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AMC MCQ · Gastroenterology

AMC Gastroenterology MCQ Practice — 350+ Questions for IMGs

Liver disease, IBD, GI bleeds, coeliac disease and pancreatitis — high-yield AMC MCQ GI practice for IMGs.

351 questions in the full bank · 5 free samples below · Spaced repetition + AI explanations on the free tier.

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Why Gastroenterology matters in AMC MCQ

Gastroenterology contributes 10–14 questions to the AMC MCQ paper and is dense with high-yield, well-defined teaching points: chronic liver disease scoring, upper GI bleeding triage, inflammatory bowel disease step-up therapy, coeliac disease serology, acute pancreatitis severity, and colorectal cancer screening intervals under the National Bowel Cancer Screening Program. AMC examiners love to test your ability to choose the next investigation in a deteriorating cirrhotic patient or the right antibiotic in spontaneous bacterial peritonitis.

The Mostly Medicine gastroenterology bank reflects RACGP, Gastroenterological Society of Australia (GESA) and Therapeutic Guidelines content, including Australian-specific items such as the iFOBT NBCSP screening pathway, hepatitis B/C cascade-of-care milestones, and the differing endoscopic surveillance intervals for Barrett’s oesophagus. You will encounter MCQs on Child-Pugh and MELD scoring, terlipressin in variceal bleeding, the timing of cholecystectomy after gallstone pancreatitis, biological therapy choice in Crohn’s disease, and lactose-versus-coeliac differential.

AMC GI vignettes commonly bundle abnormal LFT patterns with risk factors (alcohol, hepatitis serology, drug history) and ask for the next investigation or definitive diagnosis. Practising 250+ Australian-aligned GI MCQs is the most efficient way to recognise these patterns. Sign up free to unlock the full bank and see your weak subtopics highlighted automatically.

5 free Gastroenterology sample MCQs

Below are five sample questions taken straight from the Mostly Medicine gastroenterology bank. The correct answer is highlighted, with the worked explanation tucked inside a collapsed panel so you can self-test first.

Question 1Appendicitis · medium

A 32-year-old woman presents with right lower quadrant pain for 18 hours, nausea, and low-grade fever (37.8°C). WCC 14.5. CRP 45. Urine: trace blood. Which is the MOST important initial investigation?

  1. A.CT abdomen and pelvis with contrast
  2. B.Diagnostic laparoscopy
  3. C.Serum beta-hCGCorrect
  4. D.Abdominal X-ray
  5. E.MRI abdomen
Show explanation

In any woman of reproductive age with lower abdominal pain, beta-hCG must be checked FIRST to exclude ectopic pregnancy — a life-threatening condition that mimics appendicitis. This takes priority before imaging.

Question 2Upper GI Bleed · easy

A 60-year-old man on aspirin and ibuprofen presents with haematemesis and melaena. BP 95/60, HR 118. Hb 78 g/L. What is the FIRST priority?

  1. A.Urgent endoscopy
  2. B.IV proton pump inhibitor
  3. C.Two large-bore IV cannulas and fluid resuscitationCorrect
  4. D.Transfuse packed red cells
  5. E.Stop aspirin and ibuprofen
Show explanation

ABC first — haemodynamic stabilisation precedes endoscopy. Two large-bore IV cannulas and fluid resuscitation (crystalloid initially). Transfuse if Hb <70 or haemodynamically unstable. Endoscopy within 24h once stable. IV PPI reduces rebleeding but is not the first step.

Question 3Liver Disease · hard

A 45-year-old male presents with jaundice, ascites, and asterixis. He has been drinking 12 standard drinks daily for 20 years. INR 1.8, bilirubin 180, albumin 22. Child-Pugh score is 10. What is the Child-Pugh class and prognosis?

  1. A.Class A — 1-year survival 100%
  2. B.Class B — 1-year survival 80%
  3. C.Class C — 1-year survival 45%Correct
  4. D.Class C — 1-year survival 10%
  5. E.Class B — 1-year survival 60%
Show explanation

Child-Pugh score 10 = Class C (10–15). 1-year survival ~45%, 2-year ~35%. Factors: bilirubin, albumin, INR, ascites, encephalopathy. Class C patients should be considered for liver transplantation if abstinent from alcohol. This patient has likely decompensated alcoholic cirrhosis.

Question 4Liver Disease · hard

A patient with cirrhosis develops new-onset ascites. Paracentesis is performed. SAAG (serum-ascites albumin gradient) is 1.2 g/dL. What does this indicate and what is the most likely cause?

  1. A.SAAG <1.1 — exudate, likely peritoneal carcinomatosis
  2. B.SAAG ≥1.1 — transudate, portal hypertensionCorrect
  3. C.SAAG <1.1 — spontaneous bacterial peritonitis
  4. D.SAAG ≥1.1 — tuberculous peritonitis
  5. E.SAAG is not useful in cirrhosis
Show explanation

SAAG ≥1.1 g/dL indicates portal hypertension (96% accuracy) — causes: cirrhosis, heart failure, Budd-Chiari. SAAG <1.1 = low portal pressure — causes: peritoneal carcinomatosis, TB, nephrotic syndrome, pancreatitis. SAAG = serum albumin minus ascites albumin. This patient's cirrhosis with SAAG 1.2 confirms portal hypertensive ascites.

Question 5Liver Disease · hard

A 50-year-old man with known cirrhosis (Child-Pugh A) has an AFP of 850 ng/mL and ultrasound showing a 2.8 cm hepatic nodule with arterial enhancement and washout on contrast CT. What is the most appropriate management?

  1. A.Liver biopsy to confirm HCC
  2. B.Surgical resection or locoregional therapy (TACE/ablation)Correct
  3. C.Chemotherapy (sorafenib)
  4. D.Repeat AFP in 3 months
  5. E.Referral for liver transplantation immediately
Show explanation

HCC diagnosis: in cirrhotic patient, arterial enhancement + washout on CT/MRI = diagnostic for HCC — no biopsy required (LIRADS 5). Milan criteria (single lesion <5cm or ≤3 lesions <3cm, no vascular invasion, no metastases) met here. Surgical resection if adequate liver reserve (Child-Pugh A, no portal hypertension). Liver transplant if outside resection criteria but within Milan criteria.

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Gastroenterology FAQ

What hepatology content is tested in AMC MCQ?

Common stems include alcoholic hepatitis (Maddrey’s discriminant function), cirrhosis decompensation, hepatic encephalopathy management, hepatorenal syndrome, hepatitis B serology interpretation, and HCC surveillance with 6-monthly ultrasound + AFP.

Which IBD therapies should I know?

Know step-up therapy from 5-ASA → thiopurine → anti-TNF (infliximab, adalimumab) → vedolizumab/ustekinumab, plus the indications for surgery in toxic megacolon and refractory disease. PBS criteria for biologics have appeared in recent recalls.

How are GI bleeds tested?

Expect vignettes on the Glasgow-Blatchford score, urgent endoscopy timing (<24h for upper GI bleeds), pre-endoscopy IV PPI and erythromycin, and terlipressin + ceftriaxone for confirmed variceal bleeding.

Is the National Bowel Cancer Screening Program in scope?

Yes. Know that iFOBT is offered free every two years to Australians aged 50–74 (expanding to 45+) and that a positive iFOBT mandates colonoscopy within 30–120 days.

Are pancreatitis severity scores tested?

Yes. The modified Glasgow (Imrie) score and APACHE-II are commonly referenced. Recognise persistent organ failure beyond 48 hours as the defining feature of severe acute pancreatitis.