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Topic guides by domain
- Topic guide · AMC MCQAdult Medicine for the AMC MCQ: Australian Revision Hub
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Sample questions
Original questions in the exam's style. Choose an answer, then check it.
A 26-year-old man is brought to the emergency department by friends after smoking crystal methamphetamine ('ice') over the past day. He is anxious, restless and pacing, and believes people are following him. He is not aggressive, accepts reassurance from staff and agrees to take oral medication. Heart rate is 118 beats/min, blood pressure 150/90 mmHg and temperature 37.6 °C. He has no chest pain. What is the most appropriate initial pharmacological management?
Answer: C. For a cooperative patient with methamphetamine-related agitation, eTG recommends a calm, low-stimulus environment and oral benzodiazepines such as diazepam, titrated to effect. Benzodiazepines reduce agitation, sympathetic overactivity and seizure risk. Parenteral sedation and restraint are reserved for severe agitation when less restrictive options fail.
A 22-month-old boy presents to a GP with 4 months of irritability, a distended abdomen and large, pale, offensive stools. His weight has fallen from the 50th to below the 10th centile since solids including wheat cereals were introduced. On examination he is miserable, with wasted buttocks and a protuberant abdomen. There is no history of chest infections. He is eating a normal toddler diet. What is the most appropriate initial investigation?
Answer: D. This child has the classic presentation of coeliac disease: faltering growth after gluten introduction, abdominal distension, irritability, steatorrhoea and buttock wasting. The first-line test is tissue transglutaminase IgA together with total IgA, because IgA deficiency is more common in coeliac disease and causes false-negative results. Testing must be done while the child is eating gluten, and positive serology is generally followed by duodenal biopsy to confirm the diagnosis.
A 42-year-old man who works at an abattoir in rural Queensland presents with 2 weeks of fever, severe frontal headache, sweats, myalgia and a dry cough. He has never received any vaccinations for occupational exposures. Temperature 38.8 °C. Chest examination reveals right basal crackles and chest x-ray shows patchy right lower zone opacity. ALT 180 U/L, platelets 110 x 10^9/L, creatinine normal. No conjunctival suffusion is noted. What is the most likely diagnosis?
Answer: A. Acute Q fever, caused by Coxiella burnetii, is acquired by inhaling aerosols from infected cattle, sheep and goats and is classically seen in abattoir and farm workers in Queensland and New South Wales. It presents with a flu-like illness, severe headache, atypical pneumonia and hepatitis. Diagnosis is by serology (and PCR early), treatment is doxycycline, and Q fever vaccination is recommended for at-risk workers.
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