AMC MCQ Practice Test 3

Question 1

A 70-year-old woman on warfarin presents with an INR of 8.0 but no bleeding. What is the most appropriate management?

Accepted Answer

Withhold warfarin and give oral vitamin K

Answer

For a high INR without bleeding, withholding warfarin and giving low-dose oral vitamin K is appropriate.

Question 2

A 28-year-old pregnant woman at 30 weeks presents with a blood pressure of 160/110 and proteinuria. What is the diagnosis?

Accepted Answer

Pre-eclampsia

Answer

New-onset hypertension with proteinuria after 20 weeks defines pre-eclampsia.

Question 3

A 50-year-old man has sudden onset of a painful, swollen, red first metatarsophalangeal joint. Joint aspiration shows negatively birefringent needle-shaped crystals. What is the diagnosis?

Accepted Answer

Gout

Answer

Negatively birefringent needle-shaped crystals confirm monosodium urate deposition, i.e. gout.

Question 4

A 3-year-old child swallows a button battery seen lodged in the oesophagus on X-ray. What is the most appropriate management?

Accepted Answer

Urgent endoscopic removal

Answer

An oesophageal button battery requires urgent endoscopic removal to prevent caustic mucosal injury.

Question 5

A 40-year-old woman presents with fatigue, constipation, dry skin, and cold intolerance. Her TSH is elevated and free T4 is low. What is the diagnosis?

Accepted Answer

Primary hypothyroidism

Answer

A high TSH with low free T4 indicates primary hypothyroidism.