AMC MCQ exam Prep by Dr Jayse

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A 25‑year‑old woman with Crohn’s disease on azathioprine and sulfasalazine has normal Hb but low WBC and low platelets. What is the next step? Stop sulfasalazine Stop azathioprine Check creatinine

Hypertensive 63 yo lives with a well husband. Had flu and covid 19 vaccines 6mos ago, DTPa 6yrs ago Recommended vaccination? DTPa Shingles Pneumo Rsv

1 month old child having purulent eye discharge since day 1 of birth asking the cause? Gonococcal chlamydia viral conjunctivitis strep pneumonia conjunctivitis

Pregnant woman with a history of penicillin anaphylaxis is being treated with ceftriaxone for pyelonephritis. Culture shows resistance to ceftriaxone but sensitivity to penicillin and gentamicin. Clinically she is improving. What should you do? Change to gentamicin Continue ceftriaxone Start penicillin

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🩸 7 ABG PATTERNS YOU SHOULD RECOGNIZE INSTANTLY ⸻ 1️⃣ METABOLIC ACIDOSIS 🔻 pH | 🔻 HCO₃⁻ Think: Renal failure, lactic acidosis, DKA, diarrhoea, toxins 💡 Low pH + Low HCO₃⁻ = Metabolic Acidosis ⸻ 2️⃣ METABOLIC ALKALOSIS 🔺 pH | 🔺 HCO₃⁻ Think: Vomiting, NG suction, diuretics, hypokalaemia 💡 High pH + High HCO₃⁻ = Metabolic Alkalosis ⸻ 3️⃣ RESPIRATORY ACIDOSIS 🔻 pH | 🔺 PaCO₂ Think: COPD, severe asthma, CNS depression, neuromuscular disease 💡 Low pH + High CO₂ = Respiratory Acidosis ⸻ 4️⃣ RESPIRATORY ALKALOSIS 🔺 pH | 🔻 PaCO₂ Think: Hyperventilation, hypoxia/PE, sepsis, pain 💡 High pH + Low CO₂ = Respiratory Alkalosis ⸻ 5️⃣ DIABETIC KETOACIDOSIS (DKA) 🔻 pH | 🔻 HCO₃⁻ | 🔺 Anion Gap Look for: • Hyperglycaemia • Ketones • Dehydration • Kussmaul breathing 💡 DKA = High-anion-gap metabolic acidosis ⸻ 6️⃣ SALICYLATE TOXICITY A classic mixed acid–base disorder: 🔻 PaCO₂ → Respiratory alkalosis 🔻 HCO₃⁻ → Metabolic acidosis 💡 Both CO₂ and HCO₃⁻ low? Think salicylates. ⸻ 7️⃣ TYPE 2 RESPIRATORY FAILURE 🔺 PaCO₂ + hypoxaemia Chronic cases develop: 🔺 HCO₃⁻ from renal compensation Think: COPD, obesity hypoventilation, neuromuscular or chest-wall disease ⸻ 🎯 ABG MEMORY TRICK Metabolic = pH and HCO₃⁻ move together ↕️ Respiratory = pH and PaCO₂ move opposite ↔️ Master this rule and ABG interpretation becomes much easier. 📚 Want more high-yield medical notes like this? Explore concise, exam-focused notes, clinical summaries and visual learning resources at: 🌐 aumedprep.com.au Save this post for your next exam or on-call shift. 🩺

Preparing for the AMC MCQ? Study smarter with AumedPrep. 🩺 Most apps give you a question bank and leave you to figure out the rest. AumedPrep goes further. What you get: ✅ AMC-style MCQs ✅ Detailed explanations, so you understand why each answer is right or wrong ✅ Optional live discussion sessions with experienced mentors ✅ Progress tracking to show you where to focus next ✅ Built specifically for International Medical Graduates Whether it's your first attempt at AMC MCQ Part 1 or you're aiming to lift your score, AumedPrep gives you the practice, feedback and support to walk into the exam with confidence. 📲 Download AumedPrep on the App Store today. ( windows, android and Apple iOS ) Don't just answer questions. Learn, improve, and pass. #AMC #AMCMCQ #IMG #InternationalMedicalGraduates #MedicalExams #AumedPrep #MedStudent #DoctorsInAustralia Aumedprep.com.au

