85. Penicillin Allergy – Ethical Response
A patient allergic to penicillin was prescribed cefixime and developed a reaction. In addition to changing the antibiotic, what is the most appropriate step?
a. Blame pharmacy
b. Document and apologize to patient
c. Ignore and discharge
d. Charge for new prescription
e. Report patient for noncompliance
@Amcmcq @DrShakoree #feb2026@amcmcq
https://www.soma.org.uk/p/amcmcqfebruary2026

86. Migraine with Aura – Sterilization Request
A 25-year-old woman with three children and migraine with aura currently using IUCD requests permanent sterilization. Best option?
a. Low-dose combined oral contraceptive pill
b. Tubal ligation
c. She is not eligible for sterilization
d. Progestin-only pill
e. Continue IUCD only
@Amcmcq @DrShakoree #feb2026@amcmcq
https://www.soma.org.uk/p/amcmcqfebruary2026

112. Antibiotic Choice for Moderate Pediatric Pneumonia
A 4-year-old child presents with fever, cough, tachypnea, and focal crackles on auscultation. Chest X-ray confirms pneumonia. The child appears moderately unwell but hemodynamically stable. What is the most appropriate antibiotic regimen?
a. Gentamicin
b. Clindamycin
c. Amoxicillin alone
d. Ceftriaxone plus azithromycin
e. Flucloxacillin
@Amcmcq @DrShakoree #feb2026@amcmcq
https://www.soma.org.uk/p/amcmcqfebruary2026

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113. Pulmonary Embolism Despite Prophylactic Enoxaparin
A 60-year-old postoperative patient receiving prophylactic-dose enoxaparin develops sudden dyspnea. CT pulmonary angiography confirms a small pulmonary embolism. What is the most appropriate next step?
a. Stop enoxaparin
b. Continue enoxaparin and add aspirin
c. Continue prophylactic enoxaparin only
d. Add intravenous unfractionated heparin to enoxaparin
e. Stop prophylactic enoxaparin and commence therapeutic anticoagulation with apixaban
@Amcmcq @DrShakoree #feb2026@amcmcq
https://www.soma.org.uk/p/amcmcqfebruary2026

155. Interstitial Lung Disease (ILD) – Long-Term Management
A 68-year-old man with idiopathic pulmonary fibrosis presents for long-term management planning. He has exertional dyspnea and reduced diffusion capacity on pulmonary function testing. He has no active infection.
Which intervention improves long-term functional status?
a. Long-term prophylactic antibiotics
b. Pulmonary rehabilitation program
c. High-dose corticosteroids indefinitely
d. Routine bronchodilator therapy
e. Bed rest to conserve oxygen
@Amcmcq @DrShakoree #feb2026@amcmcq
https://www.soma.org.uk/p/amcmcqfebruary2026

156. Erectile Dysfunction with Preserved Morning Erections
A 34-year-old man reports difficulty maintaining erections during sexual intercourse over the past 3 months following a recent breakup. He reports normal morning erections, normal libido, and no difficulty with ejaculation. He is experiencing work-related stress and is taking an SSRI for depression.
What is the most likely cause of his erectile dysfunction?
a. Vascular insufficiency
b. Hypogonadism
c. SSRI-induced sexual dysfunction
d. Diabetic neuropathy
e. Peyronie disease
@Amcmcq @DrShakoree #feb2026@amcmcq
https://www.soma.org.uk/p/amcmcqfebruary2026

162. Delusional Disorder
A 45-year-old man believes his neighbor is spying on him through hidden cameras. He has maintained employment and social functioning otherwise. There are no hallucinations, disorganized speech, or negative symptoms. Symptoms have persisted for 8 months.
What is the most likely diagnosis?
a. Schizophrenia
b. Brief psychotic disorder
c. Delusional disorder
d. Bipolar disorder with psychosis
e. Schizoaffective disorder
@Amcmcq @DrShakoree #feb2026@amcmcq
https://www.soma.org.uk/p/amcmcqfebruary2026

163. Lung Cancer Screening in a High-Risk Smoker
A 52-year-old man presents for a routine health check. He is asymptomatic and denies cough, hemoptysis, weight loss, or dyspnea. He has a 30-pack-year smoking history and continues to smoke. Physical examination is unremarkable. In addition to counseling on smoking cessation, he asks what else he can do to reduce his risk of dying from lung cancer.
What is the most appropriate additional advice?
a. Annual chest X-ray
b. Sputum cytology screening
c. Low-dose contrast-enhanced CT chest
d. Low-dose non-contrast CT chest annually
e. No screening recommended until symptoms develop
@Amcmcq @DrShakoree #feb2026@amcmcq
https://www.soma.org.uk/p/amcmcqfebruary2026

95. A sexually active male with multiple partners has joint pain, rash on palms/soles, and urethral discharge. What test is most appropriate?
a) Anti-CCP
b) Chlamydia urine PCR
c) Gonorrhea culture
@AMCMCQ @DrShakoree

MCQ 66 – Sterilisation in a Mentally Disabled 18-year-old
@AMCMCQ
@DrShakoree
A parent requests sterilisation for her 18-year-old daughter with a
significant intellectual disability. What is the most appropriate course of
action?
a. Inform her that it is illegal to perform sterilisation at her age
b. Refer the case to the local mental health tribunal
c. Report the matter to local social services
d. Advise against the procedure without further evaluation
e. Arrange a multidisciplinary ethics review

Do you want me to start solving EXAM WEEK recalls ?

