AMC MCQ confusing question collection for discussion

Discussion in 'Australian Medical Council (AMC) EXAM' started by Guest, Oct 1, 2007.

  1. Guest

    Guest Guest

    RE Q A farmer comes to the clinic with history of wound caused by a wire. O/E the site is red and tender. Which one of the following Ix can be used to exclude clostridium difficile infection.

    a. Biopsy of the muscle
    b. aerobic culture
    c. anaerobic culture
    d. x-ray of the site and looking for subcutaneous emphysema//////////
    e. blood culture


    ??But C difficile causes a diarrhea commonly not gas gangrene.. If other cl species causing gas gangrene gram stain and culture of bulle fluid and x ray and USG can also be used to look for gas. Please correct me if im wrong ?
  2. Guest

    Guest Guest

    confusing ques...

    hi angeli,

    please correct my answer

    8. Turner syndrome lady decided to get pregnant. Your advice to her would be [/b]A- use surrogate mother with her( Turner’s) eggs
    B- implant donor’s eggs////////
    C- stimulation with Clomifen
    D- IVF is Rx of choice
  3. blue purple

    blue purple Guest

    A Sudanese boy came to you after administration of Co-timoxazole with the complaints of pallor and increasing darkness of colour of urine. His reticulocyte count was 8%. His Coomb's test was negative, no family history and on electrophoresis Type A hb was detected. What is the Dx?

    a. Hereditary Spherocytosis
    b. G6PD def
    c. Autoimmune HA
    d. Sickle cell anaemia
    e. thalassemia

    PLz ans
  4. Guest

    Guest Guest

    A Sudanese boy came to you after administration of Co-timoxazole with the complaints of pallor and increasing darkness of colour of urine. His reticulocyte count was 8%. His Coomb's test was negative, no family history and on electrophoresis Type A hb was detected. What is the Dx?

    a. Hereditary Spherocytosis
    b. G6PD def /////////
    c. Autoimmune HA
    d. Sickle cell anaemia
    e. thalassemia

    antimalaria,salphonamide ,cotrimoxazole etc. are trigger factor for haemolysis.
  5. Guest

    Guest Guest

    could u plz correct me....

    12. Old man came with palpitations. Has DM2, On Thyroxin for his hypothyroidism, has long history of HTN. What is the management? ECG is given…it shows bradicardia.
    A-cease Veropamil////
    B-Digoxin
    C-lower dose of Metphormin
    D-stop( or lower dose) of Thyroxin
  6. Guest

    Guest Guest

    Mixed Confusion

    Can anyone help me out on the following???

    A pt with deafness on one side, with 5th and 7th cranial nerve involved, middle ear infection, swelling in the anterior and upper part of the neck, how will you investigate:
    a) Biopsy of swelling
    b) Examn of postnasal area
    c) middle ear aspiration
    d) CT

    A pregnant lady, 155cm in height, at full term came for the first time, head not engaged. The most common cause is:
    a) contracted pelvis////
    b) occipito post
    c) placenta
    d) full rectum

    A pregnant lady at 28wks with 36cm uterine height. She had regular follow ups and had ultrasound at 18wks. The most probable cause is:
    a) twin pregnancy
    b) gestational diabetes
    c) viral infection
    d) ISO immunisation////

    A pt has calcium oxalate renal stones. What is the most appropraite management?
    a) Allopurinol
    b) Alkalinise the urine
    c) stop taking food and calcium
    d) give Ca++

    A senior RMO in a hospital has an inappropriate relationship with his pt, and you are the supervisor. What do you do?
    a) court
    b) talk to pt
    c) talkk to the RMO

    Thanks
  7. Guest

    Guest Guest

    could anyone help...

    1. While doing hysterectomy in lithotomy position WOF nerve is prone to injury---
    a) Pudendal nerve
    b) Sciatic nerve
    c) Common peroneal nerve
  8. Guest

    Guest Guest

    Re: confusing ques...

    Hi,
    sorry but preparing for 30/10/07 and didn't have time to check this forum the last days. As i am still behind in studying I will just quickly answer this one for you mahedi, sorry I don't have time for more...
    The answer is D, which will lead to nearlly same outcome as normal women with IVF. Checked it in up to date.
    cheers and good luck to all the candidates on Tuesday!!!
  9. samu

    samu Guest

    could anyone help...

