AMC MCQ 30/11/2007 Sydney recalls and preparation tips

Discussion in 'Australian Medical Council (AMC) EXAM' started by Guest, Dec 2, 2007.

  1. Guest

    Guest Guest

    Hi,
    I was sitting the AMC MCQ offshore exam in Sydney 30/10/2007. I will write down my recalls, some other information about the exam and a few other general things people might find helpful. Good luck with your preparation.

    The exam itself seemed pretty hard to me, at least there were not very many recalls (I guess only 20 questions!). I was often struggling and rarely feeling 100% sure about my answers, especially with the mastery questions. A lot of topics were the same but changed in a way that was quite confusing. And even if I have prepared by reading the common topics from recalls I was usually unsure about my answer! Psychiatry seemed to be a major part including the mastery questions. A lot of mastery questions were also O&G.

    No pictures from the Anthology book, no ECGs, no CTGs, only 1 or 2 CXRs, and maybe 6-10 pictures in total. Bloods were always given in a way where you could see the normal range.

    We were 10 people siting the exam in Sydney. We were able to bring the bags in the room and leave them at the entrance, some lollies were provided but drinks were not allowed at the computer. The air conditioning was on and I can only advise you guys to bring a sweater!

    For preparation I did the AMC MCQ book twice and the anthology book pictures twice. I read mainly the Oxford handbook of clinical medicine, surgery and specialities to prepare in advance for about 2 months besides working full time, and repeated old papers and questions for the last 2 weeks with literature search in a medical library and internet resource as up to date. I only did a few old exams but read throughout the main topics which I didn’t know the answers to. And by the way, I just got my results and I did well.

    Now to the questions, I must say it is really hard to recall them, as there are so many and you really don’t have much time to go through them twice. I just managed to finish my questions 3 minutes before the time ran out! So this is just a try to recall the questions and write them from my perspective as in what I read into the question! So please keep that in mind and don’t only rely on these recalls! And don’t rely on the answers. I must admit I had to guess a lot in this exam! And even if I might some notes right after the exam I just managed to type them down for you a few weeks later. So don’t get too fixed on the exact words of the questions!

    Medicine and general:

    1. Picture of mouth with –what looked to me like a- small cyst underneath the tounge?
    a) Ranula
    b) haemangioma

    2. Picture of hand with flexion contracture mainly IV and V th. digit. Dx (Diagnosis)?
    a) Duyptren’s contracture

    3. Female 28yr, neck stiffness, no focal or other neurology, head CT normal, CSF picture: 200 red cells, protein slightly increased to 70, Dx?
    a) SAH
    b) Meningitis
    c) nothing serious/normal headache

    4. CSF: picture bacterial meningtitis. Dx?
    a) Bacterial meningitis

    5. Blood picture with increased AP, ALT (>AST), AST, hep B and C negative. Dx?
    a) viral hepatitis

    6. Blood picture increased AP, ALT, Bilirubin. Dx?
    a) Cholelithiasis
    b) Cholecystitis

    7. 85 years, ductus hepaticus mass or palpable gallbladder, also cardiomegaly and hepatomegaly in medical history. Tx (treatment)?
    a) biliary shunt
    b) whipple op

    8. Bloods with increased ESR

    9. Cant recall question anymore but it contained all this: patient with rash on tonsils. Dx: viral - swab, ASO titre, WCC, fever , LN

    10. Anaemia blood picture with decreased iron and increased transf. Dx?
    a) Normocytic anaemia

    11. Status asthmaticus proper treatment in ED?
    a) Rehydrate, inh. Salbutamol, parenteral steroids
    b) rehydrate, salbutamol inh., ipratropium inh.
    c) theophylline and…

    12. Vit. B12 deficiency picture (at least my impression). Sx (symptoms)?
    a) PNP

    13. Leucaemia definitive diagnosis? LAD, fatigue, increased LUC, Hb 110 and

    14. PE (pulmonary embolism) proven with V/Q scan in a young girl. Tx?
    a) Iv heparin
    b) Warfarin
    c) Thrombolysis

    15. 80yr old lady with PE post a long distance flight. Tx?
    a) Iv heparin
    b) Warfarin
    c) Thrombolysis

    16. PE postv a rectal surgery. Tx?
    a) Iv heparin
    b) Warfarin
    c) Thrombolysis

    17. Acute drop of thrombocytes to 50.

    18. Patient develops oedema and HTN (hypertension), Hx: ESRF (end stage renal failure) and diabetes mellitus. Treatment?
    a) Start ACE-I
    b) Thiazide
    c) beta-blocker