⚡ TRIGEMINAL NEURALGIA — SMALL NERVE, BIG PAIN Sudden, severe, electric shock-like facial pain? Think Trigeminal Neuralgia. 🧠⚡ ⸻ 🔵 CN V — TRIGEMINAL NERVE The trigeminal nerve has 3 divisions: 👁️ V1 Ophthalmic → Forehead, eye & scalp 😊 V2 Maxillary → Cheek, upper lip & upper jaw 🦷 V3 Mandibular → Lower jaw, lower lip & teeth ⸻ ⚡ CLASSIC FEATURES ➊ Brief attacks of intense, shock-like facial pain ➋ Usually unilateral ➌ Often affects V2 or V3 ➍ Triggered by normally harmless stimulation 💡 Think: “Electric shocks across the face.” ⸻ 🎯 COMMON TRIGGERS • Light touch • Talking or chewing • Brushing teeth • Cold wind • Shaving or applying makeup ⸻ 🧠 MOST COMMON CAUSE Neurovascular compression of the trigeminal nerve near its root entry zone. ⸻ 🔍 DIAGNOSIS Usually based on the classic clinical history and neurological examination. 🚩 Consider secondary causes when there are atypical features such as sensory loss, bilateral symptoms, or younger age at presentation. ⸻ 💊 TREATMENT First-line: Carbamazepine Alternative: Oxcarbazepine Persistent or refractory symptoms may require additional medical therapy or procedures such as microvascular decompression. ⸻ 🎯 HIGH-YIELD PEARL Brief + unilateral + electric shock-like facial pain + trigger zones = think Trigeminal Neuralgia. Aumedprep.com.au

Internal branch → sensory above vocal cords Loss of laryngeal sensation → aspiration risk ⸻ Thyroid & ENT Surgical Anatomy Superior thyroid artery → close to external branch of superior laryngeal nerve Inferior thyroid artery → relationship with recurrent laryngeal nerve Thyroidectomy complication + hoarseness → RLN injury Thyroidectomy + inability to produce high-pitched sounds → external SLN injury ⸻ Ludwig Angina ⭐⭐⭐ Bilateral submandibular/sublingual infection → Ludwig angina Dental infection → floor-of-mouth cellulitis → Ludwig angina “Woody” induration of floor of mouth → Ludwig angina Tongue elevation → Ludwig angina Airway compromise → major danger Usually odontogenic → mandibular molar infection ⸻ Parotitis Painful parotid swelling + fever → parotitis Purulent drainage from Stensen duct → bacterial parotitis Stensen duct opens opposite upper second molar → parotid gland Dehydrated hospitalized patient → bacterial parotitis risk Mumps → bilateral parotitis + fever ⸻ Facial Nerve ⭐⭐⭐ CN VII → facial expression Bell palsy → LMN facial nerve palsy Entire ipsilateral face affected → Bell palsy Cannot wrinkle forehead + cannot close eye + drooping mouth → LMN CN VII lesion Forehead spared → UMN lesion/stroke Bell palsy treatment → corticosteroids ± antivirals depending on presentation Ramsay Hunt syndrome → vesicles in ear + ipsilateral facial paralysis Ramsay Hunt → VZV reactivation ⸻ Bell Palsy vs Stroke ⭐⭐⭐ Bell palsy: Forehead + eye closure + lower face all affected UMN stroke: Forehead relatively spared + contralateral lower facial weakness ⸻ Ramsay Hunt Syndrome Facial paralysis + painful vesicles around ear → Ramsay Hunt Varicella-zoster virus → Ramsay Hunt Geniculate ganglion involvement → Ramsay Hunt Can cause hearing loss/tinnitus/vertigo → Ramsay Hunt ⸻ Parotid Tumors Most common benign salivary gland tumor → pleomorphic adenoma Painless slow-growing parotid mass → pleomorphic adenoma Facial nerve weakness + parotid mass → malignant salivary gland tumor Facial nerve involvement in parotid mass → concerning for malignancy 🔥 20 Ultra-HY ENT Buzzwords Bulging TM → Acute otitis media Pain with tragal movement → Otitis externa Foul-smelling otorrhea + white keratin → Cholesteatoma 4-kHz notch → Noise-induced hearing loss Carhart notch → Otosclerosis Weber → affected ear → Conductive hearing loss Weber → unaffected ear → Sensorineural hearing loss Vertigo + tinnitus + fluctuating hearing loss → Ménière disease Positional vertigo + positive Dix-Hallpike → BPPV Unilateral SNHL → Vestibular schwannoma Bilateral vestibular schwannomas → NF2 Aspirin + asthma + nasal polyps → AERD Hot potato voice + uvular deviation → Peritonsillar abscess Drooling + tripod + thumbprint → Epiglottitis Barking cough + steeple sign → Croup Foul unilateral nasal discharge in child → Foreign body Hoarseness after thyroidectomy → Recurrent laryngeal nerve injury Cannot produce high-pitched sounds → External superior laryngeal nerve injury Woody floor of mouth + dental infection → Ludwig angina Facial paralysis + ear vesicles → Ramsay Hunt syndrome #amcmcq