    1. While doing hysterectomy in lithotomy position WOF nerve is prone to injury---
    a) Pudendal nerve
    b) Sciatic nerve
    c) Common peroneal nerve

    I would choose A.
  10. samu

    samu Guest

    A pt has calcium oxalate renal stones. What is the most appropraite management?
    a) Allopurinol
    b) Alkalinise the urine
    c) stop taking food and calcium
    d) give Ca++

    B

    If the stone consistes uric acid. you coudl use allopurinol.
  11. bluepurple

    bluepurple Guest

    court order

    2.) You can breach confidentiality except
    a. harm to patient
    b. harm to others
    c. emergency to hospital
    d. court order
    e. maybe beneficial to patient

    I think it is a bad recall, cause i cannot breach da confidentiality to harm to patient or harm to others. i can breach da confidentiality for a court order or maybe beneficial to patient. emergency to hospital...does not make a sense to me.

    If the ques would have been like below:
    2.) You cannoteach confidentiality except
    a. harm to patient
    b. harm to others
    c. emergency to hospital
    d. court order
    e. maybe beneficial to patient
    the answer would be court order
  12. bluepurple

    bluepurple Guest

    20.) 8yr old giral doing well in school everything normal teachers are concerned becoz she mimics intercourse in the p-layground wen children around.cause?

    a)normal behaviour
    b)sexual abuse

    ANSWER B
    Hi please explain the answer.
  13. Guest

    Guest Guest

    whatt dos B mean to start digoxin ?
  14. Guest

    Guest Guest

    Re Q A pregnant lady at 28wks with 36cm uterine height. She had regular follow ups and had ultrasound at 18wks. The most probable cause is:
    a) twin pregnancy
    b) gestational diabetes
    c) viral infection
    d) ISO immunisation////


    ohhhh if this answer is correct (i was thinking why not diabetes) then the key words are regular follow ups because glucose levels are tested routinely ... Tricky.
  15. drs

    drs Guest

    confusing question

    5 days after appendectomy,patient 38C and mucoid diarrhea:

    A.pelvic abscess
    B.Bowel obstruction
    C.Wound dehiscence[/u]
  16. dr_cute

    dr_cute Guest

    looking for study partners in melbourne

    hi doc
    any 1 preparing for amc? i m thinking of giving amcq in may2008 and looking for study partners in melbourne in st. vincent library or melb uni?
  17. vikra,m

    vikra,m Guest

    2.) You can breach confidentiality except
    a. harm to patient
    b. harm to others
    c. emergency to hospital
    d. court order
    e. maybe beneficial to patient

    I think c. as u can breach in a,b, d
  18. Tazzo

    Tazzo Guest

    1.) Which is least likely to cause HIV?

    a. blood transfusion in 1988
    b. hemophilia
    c. homosexual lees contact in ten years (couldn't figure out what lees was)
    d. I/V drug user in 1990
    e. Hetrosexual more with prostitute

    i think ais the right answer.. single blood transfusion may be the least likely to cause HIV..


    2.) You can breach confidentiality except
    a. harm to patient
    b. harm to others
    c. emergency to hospital
    d. court order
    e. maybe beneficial to patient

    d is the right answer .. even if you think is better for your patient to breech his confidentiality!!

    3.) Cyclic vulvovaginitis caused by
    a. bacterial vaginosis
    b. group B streptococcus
    c. E coli
    d. trichomonas

    i think a ..

    4.) Lung abscesses can be caused by all except
    a. Staph
    b. Klebsiella
    c. Mycoplasma
    d. bacteroides fragilis
    e. Pneumocystis carinii

    i think c or e is the right answer .. im not sure

    5.) Losing of association is associated with
    a. schizophrenia
    b. dissociative identity disorder
    c. bipolar disorder
    d.dementia

    the right answer is a .. loss of association is commonly seen in SZP patients

    6.) Arterial ischemia and absent femoral and popliteal pulses, initally you will do
    a. ankle brachial index pressure
    b. femoral arteriogram
    c. MRarteriogram
    d. arterigram

    i think c is right less invasive and benificial .. ABP index is not useful here the pulse is already absent..


    7.) Menopausal lady with progesterone containing OCP, no bleed for 3 months what would you do initially?
    a. USG to determine endometrial thickness
    b. endometrial biopsy
    c. increase the dosage of progesterone

    not sure but if u had to choose i choose a or c .. i will not jump to endometial biopsy like thiss!!

    8.) Toxic shcok syndrome is most commonly associated with (if this was an actual question then I think I will pass the exam)
    a. super absorbent pad
    b. endotoxin
    c. desquamated rash

    answer is b to my mind .. in pt with TSS usually there is endotoxin ..

