recovery, no meds.
Normal vitals, ECG. K+ 3.3mmol/L. Bradycardia, asystole, self-reverts. Priority?

a) Correction of hypokalaemia

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 b) Arrange transfer to a Cardiology Unit

Patient drinks alcohol. Came with ascites, ankle edema, raised jvp. Liver was
palpable. Hb was decreased. MCV 110.Dx?

a) Cirrhosis

b) Pernicious anemia

Sensory loss over lateral border of shoulder, lateral arm, lateral forearm and
thumb?

a) C8 T1

b) C5 C6

c) Axillary

d) Radial

37 yo lady sudden palpitations, dizziness, no chest pain. Had underlying asthma

with frequent salbutamol use. ECG provided shows paroxysmal SVT. First-line
treatment?

a) Intravenous amiodarone 300mg stat

b) Attempt a Valsalva manoeuvre

c) Metoprolol 100mg orally stat

Pt with cough, hemoptysis and weight loss. Dx?

a) Pleural effusion

b) Pulm fibrosis

c) Bronchiectasis

67 yo man with worsening COPD, green sputum, salbutamol overuse, perindopril

for HTN, penicillin allergy. He reports that he is already using his salbutamol
metered dose inhaler 12 puffs every 3 – 4 hours via a spacer at home but he is
struggling to cope due to breathlessness. Not requiring hospital admission. Most
appropriate treatment now?

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 a) Prescribe oral prednisolone 50mg for 5 days and oral amoxicillin 500mg every 8
hours for 5 days

b) Prescribe oral prednisolone 50mg for 5 days and oral doxycycline 100mg daily for
5 days

18 months old baby, k/c of DDH…. X-ray hip joint.

18 months old, scenario of septic arthritis… Ix blood culture

52 years old lady came for annual health check. Normal mammograms and cervical
screening, no significant past medical history. Elevated blood pressure 158/91
mmHg on manual sphygmomanometer. What’s correct about her blood pressure?

a) The patient has Grade 1 (mild) hypertension

b) The patient has Grade 2 (moderate) hypertension

A 16 year old aboriginal girl presents to a regional hospital with he complaint that
her ankle has become increasingly painful over the last three days. She had fallen
from play equipment at school a week earlier. Except for a recent episode of
pharyngitis her previous health has been good. Her temperature is 37.9 C and her
pulse rate is 95/min. On physical examination she has a mildly swollen ankle with
some pain on movement, but the examination is otherwise normal.The heart
sounds are normal and no murmur is heard. The lungs are clear. crp 3mg/dl
Diagnosis

a) Rheumatic fever

b) Probable rheumatic fever

Elderly lady with atrial fibrillation, mitral stenosis, hypertension, osteoarthritis.

Stable INR for 6 months, warfarin 4mg daily. eGFR 69 mL/min/1.73m2, liver function
normal. INR now 3.8, nosebleed this AM, no other issues. Claimes already took
warfarin as prescribed and did not change diet significantly. Next step?

a) Advise her not to take her warfarin today and then recheck her INR tomorrow

b) Refer her to the emergency department for urgent administration of

prothrombin complex

8yo kid aboriginal from remote community, weeping rash on elbow 3 wks. Missed
appointments, last Health Assessment 2 yrs ago. Up to date on immunizations.
Yellow crusting on elbow (?impetigo), weight 22kg. Next step?

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 a) Benzathine benzylpenicillin 1.2 million units stat via intramuscular injection

b) Oral cefalexin 12.5mg/kg orally four times a day for five days

c) Oral flucloxacillin 12.5mg/kg four times a day for seven days

Scenario of molar pregnancy, her D&C done and few months after her b-hcg is 900
but pregnancy test negative.. asking diagmosis..

a) invasive mole

22 yo girl came to you today. She ?rolled left ankle during netball today, antalgic
gait, mild lateral swelling, no deformity or bony tenderness, reduced ROM. You
suspect she has a mild uncomplicated lateral ligament sprain and recommend rest,
ice, compression and elevation. What is the best next mx?

a) Recommend immobilisation in a backslab for two weeks

b) Referral to her local physiotherapist for a six week rehabilitation program

34 yo lady on OCP & methotrexate for Crohn’s. Planning pregnancy, stopping OCP.
Methotrexate in pregnancy advice?

a) Methotrexate increases the risk of teeth staining in the foetus

b) Increase folic acid to 5mg daily and reduce her dose of methotrexate

c) Methotrexate should be ceased at least three months prior to conceiving

Young girl, Smooth, firm lump 1×1.5cm.. asking for Ix:

a) reassurance

b) FNAC

c) USG

d) mammogram

27 lady with painful menstrual periods, cyclical bloating, dyspareunia. Suspected

endometriosis. Which is true statement?