Question 12 A 72-year-old man develops sudden left-sided weakness and slurred speech 90 minutes ago. CT brain shows no haemorrhage. There are no contraindications. What is the most appropriate next step? A.  IV thrombolysis (alteplase/tenecteplase) if within the eligible time window   ✓ Correct B.  Aspirin only, thrombolysis not indicated C.  Immediate anticoagulation with warfarin D.  Wait 24 hours before any treatment or imaging E.  Discharge home with GP follow-up Explanation For acute ischaemic stroke presenting within the thrombolysis window (generally up to 4.5 hours from onset, subject to eligibility criteria) with no haemorrhage on CT, IV thrombolysis is indicated. Large vessel occlusion should also prompt consideration of endovascular clot retrieval. Question 13 A 45-year-old man has 3 months of retrosternal burning worse after meals and when lying flat, with no red flag symptoms (no dysphagia, weight loss, or GI bleeding). What is the most appropriate initial management? A.  Urgent endoscopy before any treatment B.  Trial of a proton pump inhibitor plus lifestyle advice   ✓ Correct C.  Long-term antibiotics for H. pylori regardless of testing D.  Barium swallow as first-line investigation E.  Immediate referral for antireflux surgery Explanation In a patient with typical GORD symptoms and no alarm features, empirical treatment with a PPI trial and lifestyle modification (weight loss, avoiding late meals, elevating the head of bed) is appropriate first-line management; endoscopy is reserved for red flags or treatment failure. Question 14 A 30-year-old woman has fatigue and pallor. Investigations show microcytic hypochromic anaemia, low ferritin, and low serum iron with high total iron-binding capacity. What is the most appropriate next step? A.  Start oral iron supplementation and investigate the underlying cause of iron deficiency   ✓ Correct B.  Start vitamin B12 injections C.  Immediate blood transfusion regardless of symptoms D.  Start folic acid alone E.  No treatment needed, recheck in 1 year Explanation Low ferritin with microcytic anaemia confirms iron deficiency. Management includes oral iron replacement and, importantly, investigating the underlying cause (e.g. menstrual loss, GI blood loss, dietary deficiency) rather than treating iron deficiency in isolation. Question 15 A 55-year-old man with no significant renal or GI comorbidity presents with sudden severe pain and swelling of the first metatarsophalangeal joint. Serum urate is elevated. What is the most appropriate first-line treatment for this acute episode? A.  Allopurinol started immediately during the acute attack B.  NSAID (e.g. naproxen) or colchicine   ✓ Correct C.  IV antibiotics D.  Immediate joint replacement E.  Long-term low-dose aspirin Explanation Acute gout is treated with NSAIDs, colchicine, or corticosteroids (oral or intra-articular), chosen based on comorbidities. Urate-lowering therapy such as allopurinol is not started during an acute flare, as it can prolong or worsen the attack, but is introduced later once the flare has settled. Question 16 A 60-year-old woman presents with sudden severe unilateral eye pain, blurred vision, haloes around lights, a fixed mid-dilated pupil, and a red eye with a hard globe on palpation. What is the most likely diagnosis? A.  Acute angle-closure glaucoma   ✓ Correct B.  Anterior uveitis C.  Bacterial conjunctivitis D.  Retinal detachment E.  Corneal abrasion Explanation The combination of severe pain, haloes around lights, a fixed mid-dilated pupil, and a firm globe is classic for acute angle-closure glaucoma, an ophthalmic emergency requiring urgent IOP-lowering treatment and same-day ophthalmology referral. Question 17 A 3-year-old has ear pain, fever, and irritability. Otoscopy shows a bulging, erythematous tympanic membrane with loss of light reflex. The child is systemically well otherwise.