    9.) Common cause of rupture of EPL
    a. RA and SLE
    b. avascular necrosis in neonate
    c. tenosynovitis

    what do you mean by EPL????


    10.) Which of the following is a least likely finding in sexual abuse
    a. finding gonococci
    b. finding condylomata virus
    c. labial hematoma
    d. lacerations in the vagina

    i agree with you answer is b. hematomas , laceration is common ..
    i will not be astonished if the right answer is a :)


    11.) 2 year old child with fever, irritability, MSU shows WBC 20, protein ++, which of the following is correct?
    a. amoxycillin 150mg daily
    b.suprapubic aspiration
    c. repeat urine examination
    d. send culture and wait for result

    o.k straight forword UTI why not to start antibiotic (febrile ,irritable patient) then send urine for culture and sensitivity .. i choose a

    12.) Child with UTI, which is least appropriate
    a. send culture after antibiotic treatment
    b. continue medication until urinary tract abnormality excluded
    c. do USG of urinary tract
    d. immediate micturation urethrogram

    i agree aswer d is very much inapropriate in such a patient..


    13.) 10 year old girl with simple patial seizure and 4 year history of intake of carbemazepine but convulsion 4 times in the last 2 weeks, which is the most appropriate Rx
    a. stop CBZ and start phenytoin
    b. increase dose of CBZ
    c. continue CBZ and start sodium valproate
    d. arrange CT scan and EEG

    i choose c .. epileptic drugs shoul not stopped suddenly .. and monodrug therapy is not always enough to control epilepsy in any patient ..

    14.) A neonate developed jaundice after discharge on the 2nd day, he is lethargic and has poor feeding, whats the best management?
    a. MSU
    b LFT
    c. phototherapy
    d. Rx as sepsis

    i agree with people choosing d..



    thank you and please send more questions
    Dr.Tazzo
  19. Guest

    Guest Guest

    2.) You can breach confidentiality except
    a. harm to patient
    b. harm to others
    c. emergency to hospital
    d. court order
    e. maybe beneficial to patient

    sorry about this .. i thought the q was you can NOT breach ..
    anyway you can breach conf in c,d .. i dont think about d its suspicious
    so the right is between a and b .. more likely a is right .. if you remember the q properly
    thanks Dr.Tazzo
  20. drs

    drs Guest

    Dr.Tazoo
    could you plz answer my question.nobody answer my question:
    5 days after appendectomy,patient 38C and mucoid diarrhea:

    A.pelvic abscess
    B.Bowel obstruction
    C.Wound dehiscence

    THNX
  21. Guest123

    Guest123 Guest

    could you plz answer my question.nobody answer my question:
    5 days after appendectomy,patient 38C and mucoid diarrhea:

    A.pelvic abscess
    B.Bowel obstruction
    C.Wound dehiscence


    Ans: A Pelvic Abscess
  22. docbehoshi

    docbehoshi Guest

    question about post appendectomy and patient having mucoid diarrhea and 38c ....

    answer --- pelvic abscess
  23. Answer of Qs 1-14 first part

    Hi everybody and specially angeli.....

    here is my answers

    1.B but dont ask me why ??!!!


    2.E is surely the answer. its not a logical but a ridiculous reason to forget confidentiality.


    3.Damn the AMC exam what kind of Q it is :!: here is 10 top organisms can cause vulvovaginitis :

    Candida albicans
    Chlamydia trachomatis
    Gardnerella vaginalis
    Mobiluncus
    Mycoplasma hominis
    Neisseria gonorrhoea
    Reiter’s syndrome - vulvovaginitis
    Threadworm
    Torulopsis glabrata
    Trichomonas vaginalis

    from : http://www.wrongdiagnosis.com/symptoms/vulvovaginitis/causes.htm

    now you find the answer!!!!!!!
    but maybe this Q means item C !!!!
    OK! don't be mad at me !!! dont forget the word cyclic maybe pointing to poor hygiene (E.coli is found easily in rectum so it can be a cyclic cause :p )

    and one thing unrelated :
    Reiter’s syndrome: A form of reactive arthritis characterized by arthritis, urethritis, conjunctivitis and skin lesions.

    http://www.wrongdiagnosis.com/r/reiter_s_syndrome/intro.htm


    4.C
    "Symptoms of Lung abscess
    Fever
    Malaise
    Chills
    Sweating
    Cough
    common causes :
    Streptococcus milleri
    Alveolar hydatid disease
    Mycobacterium tuberculosis
    Aspergilloma
    Actinomycosis
    Staphylococcus aureus
    Klebsiella sp
    Bronchogenic carcinoma "

    http://www.wrongdiagnosis.com/l/lung_abscess/causes.htm
    OK! OK! Dont be angry of me there isnt yet C D & E in the list but consider D & E are Aneorobs and all of us now this kind of organisms can cause abscesses.