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 a) Endometriosis can present as primary or secondary infertility

b) The diagnosis can be made by history and physical examination

Female with 6 weeks of amenorrhea, now came with vaginal spotting. Home
pregnancy test was positive.. Next Ix?

a) TVUS

b) TAS

Pt with fever, neck stiffnes. LP done:

RBCs elevated

WBCs elevated

PMNs elevated

Lymphocytes elevated

Proteins and glucose normal.

a) IV ceftriaxone

b) IV acyclovir

c) Symptomatic treatment

32 lady with childhood epilepsy well-controlled w/ sodium valproate. Considering

pregnancy. True statement?

a) Sodium valproate is known to increase the risk of birth defects including neural
tube defects and other congenital malformations

b) She should be advised that there is no need to consider her epilepsy

management until after she has a positive pregnancy test

Indications of urgent surgery?

a) Traumatic spleen rupture at lower pole

b) Upper pole of kidney rupture

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 c) Free fluid in the peritoneum

32 yo lady with underlying epilepsy dx during childhood. Came with GTC seizure
controlled on sodium valproate 500mg orally BD. Last seizure 4 months ago and
was known to local neurologist. Currently using IUD for contraception. Currently
considering a family with husband. which following is true?

a) sodium valproate increase risk of birth defects (neural tube)

b) advised take 500mcg folic acid per day at least 1 month prior conceiving and up
to end of first trimester

c) no need consider epilepsy treatment until positive pregnancy test

d) risk congenital malformation higher if taking carbamazepine as compared to

sodium valproate

e)

f) risk can be reduced if they stop after positive pregnancy test

Bacterial vaginosis treatment?

a) Metronidazole

b) clindamycin

c) bactrim

14 yo boy presents to you alleged knocked by other player (playing rugby) and fell
to ground. Denied head trauma. Since then headache (mild pressure). Witnessed by
coach shoulder took impact, no loss of consciousness. No vomiting or
neurological deficit. No blurry of vision. keen for him to return to sport as soon as
possible due to grand final in 4 days time. Best advice?

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

b) 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.

c) Advise him that he is able to commence non-contact drills tomorrow given he did
not hit his head.

d) Advise him to take paracetamol and ibuprofen today to assist with his headache.

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 e) Refer him for a CT scan of his brain to rule out an intracranial haemorrhage.

A clinic treats IV drug abuser patients . Now they want to know from you as a GP
what advice you can give to the hep B positive mothers

a) Avoid Breast Feeding

b) Check HbsAg in infant

c) Hospital administration

23 gentleman, recent travel to Africa, concerned about schistosomiasis. Advice?

a) Advise him that chronic infection from schistosomiasis is far more common than
the acute illness

b) Advise him that antibody tests are useful for distinguishing past and present
infection in travellers

20 lady w/ lower abd pain exacerbated by exercise. ‘Bad period pain’, pain during
sex. On oral contraceptive, neg urine preg test. Likely cause of pain?

a) Irritable bowel syndrome

b) Inguinal hernia

c) Pelvic inflammatory disease

42 lady requests “heart check.” Family history: father, uncles, aunt – MI in late 40s-
50s. No symptoms. BP: 125/85, HR: 75. Eye finding: photo shows cornea arcus.
Next step in management? Answer from redbook RACGP

a) Refer her directly to a clinical genetics service

b) Check her history and examination findings against the Dutch Lipid Clinic Network
criteria

67 yo man COPD, wife 65 yo make appointment concerning that she might have
COPD too. She smokes 20 cig 40 years. SOB with sputum over 6 month. No fever
night sweat weight loss. CT scan exclude lung lesion. Which of following confirms
COPD dx?

