AMC MCQ AMC MCQ - Australian Medical Council Multiple Choice Questions Haematology and Oncology Questions and Answers 3 — Questions and Answers
Question 1: A 30-year-old of Mediterranean descent has a haemoglobin of 85 g/L, MCV of 62 fL, normal iron studies, and elevated HbA2 on electrophoresis. What is the most likely diagnosis?
- Iron deficiency anaemia
- Beta-thalassaemia trait (Correct answer)
- Anaemia of chronic disease
- Lead poisoning
Correct answer: Beta-thalassaemia trait
Beta-thalassaemia trait presents with mild microcytic anaemia, normal or elevated HbA2 (>3.5%) on haemoglobin electrophoresis, and normal iron studies.
Question 2: A patient undergoes a bone marrow biopsy showing hypercellular marrow with >20% blasts. Flow cytometry reveals CD13, CD33, and MPO positivity. What is the diagnosis?
- Acute lymphoblastic leukaemia (ALL)
- Acute myeloid leukaemia (AML) (Correct answer)
- Chronic myeloid leukaemia (CML)
- Myelodysplastic syndrome
Correct answer: Acute myeloid leukaemia (AML)
AML is characterised by ≥20% myeloid blasts in the bone marrow with expression of myeloid markers (CD13, CD33) and myeloperoxidase (MPO).
Question 3: Which tumour marker is most useful for monitoring treatment response in colorectal cancer?
- CA 125
- PSA
- CEA (carcinoembryonic antigen) (Correct answer)
- AFP
Correct answer: CEA (carcinoembryonic antigen)
CEA is the primary tumour marker for monitoring recurrence and treatment response in colorectal cancer.
Question 4: A 55-year-old man presents with urinary hesitancy, a PSA of 18 ng/mL, and a hard irregular prostate on digital rectal exam. Biopsy shows adenocarcinoma, Gleason score 7. What is the initial management for localised disease?
- Watchful waiting only
- Radical prostatectomy or external beam radiotherapy (Correct answer)
- Immediate androgen deprivation therapy (ADT)
- Chemotherapy with docetaxel
Correct answer: Radical prostatectomy or external beam radiotherapy
Intermediate-risk localised prostate cancer (Gleason 7, elevated PSA) is treated with curative intent via radical prostatectomy or external beam radiotherapy.
Question 5: A 50-year-old woman post-chemotherapy presents with fever (38.5°C) and an absolute neutrophil count of 0.3 × 10⁹/L. What is the most appropriate immediate management?
- Await blood culture results before starting antibiotics
- Administer G-CSF alone
- Start empirical broad-spectrum intravenous antibiotics immediately (Correct answer)
- Oral ciprofloxacin as outpatient
Correct answer: Start empirical broad-spectrum intravenous antibiotics immediately
Febrile neutropenia is a medical emergency; empirical broad-spectrum IV antibiotics (e.g., piperacillin-tazobactam) must be started immediately without waiting for culture results.
Question 6: Which drug causes a dose-dependent cardiomyopathy that limits its cumulative lifetime dose?
- Cyclophosphamide
- Doxorubicin (anthracycline) (Correct answer)
- Vincristine
- Methotrexate
Correct answer: Doxorubicin (anthracycline)
Doxorubicin causes cumulative dose-dependent cardiotoxicity (dilated cardiomyopathy) due to free radical damage to cardiomyocytes, limiting its total lifetime dose.
AMC MCQ AMC MCQ - Australian Medical Council Multiple Choice Questions Haematology and Oncology Questions and Answers 3
A 30-year-old of Mediterranean descent has a haemoglobin of 85 g/L, MCV of 62 fL, normal iron studies, and elevated HbA2 on electrophoresis.
What is the most likely diagnosis?