    5.Surely A. Loosening (not losing) of association is related with Psychosis its a feature of schizophrenia in Speech and form of thoughts.
    Loosenening of association means : "Lack of connection between the ideas expressed by the patients" -Oxford Core Text Psychiatry 1999- Page 164
    NB : I checked Dementia Nothing about Loosenening of association was there


    6."This is an emergency and may require urgent open surgery or angioplasty.If diagnosis in doubt DO URGENT ARTERIOGRAPHY"
    Oxford Handbook Of Clinical Medicine sixth edition Page 490


    7.I don't understand what this Q mean and one thing more i hate Gynaecology & Obstetrics.


    8.If you say AMC Qs are standard just llok at this damned Q
    But C is correct according to Oxford and wrongdiagnosis site : ( Its talking about Tampones which a female should insert it in not a pad :p !!!! )

    "Toxic shock syndrome
    Causes :
    Theoretically, tampons may contribute to development of TSS by introducing S. aureus into the vagina during insertion (insertion with fingers instead of the supplied applicator increases the risk) or traumatizing the vaginal mucosa during insertion, thus leading to infection.
    When TSS isn’t related to menstruation, it appears to be linked to S. aureus infections, such as abscesses, osteomyelitis, and postsurgical infections. It's also associated with prior antibiotic use.
    Risk factors include recent use of barrier contraceptives (diaphragms or vaginal sponges), childbirth, and surgery.

    Symptoms
    Typically, TSS produces intense myalgias, fever over 104° F (40° C), vomiting, diarrhea, headache, decreased level of consciousness, rigors, conjunctival hyperemia, and vaginal hyperemia and discharge. Severe hypotension occurs with hypovolemic shock. Within a few hours of onset, a deep red rash develops — especially on the palms and soles — and later desquamates.

    Diagnosis
    Diagnosis is based on several criteria: fever, hypotension, rash that peels after 1 to 2 weeks, and at least 3 organs with signs of dysfunction. In some cases, blood cultures may be positive for S. aureus"

    http://www.wrongdiagnosis.com/t/toxic_shock_syndrome/book-diseases-7a.htm


    9.No Idea a boring Q


    10.B but dont have any idea


    11.B but i think the correct answer must be E that you forget it :wink: because a is strongly wrong for prophylaxy we can use Trimethoprim and for Rx trimethoprim/ co-amoxiclav / nolidixic acid , no place for repeating the test and really foolish to wait for the result. So i can be agree with B in these items although according to Oxford Handbook Of Clinical Specialists 6th edition MSU can be even done in infancy but less reliable.
    A 2 years old baby is not infant is it ??? :eek:

    12.A is correct is it too hard to tell the baby "Hey sweety ! pee a little for Doc. to send it to Lab." ??? :roll:
    Acccording to Oxford Handbook Of Clinical Specialists 6th edition the Rx should start before knowing the culture sensitivities not before sending the culture, but i dont find any criteria in this book for micturation urethrogram the book said do it for classifying the reflux but when dont mentioned !!!!


    13.D why a controlled seziure should become worsen;Think about an organic cause

    14.A lethargic Poor feeding baby ---> SEPSIS even without fever,jaundice until prove otherwise - At last a good Q in AMC exam

    Thank For your Qs
  24. Answer To Doctor666

    Hi Doc.

    The answer is obviously Ca salts.
    Ca in the best optimism is good to prevent not to Rx osteoporosis you must give Ca-D to an osteoporotic patient as Vit-D increases absorption of Ca from gut.
  25. Answer to 3rd nerve lesion

    YES my friend it is completely possible to have a 3rd nerve lesion without any pupil reflex disturbance !!!!!