Not only monthly recalls

24. A 52-year-old man presents to the emergency department
with sudden onset of severe right upper quadrant pain radiating to
the shoulder, hypotension, tachycardia, and diaphoresis. He has a
history of high-dose oral contraceptive pill use—sorry, that would
not apply to him. Instead, imagine a 28-year-old woman on high-
dose OCPs presenting similarly. Her haemoglobin has dropped
from 140 g/L to 90 g/L over a few hours. (Same scenario as 16/29
but here ask about diagnosis next step)
a. Immediate laparotomy
b. Contrast-enhanced CT abdomen
c. Intravenous fluids and crossmatch for transfusion only
d. Observation in high-dependency unit
e. Diagnostic ultrasound
@AMCMCQ | @DrShakoree

A 12-week pregnant Aboriginal woman’s serology shows HBsAg negative, anti-HBs positive, and VDRL positive. What is the next step?
• A) Benzathine penicillin
• B) Treatment for Hepatitis B
• C) Repeat serology
• D) Initiate antiretroviral therapy
@DrShakoree @AMCMCQ

1. A 55-year-old dairy farmer presents with 2 days of high-grade
fever, headache, and photophobia. Cerebrospinal fluid analysis
shows lymphocytic pleocytosis, low glucose, and Gram-positive
bacilli on microscopy.
a. Brucella abortus
b. Coxiella burnetii
c. Listeria monocytogenes
d. Streptococcus pneumoniae
e. Neisseria meningitidis

New month
New recalls
Coming soon
@amcmcq
@DrShakoree

Question 178
A 28-year-old woman presents to the emergency department with a six-week history of recurrent, transient lower abdominal cramping that resolves spontaneously. Her last normal menstrual period occurred approximately six weeks ago. Her vital signs are stable, and her abdomen is soft and non-tender. A transvaginal ultrasound (TVUS) shows an empty uterus with a endometrial thickness of 8 mm, and no adnexal masses or free fluid in the pouch of Douglas. Her serum beta-hCG is 700 IU/L.
a) Perform an urgent diagnostic laparoscopy
b) Repeat the serum beta-hCG assay in 48 hours
c) Administer an intramuscular dose of methotrexate immediately
d) Arrange for a repeat transvaginal ultrasound in 7 days
e) Reassure the patient and return to standard routine antenatal care

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We will discuss every AMC exam

Question 206
A 68-year-old male presents to the urology clinic for a planned transrectal ultrasound-guided prostate biopsy due to an elevated serum prostate-specific antigen (PSA) level of 7.2\text{ ng/mL}. He has a history of mild hypertension but no prior cardiac valvular disease, prosthetic joints, or history of infective endocarditis. A midstream urine (MSU) culture obtained one week ago demonstrates no bacterial growth. The patient asks if he needs specific antibiotic prophylaxis to prevent a heart infection before the procedure.
A) Routine antibiotic prophylaxis for infective endocarditis is not indicated.
B) Administer oral ciprofloxacin 500 mg 24 hours prior to the procedure.
C) Administer intravenous ampicillin 2 g and gentamicin 1.5 mg/kg 30 minutes before the biopsy.
D) Administer oral amoxicillin 2 g one hour before the biopsy.
E) Delay the biopsy and repeat the midstream urine culture to confirm sterility.
@amcmcq @amcmcqrecalls

Question 116
A 73-year-old male presents to the outpatient clinic complaining of a progressive decrease in his vision over the past four years. He notes that the impairment is particularly troublesome at night because of a severe, disabling glare from oncoming car headlights, which has forced him to stop driving after dark. He mentions that his prescription spectacles were updated three years ago by an optometrist, but this provided minimal improvement. He has no history of diabetes, ocular trauma, or topical corticosteroid use. On physical examination, his best-corrected visual acuity is 6/18 in both eyes. Cranial nerve examination is otherwise unremarkable. On distant direct ophthalmoscopy at a distance of one meter, the normal orange-red background illumination of the retina is completely absent bilaterally, replaced by a dark, opaque pupillary shadow. What is the most appropriate definitive management for this patient's condition?
a) Refer the patient to an optometrist for a comprehensive refraction and updated spectacles
b) Initiate regular intravitreal injections of an anti-vascular endothelial growth factor (anti-VEGF) agent
c) Refer the patient to an ophthalmologist for a surgical phacoemulsification and intraocular lens implantation
d) Prescribe oral acetazolamide to reduce intraocular pressure and improve visual acuity
e) Reassure the patient that these are normal age-related changes and advise lifestyle modifications
@amcmcq