AMC MCQ - Australian Medical Council Multiple Choice Questions Gastroenterology and Surgery Questions and Answers

Question 1

A 58-year-old man with a long history of GORD undergoes a surveillance endoscopy.
Biopsies from a 4 cm segment of columnar-lined oesophagus confirm Barrett's oesophagus with low-grade dysplasia.
The finding of low-grade dysplasia is confirmed by a second specialist pathologist.
According to Australian guidelines, what is the most appropriate next step in management?

Accepted Answer

Repeat endoscopy with Seattle protocol biopsies in 6 months.

Answer

Repeat endoscopy with biopsies in 2-3 years.

Answer

Commence annual endoscopic surveillance.

Answer

Refer for endoscopic radiofrequency ablation.

Question 2

A 45-year-old woman presents with a 2-week history of epigastric pain, nausea, and early satiety. A urea breath test is positive for Helicobacter pylori. She has no known drug allergies. According to current Australian Therapeutic Guidelines, which of the following is the most appropriate first-line eradication therapy?

Accepted Answer

A proton pump inhibitor, amoxicillin, and clarithromycin for 7-14 days.

Answer

A proton pump inhibitor, amoxicillin, and metronidazole for 7 days.

Answer

A proton pump inhibitor, clarithromycin, and metronidazole for 14 days.

Answer

Bismuth quadruple therapy for 14 days.

Question 3

A 22-year-old man presents to the emergency department with a 24-hour history of central abdominal pain that has now migrated to the right iliac fossa. He has a low-grade fever, anorexia, and tenderness on palpation at McBurney's point. His inflammatory markers are raised. What is the definitive management for uncomplicated acute appendicitis?

Accepted Answer

Laparoscopic appendicectomy.

Answer

Intravenous antibiotics and observation for 48 hours.

Answer

Urgent CT scan of the abdomen and pelvis.

Answer

Percutaneous drainage of the appendix.

Question 4

According to the National Bowel Cancer Screening Program in Australia, what is the recommended screening method and interval for an asymptomatic 55-year-old person at average risk of colorectal cancer?

Accepted Answer

Biennial immunochemical faecal occult blood test (iFOBT).

Answer

Annual immunochemical faecal occult blood test (iFOBT).

Answer

Colonoscopy every 10 years.

Answer

Flexible sigmoidoscopy every 5 years.

Question 5

A 48-year-old man presents with severe epigastric pain radiating to his back, associated with nausea and vomiting. His serum lipase is markedly elevated. An ultrasound reveals gallstones in the gallbladder but no common bile duct dilatation. He is diagnosed with mild, gallstone-induced pancreatitis. His symptoms resolve with conservative management. What is the most appropriate next step to prevent recurrence?

Accepted Answer

Laparoscopic cholecystectomy during the same hospital admission.

Answer

Discharge with a low-fat diet and follow-up in 6 months.

Answer

Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy.

Answer

Ursodeoxycholic acid therapy.

Question 6

Which of the following is considered a primary 'alarm' symptom in a patient with gastro-oesophageal reflux disease (GORD) that warrants urgent endoscopic investigation?

Accepted Answer

Dysphagia.

Answer

Regurgitation after meals.

Answer

Waterbrash.

Answer

Epigastric burning relieved by antacids.