AMC MCQ - Australian Medical Council Multiple Choice Questions Obstetrics and Gynaecology Questions and Answers

Question 1

A 62-year-old woman, G2P2, who went through menopause 10 years ago, presents with a single episode of vaginal spotting.
She is not on hormone replacement therapy and has a BMI of 32 kg/m².
What is the most appropriate initial investigation to assess her risk of endometrial carcinoma?

Accepted Answer

Transvaginal ultrasound to measure endometrial thickness

Answer

Cervical HPV test

Answer

Diagnostic hysteroscopy with endometrial biopsy

Answer

Serum CA-125 measurement

Question 2

A 28-year-old primigravida attends her first antenatal visit at 10 weeks' gestation. She is interested in screening for fetal chromosomal abnormalities like Down syndrome. According to Australian guidelines, which of the following is the most commonly offered and recommended initial screening test?

Accepted Answer

Combined first-trimester screening (nuchal translucency ultrasound and maternal serum markers)

Answer

Amniocentesis at 16 weeks

Answer

Maternal serum alpha-fetoprotein (MSAFP) alone

Answer

Fetal morphology ultrasound at 20 weeks

Question 3

A 32-year-old woman at 34 weeks' gestation presents with a persistent headache and visual disturbances. Her booking blood pressure was 110/70 mmHg. Today, her blood pressure is 150/95 mmHg. A urine dipstick shows 2+ proteinuria. According to the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ) guidelines, which of the following is the most likely diagnosis?

Accepted Answer

Pre-eclampsia

Answer

Gestational hypertension

Answer

Chronic hypertension

Answer

Eclampsia

Question 4

According to the National Cervical Screening Program in Australia, what is the recommended primary screening test and interval for an asymptomatic 30-year-old woman with no history of cervical abnormalities?

Accepted Answer

Human Papillomavirus (HPV) DNA test every 5 years

Answer

Liquid-based cytology (Pap smear) every 2 years

Answer

Co-testing with HPV and cytology every 3 years

Answer

Visual inspection with acetic acid (VIA) annually

Question 5

A 29-year-old G1P0 at 40 weeks' gestation is in active labour. The cardiotocograph (CTG) shows a baseline fetal heart rate of 130 bpm, moderate variability, and repetitive, shallow decelerations where the nadir occurs after the peak of each contraction. What is the most appropriate immediate action?

Accepted Answer

Administer an intravenous fluid bolus and place the mother in a lateral position

Answer

Proceed immediately to an emergency caesarean section

Answer

Continue routine monitoring as this is a normal pattern

Answer

Start an oxytocin infusion to augment labour

Question 6

A 24-year-old woman presents with a history of irregular menstrual cycles, occurring every 3 to 6 months, and significant acne. An ultrasound report notes that both ovaries have multiple small follicles. According to the Rotterdam criteria, which are widely used in Australia, what additional feature is required to diagnose Polycystic Ovary Syndrome (PCOS)?

Accepted Answer

Evidence of clinical or biochemical hyperandrogenism

Answer

Insulin resistance on a glucose tolerance test

Answer

A luteinising hormone (LH) to follicle-stimulating hormone (FSH) ratio greater than 2:1

Answer

Body Mass Index (BMI) greater than 30 kg/m²