    19. Tx with thiazide and ACE-I in combination. Can cause the following changes:
    a) Insulin increase
    b) insulin decrease
    c) glucose increase
    d) potassium decrease

    20. Alcohol, now acute confusion

    21. Wernicke patient develops low BSL in ED. Tx?
    a) Thiamine, ten Glucose infusion
    b) 10ml of 50% (or 20ml of 10%) Glucose stat
    c) Glucose infusion
    d) Glucagon

    22. Alcohol

    23. Culture came back positive for salmonella infection on the 4th day after travelling. Patient already received a 3-day treatment of metronidazole. His symptoms haven’t changed since. Mx (management)?
    a) Metronidazole for 3 weeks
    b) do nothing

    24. Alcohol abuse now with acute nausea and vomiting. Abdominal pain also to back. In ED Shock. Dx?
    a) Pancreatitis

    25. 10 years history of acidity/reflux, well controlled with medicine, no history of weight loss. Now dysphagia/swallowing preoblems especially for meat. Dx?
    a) Oesophagus carcinoma
    b) stricture of esophagus
    c) barrets esophagus
    d) side effects of drugs

    26. Bleeding ulcer on endoscopy and test positive for helicobacter pylori. Mx?
    a) Adrenalin injection on endoscopy
    b) iv omeprazole

    27. Best test to re-check post 7days of triple therapy for H. pylori?
    a) Urease breath test

    28. Fluids resuscitation for burn victim with 15% surface affected, 80kg? (my addit 4x15x80=4800ml)
    a) give 3 l Hartmans and 2 l dextrose
    b) same with blood products and Hartmanns
    c) N/Saline and Hartmanns

    29. Burns with…. Mx?
    a) Intubation

    30. 15yr old girl with Crohn’s disease. Comes with faecal soiling. No pain/ no blood. On examination you will find?
    a) Vesicle or so
    b) Fistula
    c) Fissure

    31. Rash on legs

    32. Patient with haemoptysis and haematuria and Epistacsis. Dx?
    a) Wegener’s

    33. Patient with haemoptysis and haematuria. Investigation?
    a) Antimembr. Ab
    b) ANA

    34. 78 yr old wife with cognitive changes, confusion. Ix?
    a) CT

    35. Fecal impectation rectum

    36. Alcoholic male found behind bar, previous episode of binch drinking, speech…? Dx?


    37. Man /boy collapsed during rugby/football game on the field. No contact to other players before on field. Now loss of consciousness for 30 minutes. Dx?
    a) Vasovagal
    b) SAH
    c) Seizure

    38. congestive heart failure

    39. Long-standing smoker, age around 80 presents with frothy sputum, pleuritic chest pain, tachycardic, clear chest on auscultation, post flight. Dx?
    a) PE
    b) Cancer

    40. Long-standing smoker, age around 80 presents with haemoptysis, pleuritic chest pain, tachycardic, clear chest on auscultation, post flight…some other question about it

    41. Longstanding smoker presents with neurological signs on hands and arms

    42. Patient with PE szenario. ECG normal but tachycardia 100bpm. What do you expect to see on CXR?
    a) Nothing
    b) Effusion

    43. WPW history. Now tachycardic with (no ECG was given, only description) broad complexes in ECG and it looks like AF. Tx?
    a) Electrocardioversion
    b) Digoxin

    44. ECG ST elevation in V1-V3, SVT (only describtion, no ECG given). Most likely diagnosis?
    a) PE

    45. Patient with SVT and low BP and decreased level of conciousness. Treatment?
    a) Verapamil
    b) Sotalol
    c) Valsalva maneuver
    d) Cold water


    Surgery:

    1. Patient with rectus muscle pain and mass on the side of abdomen when strained. Nothing to palpate when lying down. Dx?
    a. Rectus strain
    b. hernias with several names which I never heard of

    2. Ruptured AAA

    3. Wound of patient’s fist/hand 14 hours post injury. What to do after debridement?
    a. Suture and antibiotics
    b. Suture and drain
    c. Leave open

    4. Empty rectum but blood (? Can’t remember what I meant by that in my notes)

    5. Bowel motions every 4-5 days only?
    a. Normal

    6. Mass in right upper quadrant that moves with breathing. Dx?

    7. When do you do an explorative laparotomy post accident at work (explained the whole szenario)?
    a. Retroperitoneal air
    b. (?retroperitoneal) Bleed
    c. blood collection in liver
    d. blood collection in spleen

