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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

Question 156An 8-month-old infant is brought to the emergency department with a 3-day history of worsening cough, tachypnea, and poor feeding. On physical examination, the infant is visibly lethargic, has a respiratory rate of 62 breaths per minute, subcostal retractions, and widespread bilateral coarse crackles on auscultation. The capillary refill time is prolonged at 4 seconds, the oral mucosa is dry, and the infant is entirely unable to tolerate oral fluids. A clinical diagnosis of severe bronchopneumonia with secondary decompensated hypovolemic shock is established. What is the most appropriate initial fluid management strategy for this infant?A. Administer an immediate intravenous bolus of 20 mL/kg of 0.9% normal saline.B. Commence maintenance fluids using 0.45% sodium chloride with 5% dextrose via an intraosseous needle.C. Insert a nasogastric tube and begin slow enteral administration of oral rehydration solution.D. Commence maintenance fluids using 5% dextrose in water (D_5W) at full maintenance rate.E. Administer an immediate intravenous bolus of 20 mL/kg of 5% albumin solution.

Question 225
A 38-year-old female presents to a general practice clinic expressing deep distress over her marriage. She reports that she is absolutely certain her husband is engaging in an extramarital affair. When the clinician explores her reasoning, she states that her absolute proof lies in the fact that for the past two weeks, he has stopped eating the specific brand of breakfast cereal that she purchases for him every morning, which she interprets as a clear sign that he is being fed breakfast by another woman. She acknowledges that he has no past history of infidelity, works regular hours, and that she has found no messages or physical evidence. What specific feature of her thought process classifies this belief as a true delusion?
a) The fact that she maintains an absolute, unshakeable conviction in the truth of the thought despite a total lack of logical or objective evidence
b) The documented historical fact that her husband had cheated on her once early in their marriage ten years ago
c) The biochemical reality that changing a breakfast cereal preference is a known physiological sign of emotional distress
d) The presence of significant baseline marital discord and frequent arguments over their household finances
e) The fact that her sister agrees with her suspicion and validates her concerns
@AMCMCQ

Question 9
A 3-year-old boy is brought to the emergency department by his parents with a 12-hour history of sudden, episodic abdominal pain. The parents describe that the boy appears perfectly fine one moment, then suddenly screams in agony, draws his knees up to his chest, and vomits bile-stained fluid. These episodes occur every 15 to 20 minutes. He has passed two loose stools containing streaks of blood and mucus within the last 4 hours. On physical examination, the child is lethargic between episodes. His abdomen is mildly distended, and an abdominal radiograph (AXR) shows a few non-specific dilated loops of small bowel with an absence of gas in the right lower quadrant.
Which of the following is the most appropriate diagnostic imaging investigation to confirm the suspected condition?
A) Barium enema radiography
B) Barium swallow and small bowel follow-through
C) Abdominal ultrasound
D) Contrast-enhanced CT scan of the abdomen
E) Radionuclide Meckel's diverticulum scan @amcmcq #mayrecalls2026

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2. A 3-year-old boy is seen for a routine well-child checkup. His parents express concern that he seems "clumsy" compared to his older siblings at the same age. They specifically note that he struggles with fine motor tasks and they worry he is falling behind in his developmental milestones. On examination, the child is cooperative and follows simple commands. Which of the following fine motor achievements would most accurately indicate that this child is meeting the expected developmental milestones for a 3-year-old?
a.Using safety scissors to cut out a circle
b.Building a bridge using three small wooden blocks
c.Fully buttoning a front-opening shirt without assistance
d.Completing a complex jigsaw puzzle of 12 pieces
e.Printing their own first name legibly

(Question 8)
A young couple visits a general practitioner for preconception counseling. Both the man and the woman have a diagnosis of schizophrenia. They are currently stable on medication and are planning to have children. They ask about the risk of their future child developing schizophrenia. Based on current genetic data, what is the approximate risk?
a) Approximately 1% (general population risk)
b) 10% to 13%
c) 40% to 46%
d) 75% to 80%
e) Virtually 100%
@DrShakoree @amcmcq #April2026@amcmcq

(Question 10)
A 28-year-old woman, G1P1, has just delivered a healthy baby. She experiences a postpartum hemorrhage with an estimated blood loss of 1200 mL. On examination, the uterine fundus is found to be firm and well-contracted. A 2nd-degree vaginal tear is noted. What is the most appropriate next step in investigating the cause of the ongoing bleeding?
a) Immediate fundal massage
b) Administration of additional Oxytocin
c) Uterine artery embolization
d) B-Lynch suture placement
e) Thorough cervical and vaginal examination @DrShakoree @amcmcq #April2026@amcmcq

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