    CN III paresis: The lateral rectus and superior oblique are unopposed, turning the eye outward and downward. An acute lesion may be peripheral (diabetic or ischemic) or central (posterior communicating artery aneurysm or
    cavernous sinus lesion). Both have ptosis, absent eye elevation, and adduction, but a peripheral lesion has normal pupil size and movement (“pupillary sparing”). A central lesion produces a pupil that is dilated and unresponsive to light or accomodation. Causes include tumor, aneurysm, or severe trauma. Unilateral third nerve palsy with contralateral superior rectus palsy and bilateral partial ptosis, and bilateral third nerve palsy always represents a central lesion. Unilateral external ophthalmoplegia with normal contralateral superior rectus function, unilateral internal ophthalmoplegia, and unilateral ptosis represents a peripheral lesion.
  26. I think that the girl with increased seizures: It would make sense to do an urgent CT scan and EEG to rule out another cause. Otherwise you are just treating blindly assuming that there is not another sinister cause.

    Im only a house officer,so what do I know!

    Anna UK
  27. Girl in fire:

    the question tells you that she has a gag reflex, so give her oxygen first!
    She wont tolerate an airway.
    This will also indicate to you whether her airways are swollen by how much oxygen you can bag, then you can decide whether to intubate. If she struggles you could make a bad situation worse
    You can also use other adjuncts

    Anna UK
  28. metastatic cancer lady:

    You should not hide information frompatients but you should use your clinical judgement.
    Ask the patient what/how much she would like to know.

    If she says she doesnt want to know you can say to her, If it was that you became very ill,how much intervention would you like? This is how to deal with these very common situations.

    Consider relatives opinion only but DO WHAT IS IN THE PATIENTS BEST INTERESTS always
  29. DKA

    NSS lots and lots of it!

    Then sliding scale etc

    Anna
  30. Gout

    Colch first and azo for prevention and paracetamol is ok for adjunct

    Anna
  31. AAA

    as it is still pulsatile youve time to scan it. Surgeons will need to know what they are dealing with.
    Anna
  32. Guy with PR bleed.
    They dont mention temp, so probably not diverticular, no altered bowel habit so not CA probably ulcerative colitis...a bit vague isnt it?
    Anna
  33. guest abc

    guest abc Guest

    Hi

    for the question of lung abscess -
    the answer is PCP, bacterodes fragilis can cause lung abscess and it is found to be isolated in about 10% of the anaerobes causing lung abscess (source: Internal Medicine - Harrisons)

    for the question of the HIV blood transfusion
    the answer is A, blood transfusion in 1988, this is because in 1988 due to Uganda development of blood transfusion service , all the blood should be tested for HIV, hepatitis b and c antigen.
  34. drcam

    drcam Guest

    think answer to first question is hemophilia since they give heat treated factor viii or ix concentrate which kills the virus(as its heated)
  35. Guest

    Guest Guest

    for the treatrment of established osteoporosis exercise is least effective.it is useful to prevent osteoposrosis.
  36. Guest

    Guest Guest

    You are a psychiatrist. after you have closed ur clinic, one of ur patient who has dependent personality disorder is waiting for you because she doesnt know how to retrun her own place.

    which of the following is likely to create potential professional misconduct

    blame her
    tell her that it is out of ur boundry
    offer her to call a taxi for her
    offer her to give a lift to to her
    call a police

    which one is correct answer?
  37. Guest

    Guest Guest

    what is the age of pt who can give consent in australia?
  38. Guest

    Guest Guest

    A 14 year old pregnant girl comes to you to request a termination. Her boyfriend who is 21 left her when she discovered she was pregnant. She is living away from home. What do you do?

    a) ring parents for consent
    a) ring child care protection agency
    a) inform police because of difference in age of male
    a) take her informed consent and terminate pregnancy
  39. Guest

    Guest Guest

    a.ring parents
  40. Guest

    Guest Guest

    Q 1 the answer is B cause the screening blood was effective after 1992 so anything transfused before that was a risk and so is sex with prostitutes only hemophlia cause no year is givin so now that is low risk
  41. Guest

    Guest Guest

    vulvovaginitis is caused by candida albicans and this option is not given here
  42. Guest

    Guest Guest

    greenish discharge from one nipple I think it is Ductal Ectasia
  43. DOC .WASEEM

    DOC .WASEEM Guest

    MCQ'S

    AS FOR THE QUESTION WITH CONTACT NUMBERS IS CONCERNED....

    I'd go for E..

    I think no matter what a doctor should not have contact with patient outside or after clinic hours... its unethical....wat do u say
  44. Guest

    Guest Guest

    25yo female patient sked for GI Surgery. Her Hb is 185g/L. What would be the appropriate Pre OP IV fluid?

    A. LR before surgery
    B. LR during Surgery
    C. 4DNacl before surigery
    D. 4DNaCl during surgery
    E. IV Fluid not required

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