    8. Patient with fracture presents with pain on forearm and hand, increased on extension, slight swelling. Extension fixation. Cause?
    a. Haematoma
    b. Damage median nerve
    c. Carpaltunnel syndrome

    9. MVA (motor vehicle accident) with fractured ribs 2-7 (bilateral?). Now presents with difficulty breathing and pain. Mx?
    a. Strapping ribs
    b. Nerval block of ribs at…
    c. Intubate and ventilate


    Paediatrics:

    1. Picture of child with generalised icterus. Which investigation would you perform to confirm the diagnosis? (Nothing like bili or so given)

    2. Pictures of a child’s back showing pink scaly patch, about 2 x 1 cm?

    a. Rosacea

    3. Picture of CXR of a child with left upper lobe consolidation and some round shaped lesions, (?pneumatocele). (Not 100% sure if this was the question but I think it was:) Which treatment?
    a. Flucloxacillin

    4. CSF given. I think viral picture. Child post birth, developes vesicles somewhere. Tx?
    a. Acyclovir

    5. Child with 3 days of fever then develops a rash. Dx?
    a. 3 day fever

    6. Child with scaly rash on neck, macular, mouth pink tounge, sore throat. Dx?
    a. Scarlet fever
    b. Mumps

    7. Child younger than1 yr., soft palpable mass behind nipple. Tx?
    a. Reassurance and monitoring

    8. Leucaemia, lethargy for 3 months, Lab. shows leuocytosis with mainly functioning leucos. What is the investigation to confirm most likely diagnosis?
    a. LN aspiration
    b. Philadelphia chromosome

    9. Child 13 or 18 months old, SSRI ingested, as per parents “quite some amountâ€. How can you evaluate the risk of toxicity?
    a. ECG
    b. EUC
    c. Level

    10. Asthma 10-13yr old child, 2 attacks in the last year, now for general check-up in your surgery. Mother states child had cough all winter. Mother concerned. Currently on ventolin PRN. Mx?
    a. Start PEF monitoring and measure regularly
    b. start preventer (name given)

    11. Asthma exacerbation again in child. Mx?
    a. Fluticasone
    b. salmeterol inh.
    c. Ipratropium
    d. 6hrly ventolin

    12. Ikterus

    13. Preterm baby develops respiratory distress a few hours after birth. Dx?

    a. RDS

    14. Toddler was at birthday party of family member. Sudden onset of cough and wheeze. Mx?
    a. In-and epiratory CXR
    b. Bronchoscopy

    15. Similar question, can’t recall the difference: Toddler was at birthday party of family member. Sudden onset of cough and wheeze. Mx?
    a. In-and epiratory CXR
    b. Bronchoscopy

    16. 2 yr. old swallowed a 2.5cm long screw. AXR shows the screw in the RUQ. Mx?
    a. R/V in 2 days
    b. Endoscopy
    c. Follow-up ultrasound

    17. Child with burns and stridor. Mx?
    a. Intubation

    18. CF (cystic fibrosis) sweat test. Child with recurrent respiratory infections, no weight gain

    19. *Milestones question. Child can roll, hold head up, sit bending forward, babble, grasp palm, stand when hold. Age?
    a. 5 months
    b. 7 months
    c. 10 months
    d. 12 months

    20. SIDS. Parents are coming to you telling you this is all they are doing now and want advice. What can be most effective after 1st affected child to prevent?
    a. Baby alarm
    b. Stop smoking
    c. Breast feeding only
    d. Lay supine
    e. Lay on belly

    21. What is APGAR if child HR 140, moves all limbs, cries, arms cyanosed and maybe a few more hints?
    a. 9

    22. Lateral CXR of a child with stridor. Dx?
    a. Epiglotitis
    b. Laryngomalazia
    c. Croup

    23. Child, bowel obstruction

    24. Neonate with respiratory distress


    25. Intussuseption szenario

    26. Child 3 yr. old with laceration on scalp. Clean and not contaminated. Child not immunised. Mx?
    a. Antibiotics
    b. Tetanustoxin
    c. Tetanusimmunoglobulin
    d. TDPertussis vaccination
    e. TD vaccination

    27. Hirschsprungs

    28. Child with decreased femoral pulses, Dx?
    a. Coarctation
    b. Hypoplastic left heart

    29. Child 12 hours post birth, cyanotic, no murmur

    30. Neonate at 1.5hours. Nurse states did turn blue on hands and feet. On examination normal heart and lung examination. What is true?
    a. Seizure
    b. Start giving oxygen
    c. Early resp. distress signs