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 a) Hyperinflation with bronchial wall thickening on a chest xray

b) Spirometry: FEV1 to FVC ratio < 80% and FEV1 < 70% predicted after
bronchodilator

c) Spirometry: FEV1 to FVC ratio < 70% and FEV1 < 80% predicted after
bronchodilator

d) Presence of a daily productive cough for more than 3 months in a smoker or ex-
smoker

e) Spirometry: FEV1 to FVC ratio < 70% and FEV1 < 70% predicted before
bronchodilator

A 13 year old boy is admitted for acute appendicitis set to go for appendectomy
after 12 hours along with 18 years old, patients not reachable, sister to whom to
take consent to

a) The patient

b) Sister

c) Hospital administration

14 year old Patient with drowsiness , drooling of saliva, right sided tonsillar
enlargement, uvula deviated

a) Endotracheal intubation

b) Nasopharyngeal intubation

Pt presented with recurrent vertigo. No hearing loss. Dx?

a) Menierre’s disease

b) Vestibular neuronitis

c) Otosclerosis

Patient refused blood transfusion. During surgery, shock.. what will you do?

a) Iv dextrose

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 b) Iv hemacel

c) Iv hartmans solution

d) Iv ringer

e) Iv saline

Patient presented with decreased vision 6/18, which worsened recently 6/24. Poorly
controlled diabetes.. Dx?

a) Diabetic retinopathy

b) Cataract

c) Glaucoma

25 month baby, noticed by mum developmental concerns. Red flag?

a) Difficulty in understanding his peer’s emotions

b) Difficulty walking up and down stairs

c) A vocabulary of 15 words

d) Unable to run well

e) Speech occasionally difficult to understand

42yo guy , health check. His father developed bowel cancer at age 55 and his
mother has hypertension. You review his cardiovascular risk factors, nutrition,
alcohol and physical activity. When start faecal occult blood testing?

a) At age 50, and then every 2 years

b) At age 45, and then every 2 years

c) At age 55, and then every 2 years

37 man, health check, smoker, fit with regularly exercise, normal lab test,
varenicline. Additional CV risk management?

a) Recommend that he commences aspirin 100mg orally daily

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 b) Advise him that medication is not indicated at this time for primary prevention of
cardiovascular disease but he should return in 1-2 years’ time for review of his
level of risk

48 lady, facial rash, no improvement with metronidazole. photo shows: seborrheic

dermatitis What treatment?

a) Azelaic acid 15% gel topically, twice daily until the skin returns to normal

b) Hydrocortisone and clotrimazole (1% + 1%) cream topically, twice daily until skin
is clear or for up to two weeks

26 MALE, dorsum of L hand lesion, slow growth, no discharge/pain. Work as sheep

shearer. What management advice?

a) Advise a punch biopsy to exclude a likely ulcerated basal cell carcinoma

b) Advise that no immediate treatment is necessary, as it is probably a virus, and will

heal spontaneously

c) Recommend topical application of efuxid? cream weekly for a duration of 3

weeks and then review

d) Recommend immediate excision and skin graft by the local surgeon

54 male, left elbow pain/swelling for 1 week post-work injury. Non-infectious

diagnosis confirmed. Photo shows swelling present despite flexion and extension
of elbow ?? olecranon bursitis . First-line treatment?

a) Naproxen 500mg orally, twice daily, for seven days

b) Surgical referral for excision and drainage

c) Prednisolone 30mg orally, mane, for three days

d) Resting the left elbow and wearing a compression bandage to reduce swelling

10yo girl, non-itchy white patches on face, worse in summer. Ill-defined, scaly
patches around mouth/cheeks. Diagnosis?

a) Vitiligo

b) Pityriasis alba

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 c) Atopic dermatitis

d) Lichen simplex chronicus

42 female planning India trip in 2 months. Asks about cholera vax. Hx of

hypertension, IBS. Advice?

a) Advise that some countries require cholera vaccination as an entry requirement.

b) Advise there is a very low risk of cholera if she follows recommendations

regarding safe food, water, sanitation and handwashing.

15yo male came for wrist pain after bike fall. Swelling, tenderness in snuffbox. Next
step in investigation?

a) Arrange plain x-ray imaging of the right wrist

b) Arrange a computed tomography scan of the right wrist

c) Arrange a right wrist ultrasound scan

Parent wants exemption for 6-month-old child’s vaccination. Needs valid medical
contraindication. What’s valid contraindication?

a) Anaphylaxis following any component of the relevant vaccine

b) Mother has a history of an anaphylaxis following vaccination

c) He has a past medical history of egg allergy

50 non indigenous male wants flu vaccine. Used to free vaccine. Eligible groups for
free flu vaccine?

a) Mild asthma

b) People aged over 65 years

c) People aged over 55 years

Female pt at 18 weeks presented with urinary obstruction and constipation.

Previous usg showed retroverted uterus. Cause?

a) Incarcerated uterus?

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Alendronate therapy pre requisiste?

a) Dental checkup

b) esophagoscopy?

A 72 yr old with dx of Alzheimer’s dementia has just been diagnosed with a

terminal illness. His wife wishes her husband to have palliative care, but his 25 yr
old son demands full treatment.

