MCQs: Australian Medical Council

1. An infant develops jaundice 6 hours after birth.

Which one of the following is the most likely diagnosis?

a. Hemolytic disease of the newborn.

b. Umbilical sepsis.

c. Physiological jaundice.

d. Atresia of the bile ducts.

e. Neonatal hepatitis.

2. A woman who is 16 weeks pregnant presents with symptoms suggestive of a urinary tract infection.

Which of the following is correct?

a. She should be assured that urinary tract infections are common in pregnancy and require no treatment.

b. A midstream urine should be collected and the bacteriology report awaited.

c. A midstream urine should be collected and a wide spectrum antibiotic prescribed.

d. A self-retaining catheter should be introduced to promote free drainage of urine.

e. A suprapubic bladder tap should be carried out to ensure the collection of an uncontaminated specimen of urine.

3. A 45-year-old man develops weakness and wasting of the right hand.

Which one of the following is least likely to be the cause?

a. Old injury to the elbow joint.

b. Bronchogenic carcinoma of the right upper lobe.

c. Multiple sclerosis.

d. Syringomyelia.

e. Motor neuron disease.

4. A 10-year-old boy presents with a history of central abdominal pain of a few hours’ duration. On examination he has minimal tenderness in the right iliac fossa and no abnormal findings on rectal examination.

Which of the following alternatives should be carried out?

a. Arrange a barium meal/follow through.

b. Arrange to see the patient later on in the day for review.

c. Send the patient away with instructions to return if the pain becomes worse.

d. Tell the patient to come back in a week.

e. Immediate appendectomy.

5. A 65-year-old woman has a two-year history of mucous diarrhea duet o a large villous adenoma of the rectum. She is also taking digoxin and diuretics for chronic congestive failure.

Which of the following investigations would be the most helpful prior to surgery?

a. Serum chloride.

b. Serum digoxin.

c. Serum calcium.

d. Serum potassium.

e. Hemoglobin.

6. A 38-year-old woman, who had a subtotal thyroidectomy 8 years previously, is again thyrotoxic.

Which one of the following is the most appropriate management?

a. Perform total thyroidectomy after preparation with carbimazole.

b. Radioactive iodine after preparation with oral iodine treatment.

c. Prescribe immunosuppressive treatment with azathioprine.

d. Control with cardimazole and then administration of radioactive iodine.

e. Short-term treatment with beta-blockers until remission occurs.

7. A patient, who has had three successive spontaneous abortions, reached the twelfth week of pregnancy on the fourth attempt, when she passed a moderate amount of blood with clots per vagina and complained of intermittent lower abdominal pain. On vaginal examination, the cervical canal admitted one finger readily and bimanual palpation revealed a uterus compatible in size with a pregnancy of only eight weeks duration. The menstrual cycle had been regular (5/28) before this pregnancy and the duration of pregnancy calculated from the first day of the last menstrual period was definitely known. 

Which one of the following is the most likely diagnosis?

a. Threatened abortion.

b. Cervical incompetence.

c. Incomplete abortion.

d. Ectopic pregnancy.

e. Missed abortion.

8. A primigravida patient at 34 weeks gestation presents with a history of not having felt fetal movements for 24 hours.

Which one of the following statements is most appropriate?

a. She probably has an intra-uterine fetal death.

b. You should immediately arrange transfer to labor ward for early induction labor, providing the baby is still alive.

c. She should have urgent antenatal cardiotocography (CTG).

d. She should have an ultrasound scan.

e. Urgent serum estriol assay should be arranged.

9. A 5-year-old presents with a history of urgency of micturition, occasional enuresis, and a slight, non-offensive vaginal discharge for 3 months. She has had no vaginal bleeding. Examination reveals some reddening of the labia majora.

Which one of the following is the most likely diagnosis?

a. Trichomonal infection.

b. Gonorrhoea.

c. Cystitis.

d. Foreign body.

e. Non-specific vulvo-vaginitis.

10. A 19-year-old woman, prescribed a triphasic oral contraceptive for the first time one month ago, complains of frequent spotting.

Which one of the following is the most appropriate management?

a. Increase the dose of estrogen.

b. Increase the dose of progestogen.

c. Advise alternative contraception.

d. Continue the medication and review in two months.

e. Change to biphasic pill.

11. A 5-year-old boy is diagnosed in the Emergency Department as having measles, the first symptoms having started 2 days previously. He has a 2-year-old sister, who has received the recommended immunization schedule.

Which one of the following is the most appropriate treatment?

a. Treat him symptomatically and send him home.

b. Refer him to the infectious diseases hospital.

c. Give him gamma globulin.

d. Give gamma goblin to the sister.

e. Reassure the mother that ‘he is over the worst of it’.

12. A 67-year-old woman recently noticed a non-painful lump in the right breast.

Which one of the following is the most likely diagnosis?

a. Subacute mastitis with early abscess formation.

b. Advanced adenocarcinoma of the breast.

c. Early intraduct carcinoma with obstruction of ductal ampullae.

d. Severe fibrocystic disease of the breast (fibroadenosis with multiple cysts).

e. Extensive fat necrosis of the breast.