    31. Child around 3 yrs with abdominal mass and haematuria. Dx?
    a. Wilms tumour

    32. Child 14yr, pain on side of knee. Limb shortened, limps, hib abducted. (Note: not given obese in history) Dx?
    a. Slipped epiphysis
    b. Perthes disease
    c. Osteochondrosis

    33. Child with cough and dyspnoea. On auscultation crepitations on the right and dull on percussion over right middle lobe. Dx?
    a. Effusion
    b. Pneumonia

    34. Child with haemophilus meningitis and pneumonia gets exposure to other child (age <4yr) without immunisation. Mx of the exposed child?
    a. Amoxicillin orally for 4 days
    b. Rifampicin for 4 days
    c. Cefachlor oral for 4 days
    d. Chloramphenicol shot im
    e. Penicillin iv

    35. Child born and not able to take breath. What u will do first?
    a. phryngeal suction
    b. intubation and ventilation
    c. wait and watch
    d. x-ray

    36. Parents asking about risk for their future child, as mother’s brother has arachnodactily?
    a. The risk for the child is same as in normal population
    b. 50% change of having
    c. 50% change of being a carrier

    37. parents came to physician, they have a child with the cleft palate and want to know what is the probability of cleft palate in their second child
    a. 3%
    b. 7%
    c. 0.4%
    d. 4. 4%


    O&G:

    1. Galactorrhoea 4 months post breast-feeding was stopped, child now 8 months old. Tx?
    a. Reassurance
    b. Bromocriptine

    2. Women 30-32 weeks gestation comes in with symptoms of preeclamsia. Fetus seems well. Management?
    a. Hydralazine
    b. Induce labour
    c. CS

    3. Girl on OCP (oral contraceptive pill) for 2 months, not working as she has no regular menstruation and co. Mx?
    a. Continue for 2 more months

    4. 15 yr old girl has collected information about depot contraception and requests it. Management?
    a. Re-educate her about options and risks, then give it to her if she still insists on it
    b. Ask mother for permission
    c. It is contraindicated in that age group

    5. Vagina dry, cyclic (pre)menopause

    6. Vaginal/vulva swelling and pain Dx?
    a. Barthol. Abscess
    b. Bart. Cyst

    7. Rash vaginal or so Dx?
    a. Secondary to syphilis
    b. Ulcer vulva

    8. Vaginal itch

    9. Absolute contra indication (CI) for IUD?
    a. Previous cervix
    b. STD
    c. Uterus malformation

    10. IUC using female, now amennorhoea. Result shows she is pregnant. Mx of IUD?
    a. Leave in
    b. Take out immediately by pulling on the wires you can see
    c. Scope

    11. 45 yr old female with positive FNA for cancer. What do you do to decide for conservative Tx?
    a. Check LN axillary manually to exclude spread
    b. Mammogram
    c. US of breast (comment: no option for MRI or CT given)

    12. Mother 18 weeks of gestation with bacterial vaginosis. Mx?
    a. Tell her to check again at 28 weeks and if still there treat with…
    b. Metronidazole now
    c. No need for action

    13. Mother, GBS (Group B strep.) positive at 30 weeks gestation. When to give IV penicillin?
    a. In labour
    b. Perform CS and give during CS
    c. Start with first cut of CS
    d. To baby after birth

    14. Primary amenorrhoea in a 18yr old girl. No breast development. Mx?
    a. Karyotyping

    15. Parents with 3 previous miscarriages. Mx?
    a. Karyotype of both parents

    16. Uterus umbifig. What’s true about pregnancy?
    a. Will never be pregnant
    b. Tell her normal chances
    c. Most likely infertile
    d. Increased risk for miscarriage

    17. Mother who is breast-feeding gets mastitis. Mx?
    a. Stop breastfeeding until she is well to prevent contamination
    b. Stop on affected side
    c. Stop feeding from affected side and use breast pump there

    18. Mother Hepatitis B positive


    Psychiatry: (there were many psych. questions but those are the ones I just can’t remember!)