Most appropriate step in this situation?

a) Follow wife’s wishes

b) Follow son’s wishes

c) Check competence of the pt

d) Contact guardianship court

e) Have a family meeting

PSA>20 , irregular DRE ,bone metastasis and back pain .Treatment to be given ?

a) chemotherapy

b) androgen deprivation

c) orchidectomy

d) radiotherapy

23 lady presents with depression, anger outbursts, binge eating, alcohol use,
promiscuity, self-harm history. Missed appts, distrust in system. Likely diagnosis?

a) Antisocial

b) Avoidant

c) Borderline

4mo boy, routine immunizations, past intussusception. NIP schedule today?

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 a) Dtap Hib, pneumococcal and rotavirus

b) Dtap, hib, hep B and pneumococcal

15yo girl, chest tightness on exertion, short of breath, can’t play netball fully.
Family history: grandfathers, MI & aortic aneurysm. Likely diagnosis?

a) Angina

b) Asthma

c) Costochrondritis

4mo infant, flaky scalp, yellow crusts, frontal region. (photo shows cradle cap, no
redness). Diagnosis?

a) Advise skin scrapings to confirm the diagnosis

b) Advise application of an emollient and then removal of the scales with a soft
brush/comb

54 female, dysuria, freq urination, UA: +++ leukocytes, + nitrates, ++ blood.

Organism cause?

a) Proteus mirabilis

b) Escherichia coli

c) Enterococcus species

10month old baby girl, sudden vomiting, diarrhea, distress. True statement about
intussusception?

a) The child is unwell between episodes of pain

b) Lethargy may be a presenting sign

72 lady, sudden onset chest ‘fluttering’, breathless, htn, mitral valve prolapse. ECG
rhythm?

a) Atrial flutter

b) Rapid atrial fibrillation

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76 gentleman, COPD, worsening SOB, fever, colored sputum. Smoking 15 cigs/day.
Treated with prednisolone, antibiotics. Still breathless on LABA/ICS. Next step to
slow COPD?

a) Inhaled long acting anticholinergic

b) Smoking cessation

28 guy, type 1 diabetes, travel to Bali in 6 weeks. Vaccinations/precautions?

Common cause of Traveler’s Diarrhea?

a) Enterotoxigenic Escherichia coli (ETEC)

b) Enteroinvasive Escherichia coli (EIEC)

73 old man, tender lower eyelid lump, no vision changes, prior episodes. (photo
given likely meibomian abscess) Likely diagnosis?

a) Meibomian abscess

b) Epiphora

c) Dacryocystitis

27yo couple planning pregnancy. Chances of conception in 1st yr with unprotected

sex???????? (general knowledge qs)

a) 70 – 75%

b) 80 – 85%

Positive VDRL In pregnant woman.What to do next?

a) Termination of pregnancy

b) treat mother now

c) treat baby post birth

Pt with frcture forearm reduction by ed consultant, history taken by intern and

srgery arranged by surgical resident. Who has duty to take consent from pt??

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 a) Consltant

b) Intern

c) Resident

Child brought to hospital by parents who moved in recently because of fracture

femur. Parents say child is playful and not cautious. That he’s had many fractures
before. On examination only swollen at site of fracture femur.

a) Talk to school teacher

b) Non accidental injury

c) Osteogenisis imperfecta

vonwillebrand disease, pt bleed too much after dental treatment have history of
bleeding from nose a/ aptt pt was normal.

Drilling of urine while coughing on examination therewassmall cystocoele

treatment will be ???

Gynecomastia. 16 yo male athlete, BA controlled by salbutamol and fluticasone .

Reason?

a) Normal adolescent

b) salbutamol

c) fluticasone

d) anabolic steroid use

Smoker having enlarge lymph node in inguinal area and weight loss with tender
mass at the lower part where was the primary tumor

Mother brings 32 year old man with learning disability. Recently he started having
aggressive outbursts with head banging plus insomnia and weight loss. Best
medication for him?

a) Escitalopram

b) Olanzapine

c) Diazepam

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Pregnant women is an asylum seeker, lives with husband in community. Feels
scared of people talking about her, frightened when husband goes to work.
Irritable. (No time frame given) likely diagnosis?

a) psychosis

b) PTSD

c) GAD

d) MDD

Woman in labour meconium noticed on rom. Fetal head -1 position. Ctg reassuring.
Fetal position ROP. What to do

a) Caesarean

b) Epidural analgesia

c) Oxytocin

Fetus was behind the age but parts palpable.