Preparing for the AMC MCQ? Study smarter with AumedPrep. 🩺 Most apps give you a question bank and leave you to figure out the rest. AumedPrep goes further. What you get: ✅ AMC-style MCQs ✅ Detailed explanations, so you understand why each answer is right or wrong ✅ Optional live discussion sessions with experienced mentors ✅ Progress tracking to show you where to focus next ✅ Built specifically for International Medical Graduates Whether it's your first attempt at AMC MCQ Part 1 or you're aiming to lift your score, AumedPrep gives you the practice, feedback and support to walk into the exam with confidence. 📲 Download AumedPrep on the App Store today. ( windows, android and Apple iOS ) Don't just answer questions. Learn, improve, and pass. #AMC #AMCMCQ #IMG #InternationalMedicalGraduates #MedicalExams #AumedPrep #MedStudent #DoctorsInAustralia Aumedprep.com.au

Preparing for the AMC MCQ? Study smarter with AumedPrep. 🩺 Most apps give you a question bank and leave you to figure out the rest. AumedPrep goes further. What you get: ✅ AMC-style MCQs ✅ Detailed explanations, so you understand why each answer is right or wrong ✅ Optional live discussion sessions with experienced mentors ✅ Progress tracking to show you where to focus next ✅ Built specifically for International Medical Graduates Whether it's your first attempt at AMC MCQ Part 1 or you're aiming to lift your score, AumedPrep gives you the practice, feedback and support to walk into the exam with confidence. 📲 Download AumedPrep on the App Store today. ( windows, android and Apple iOS ) Don't just answer questions. Learn, improve, and pass. #AMC #AMCMCQ #IMG #InternationalMedicalGraduates #MedicalExams #AumedPrep #MedStudent #DoctorsInAustralia Aumedprep.com.au

🧬 MEN Syndromes — Distinguish Them in 60 Seconds ⸻ 1️⃣ MEN 1 — Wermer Syndrome The “3 Ps” 🔸 Pituitary Tumour → e.g., Prolactinoma 🔸 Parathyroid Hyperplasia → most common initial presentation → hypercalcaemia 🔸 Pancreatic Islet Cell Tumours → Gastrinoma (Zollinger–Ellison) + Insulinoma 🧬 Gene: MEN1 (Chromosome 11) → Tumour suppressor mutation ⸻ 2️⃣ MEN 2A — Sipple Syndrome The “2 Ps + 1 M” 🔸 Parathyroid Hyperplasia → hypercalcaemia 🔸 Phaeochromocytoma → adrenal gland tumour 🔸 Medullary Thyroid Carcinoma (MTC) 🧬 Gene: RET proto-oncogene (Chromosome 10) → Activating mutation ⸻ 3️⃣ MEN 2B — Mucosal & Marfanoid The “1 P + 2 Ms” 🔸 Phaeochromocytoma 🔸 Medullary Thyroid Carcinoma → most aggressive form, early onset 🔸 Mucosal Neuromas + Marfanoid Habitus ⚠️ NO parathyroid disease — key distinguishing feature! 🧬 Gene: RET proto-oncogene (Chromosome 10) → Activating mutation ⸻ 4️⃣ The Master Comparison ➊ MEN 1 → Pituitary + Parathyroid + Pancreas (MEN1 gene, Chr 11) ➋ MEN 2A → MTC + Pheo + Parathyroid (RET gene, Chr 10) ➌ MEN 2B → MTC + Pheo + Neuromas/Marfanoid — NO parathyroid (RET gene, Chr 10) ⸻ 🧩 Exam Pearls 🔹 MEN 2B is the MOST aggressive — presents earliest with MTC 🔹 Phaeochromocytoma rule → ALWAYS give alpha-blocker BEFORE beta-blocker to prevent hypertensive crisis 🔹 MEN 1 vs MEN 2 genetics → Tumour suppressor (MEN1) vs Activating oncogene (RET) 🔹 Hypercalcaemia in MEN → think Parathyroid (MEN 1 and 2A only — NOT 2B) ⸻ Aumedprep.com.au ⸻ #MENSyndrome #Endocrinology #MedicalEducation #doctor

