AMC MCQ - Australian Medical Council Multiple Choice Questions Respiratory Medicine Questions and Answers

Question 1

A 24-year-old university student presents with a 3-month history of intermittent dry cough and wheezing, particularly after playing soccer.
She has no significant past medical history and does not smoke.
She uses her friend's salbutamol inhaler once or twice a week with good effect.
According to the most recent Australian Asthma Handbook guidelines, which of the following is the most appropriate initial treatment for her mild asthma?

Accepted Answer

As-needed low-dose budesonide-formoterol.

Answer

Regular low-dose inhaled corticosteroid (ICS) with as-needed salbutamol.

Answer

As-needed salbutamol monotherapy.

Answer

A course of oral prednisolone followed by as-needed salbutamol.

Question 2

A 68-year-old man with a 40-pack-year smoking history presents with progressive dyspnoea and a chronic productive cough. A chest X-ray shows hyperinflation but no focal consolidation. Which of the following investigations is required to confirm a diagnosis of Chronic Obstructive Pulmonary Disease (COPD) according to the COPD-X guidelines?

Accepted Answer

Post-bronchodilator spirometry.

Answer

High-resolution computed tomography (HRCT) of the chest.

Answer

Arterial blood gas (ABG) analysis.

Answer

Six-minute walk test.

Question 3

A 22-year-old tall, thin male presents to the emergency department with a sudden onset of right-sided pleuritic chest pain and mild shortness of breath that began 4 hours ago. His vital signs are stable: RR 18/min, SpO2 97% on room air, HR 85/min, BP 125/80 mmHg. A chest X-ray confirms a 4 cm primary spontaneous pneumothorax. He is not in significant distress. What is the most appropriate next step in management?

Accepted Answer

Observation for 4-6 hours with supplemental oxygen and analgesia.

Answer

Immediate insertion of a large-bore intercostal catheter.

Answer

Urgent video-assisted thoracoscopic surgery (VATS).

Answer

Needle aspiration of the pleural space.

Question 4

A 55-year-old woman presents to her GP with a 4-day history of cough productive of purulent sputum, fever, and right-sided chest pain. A chest X-ray confirms a right lower lobe consolidation. She has no significant comorbidities, has not been hospitalised recently, and has no known risk factors for atypical pathogens. Which of the following is the most appropriate oral antibiotic for the outpatient management of her non-severe community-acquired pneumonia (CAP)?

Accepted Answer

Amoxicillin

Answer

Ciprofloxacin

Answer

Trimethoprim-sulfamethoxazole

Answer

Doxycycline

Question 5

A 58-year-old male truck driver with a BMI of 34 kg/m² is referred by his wife due to loud snoring, witnessed apnoeas during sleep, and significant daytime somnolence. He has a history of hypertension. His Epworth Sleepiness Scale score is 16/24. Physical examination reveals a crowded oropharynx and a neck circumference of 44 cm. What is the most appropriate next step to confirm the suspected diagnosis?

Accepted Answer

Referral for a formal in-laboratory or home-based sleep study (polysomnography).

Answer

Trial of continuous positive airway pressure (CPAP) therapy.

Answer

Prescription of a mandibular advancement splint.

Answer

Empiric advice on weight loss and sleep hygiene alone.

Question 6

A 72-year-old man with a known history of severe COPD is brought to the hospital with increased breathlessness, wheeze, and purulent sputum. He appears drowsy. His initial oxygen saturation on room air is 86%. According to the Thoracic Society of Australia and New Zealand (TSANZ) guidelines for acute oxygen use, what is the recommended target oxygen saturation (SpO2) range for this patient?

Accepted Answer

88-92%

Answer

94-98%

Answer

92-96%

Answer

Above 98%