    1. Middle aged women presents low mood. Sounds like depression. Started St. John’s Worth 300mg and it helped a bit but still not enough and still depressed. Not suicidal. Mx?
    a. Increase St. Johns Worth to 600mg
    b. Add SSRI (name and dose given, think Fluoxetine 75mg)
    c. Wash out period for St. John’s Wrth, then start SSRI (name and dose given)


    Ethics & Co:

    1. Primary prevention means?
    a. Decreased prevalence
    b. Dcreased incidence and preterm death

    2. Old man with dementia with new diagnosis of untreatable cancer. His wife is the carer and asks you not to tell him about diagnosis as he would get depressed and then she couldn’t care for him anymore at home. Which allows you most not to tell the diagnosis to the patient?
    a. You made the decicion that patient would not understand the diagnosis
    b. Wife can’t care for him anymore if he hears diagnosis
    c. Treatment of dementia plus depression is very difficult

    3. Old man lives with daughter and son in law. Comes to you as a GP with bruises. He tells you about some abuse/violence by the son in law but asks you not to tell the son in law or his daughter. Mx?
    a. Call police and tell them
    b. Cll daughter to talk about it
    c. Tll ptient to come for regular visits at you surgery from now on to check-up on him

    Surgery at night, an emergency operation is getting ready to start. The surgeon walks in ataxic with symptoms of being drunk/current ETOH abuse. You talk him but he replies “mind your own businessâ€. Then what u will do next
    4. Mx?
    a. Call security to stop him and take him out of theatre (?or police)
    b. Call your bosses/ CMO stat
    c. Call ethic commun. Or board stat
    d. Call someone tomorrow morning
    e. Find other surgeon to replace him/ talk to another colleague that he will take charge

    5. Study about HIV. Blind study.
    a. Tell people the test results
    b. As it is a blind study you can’t tell the patients but advise them to do HIV test themselves afterwards

    6. GP can be involved in clinical study. What is your main responsibility?
    a. To be familiar with the Helsinky
    b. Make sure it fits the ethics
    c. Make sure your patients get paid

    7. which one can decrease the prevalence of a disease in the population? herd immunity/ treatment/ health programme
  2. Guest

    Guest Guest

    thx, good on you
  3. Guest

    Guest Guest

    how did u sit Offshore MCQ in Sydney? Venues changed? anywell, thaxs for sharing your expenrience.
  4. Guest

    Guest Guest

    need help

    hi there .i am keen the exam plz help me with the notes
  5. Guest

    Guest Guest

    would abyone like to discuss the answers???
  6. nyeinoo

    nyeinoo Guest

    want to check the answers.

    yes i want to check the answer. how can i do that?
    do u have email?
  7. nyeinoo

    nyeinoo Guest

    want to discuss

    it is my email nyeinoo@gmail.com
    want to discuss on 30.11.07
    can send the answer with number. i will send u back after i get email from u. thanks
  8. Guest

    Guest Guest

    answers

    may u please send mw za answers of obs & gyne
    muhfa85@gmail.com
    tanks in advance
  9. NEELAM

    NEELAM Guest

  10. AMCdoctor

    AMCdoctor Guest

    what is the answer

    what is the anwseer for them
    5 a 3 weeks old baby presented with jaundice which began at 4 days of life. Total bilirubin is 200( conjugated bilirubin 120)WOF diagnosis

    A Congenital hypothyroidism
    B Sepsis
    C Rh incompatibility
    D Biliary atresia
    E Breast feed

    6 A mother brought his 9 years old boy to the GP , She was concerned that her son is too fat. On examination , he had hight (90 Centile) , weight (95 centile) . Which of the following investigation would you find in this boy
    A Serum growth hormone level
    B Serum cortisol level
    C Serum parathyroid hormone level
    D Serum TSH level
    E Serum aldosterone level
  11. Thanks for the help

    Thanks for the help.
    Pradeep
  12. Guest

    Guest Guest

    hi thanks very much, its really of great help...
  13. Guest

    Guest Guest

  14. Guest

    Guest Guest

    Hi there

    I'm planning to take AMC in September, I'm in Newcastle looking for astudy group :D
  15. Guest

    Guest Guest

    what do you guys think about the canadaQbank ,is it a good idea to do this 2 mnths beforeamc mcq or not?
  16. anisha

    anisha Guest

  17. sandeep83

    sandeep83 Guest

  18. Guest

    Guest Guest

    Hello

    Thanks for your useful information about AMC!
    As "Mr angelitainca" , most of the people who passed AMC exam say OHCM(Oxford Hand Book of Clinical Medicine), OHCS(surgery), Oxford hand book of clinical specialities , GP books(Sold by AMC) are quite enough to sit the exam if you practiced AMC old questions.


    See you,
    I'ld like to share and receive information regarding AMC coz I might sit AMC at Perth in November 2010.

    See you,

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