Fundal height was 4weeks behind.

a) Iugr

b) Constit delay

c) Renal agenesis

There was one woman who came with ankle disclocation in pregnancy and all her
symptoms (headache proteinuria) suggested she also has preclampsia? They
asked for investigations

a) ankle xray

b) lfts

c) 24 hour bp monitoring

Boy from Sudan came with low vitamin D what can you give

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 a) Calcitriol

b) Cholecalciferol ******

c) Vitamin B

d) iron

Boy 14 years abducting there is an ray

a) Hip bracing

b) Pin fixation

c) nsaid

Middle aged previously healthy man comes with a painless left side scrotal lump
for one month. Recent hx of left leg infection.O/E the right side testis is normal
except fr a horizontal crease.Left side testis cannot be palpated nt cord is normal
Left side groin has few lymph nodes i think tender) BL gynaeconastia

Which of the following points more towards a malignancy?

a) gynacomastia

b) groin lymph nodes

c) Abnormal right side testes

Ct scan chest with mass in left upper lobe what to do

a) Sputum culture

b) Percut biopsy

c) Tb treatment

30 guy, painful, swollen left knee with erythema. Positive patellar tap. Recent knee
trauma. MOST likely diagnosis?

a) Cellulitis

b) Septic arthritis

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35 lady, joint pains. You consider order ANA but wonder about validity of test.
Given

a) true positive test

b) false positive test

c) false negative

d) true negative

Which below is true

a) Negative predictive value = A/(A+B) × 100

b) Specificity = D/(D+B) × 100

c) Positive predictive value = A/(A+C) × 100

d) Sensitivity = A/(A+B) × 100

e) Positive predictive value = D/(D+B) × 100

82 old man, bright red hard palate. Photo show redness over palate. Advise on
management?

a) Advise him that this condition is related to candida in the mouth and can be
managed initially with oral hygiene measures

b) Advise him that this is a sign of improperly fitted dentures and he should see the
dental prosthetist again as soon as possible

74 male, fatigue, 2kg weight loss, nocturnal back pain x 6wks, pallor, multiple
wedge compression fractures on thoracic spine x-ray. diagnosis?

a) Prostate specific antigen (PSA) level

b) Serum protein electrophoresis, immunofixation

Positive VDRL In pregnant woman.What to do next?

a) Termination of pregnancy

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 b) treat mother now

c) treat baby post birth

Pt with frcture forearm reduction by ed consultant, history taken by intern and

srgery arranged by surgical resident. Who has duty to take consent from pt??

a) Consltant

b) Intern

c) Resident

Child brought to hospital by parents who moved in recently because of fracture

femur. Parents say child is playful and not cautious. That he’s had many fractures
before. On examination only swollen at site of fracture femur.

a) Talk to school teacher

b) Non accidental injury

c) Osteogenisis imperfecta

Dribbling of urine while coughing on examination there was small cystocoele

treatment will be ???

Gynecomastia. 16 yo male athlete, BA controlled by salbutamol and fluticasone .

Reason?

a) Normal adolescent

b) salbutamol

c) fluticasone

d) anabolic steroid use

Smoker having enlarge lymph node in inguinal area and weight loss with tender
mass at the lower part where was the primary tumor

There were two psychiatry questions which really confused me, and I haven’t seen
them anywhere.

Mother brings 32 year old man with learning disability. Recently he started having
aggressive outbursts with head banging plus insomnia and weight loss. Best

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medication for him?

a) Escitalopram

b) Olanzapine

c) Diazepam

Pregnant women is an asylum seeker, lives with husband in community. Feels

scared of people talking about her, frightened when husband goes to work.
Irritable. (No time frame given) likely diagnosis?

a) psychosis

b) PTSD

c) GAD

d) MDD

woman in labour meconium noticed on rom. Fetal head -1 position. Ctg reassuring.
Fetal position ROP. What to do

a) Caesarean

b) Epidural analgesia

c) Oxytocin

Fetus was behind the age but parts palpable.

Fundal height was 4weeks behind.

a) Iugr

b) Constit delay

c) Renal agenesis

There was one woman who came with ankle disclocation in pregnancy and all her
symptoms (headache proteinuria) suggested she also has preclampsia? They
asked for investigations

a) ankle xray

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 b) lfts

c) 24 hour bp monitoring

Boy from Sudan came with low vitamin D what can you give

a) Calcitriol

b) Cholecalciferol

c) Vitamin B

d) Iron

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