Preparing for the AMC MCQ? Study smarter with AumedPrep. 🩺 Most apps give you a question bank and leave you to figure out the rest. AumedPrep goes further. What you get: ✅ AMC-style MCQs ✅ Detailed explanations, so you understand why each answer is right or wrong ✅ Optional live discussion sessions with experienced mentors ✅ Progress tracking to show you where to focus next ✅ Built specifically for International Medical Graduates Whether it's your first attempt at AMC MCQ Part 1 or you're aiming to lift your score, AumedPrep gives you the practice, feedback and support to walk into the exam with confidence. 📲 Download AumedPrep on the App Store today. ( windows, android and Apple iOS ) Don't just answer questions. Learn, improve, and pass. #AMC #AMCMCQ #IMG #InternationalMedicalGraduates #MedicalExams #AumedPrep #MedStudent #DoctorsInAustralia

What is the most appropriate initial management per Australian guidelines? A.  Immediate IV antibiotics B.  Analgesia with a watchful waiting approach, reserving antibiotics for red flags or non-resolution   ✓ Correct C.  Grommet insertion immediately D.  Oral antihistamines only E.  Nasal decongestant spray as sole treatment Explanation For most children over 2 years with uncomplicated acute otitis media who are systemically well, Australian guidelines support analgesia (e.g. paracetamol/ibuprofen) and a watchful waiting approach, as most cases resolve spontaneously; antibiotics are reserved for children under 6 months, systemically unwell children, bilateral disease in young children, otorrhoea, or symptoms not improving after 48 hours. Question 18 A 40-year-old man has sudden severe colicky loin-to-groin pain, nausea, and microscopic haematuria on urinalysis. What is the most appropriate initial imaging investigation? A.  Non-contrast CT kidneys-ureters-bladder (CT KUB)   ✓ Correct B.  MRI abdomen C.  Barium enema D.  Plain abdominal X-ray alone E.  No imaging required Explanation For suspected renal colic, non-contrast CT KUB is the investigation of choice, offering high sensitivity and specificity for detecting ureteric and renal calculi and identifying complications such as obstruction. Question 19 A 32-year-old asymptomatic woman attends for routine cervical screening in Australia. She has never had an abnormal result. What is the recommended screening approach under the current National Cervical Screening Program? A.  Annual Pap smear from age 18 B.  Primary HPV test every 5 years from age 25   ✓ Correct C.  Pap smear every 2 years from age 20 D.  No screening required until age 50 E.  HPV test every 12 months regardless of results Explanation Australia's National Cervical Screening Program uses primary HPV testing every 5 years for people with a cervix aged 25–74 who are asymptomatic and have no history of high-grade abnormality, replacing the previous 2-yearly Pap smear program. Question 20 A patient on warfarin for atrial fibrillation presents with an INR of 9.0 and minor bruising but no active bleeding. What is the most appropriate management? A.  Continue warfarin at the same dose B.  Withhold warfarin and give oral vitamin K   ✓ Correct C.  Give fresh frozen plasma immediately regardless of bleeding D.  Increase the warfarin dose E.  No action needed, recheck INR in 4 weeks Explanation For an INR this high without significant bleeding, guidelines recommend withholding warfarin and giving oral vitamin K to reduce the INR and bleeding risk, with close monitoring; prothrombinex/FFP is reserved for major or life-threatening bleeding.