AMC MCQ · Psychiatry
AMC Psychiatry MCQ Practice — 300+ Questions for IMGs
Depression, anxiety, psychosis, suicide risk and Mental Health Act — AMC MCQ psychiatry practice for IMGs.
313 questions in the full bank · 5 free samples below · Spaced repetition + AI explanations on the free tier.
Why Psychiatry matters in AMC MCQ
Psychiatry contributes 10–12 questions to AMC MCQ, and IMGs commonly underestimate it. The blueprint includes major depressive disorder, generalised anxiety, schizophrenia and first-episode psychosis, bipolar disorder, suicide risk assessment, eating disorders, dementia and delirium differentiation, and the legal frameworks around involuntary treatment under each state’s Mental Health Act.
Mostly Medicine’s psychiatry bank is mapped to the RANZCP clinical practice guidelines, Therapeutic Guidelines: Psychotropic, and the SafeScript real-time prescription monitoring system used across Australia. You’ll see MCQs on first-line SSRI choice (sertraline, escitalopram), augmentation strategies in treatment-resistant depression, ECT indications, atypical antipsychotic selection (and metabolic monitoring), lithium toxicity recognition, clozapine titration, and the Mental State Examination structure.
AMC psychiatry vignettes regularly ask you to weigh capacity, risk, and the threshold for involuntary admission — a uniquely Australian medico-legal flavour. Practising 200+ Australian-aligned psychiatry MCQs builds confidence in this nuanced area. Sign up free to unlock the full bank and start tracking your weak subtopics.
5 free Psychiatry sample MCQs
Below are five sample questions taken straight from the Mostly Medicine psychiatry bank. The correct answer is highlighted, with the worked explanation tucked inside a collapsed panel so you can self-test first.
A 27-year-old woman at 8 weeks postpartum scores 14 on the EPDS. She denies thoughts of self-harm. What is the MOST appropriate initial management?
- A.Immediate psychiatric admission
- B.Prescribe sertraline and review in 4 weeks
- C.Reassure — normal baby blues, review in 2 weeks
- D.Psychoeducation, social support, CBT referral, close GP follow-upCorrect
- E.Benzodiazepine for short-term anxiety relief
Show explanation
EPDS ≥13 = moderate-severe PND. Without safety concerns, first-line is psychoeducation, social support, and psychological therapy (CBT/IPT). Medication (sertraline) added for moderate-severe. Baby blues resolve by 2 weeks — this is 8 weeks postpartum.
A 45-year-old man with moderate depression has failed 2 adequate trials of SSRIs. He has no psychotic features. What is the MOST appropriate next step?
- A.Add lithium augmentation
- B.Switch to venlafaxine (SNRI)Correct
- C.Refer for ECT
- D.Add antipsychotic
- E.Increase dose of current SSRI
Show explanation
After 2 failed SSRI trials, switching to an SNRI (venlafaxine) is standard next step for treatment-resistant depression. Lithium augmentation and ECT are later options. Antipsychotics are for psychotic depression or augmentation after further failure.
A 38-year-old man presents with 6 weeks of persistent low mood most of the day, anhedonia, early morning awakening, poor concentration, and psychomotor retardation. He denies suicidal ideation. He has no prior psychiatric history. What is the MOST appropriate initial management?
- A.Tricyclic antidepressant (amitriptyline)
- B.SSRI (e.g. sertraline) plus psychoeducation and psychological therapy referralCorrect
- C.Inpatient psychiatric admission
- D.Benzodiazepine for symptom relief
- E.Lithium as mood stabiliser
Show explanation
Moderate depression (≥5 DSM-5 criteria >2 weeks): first-line is SSRI (sertraline, escitalopram, fluoxetine) plus psychological therapy (CBT). TCAs are second-line due to side effects and lethality in overdose. Benzodiazepines do not treat depression and cause dependence. Lithium is for bipolar disorder. Inpatient admission for severe depression with psychosis or active suicidality.
A 25-year-old woman with known bipolar I disorder is 8 weeks pregnant and presents to her GP. She is currently on lithium and has been euthymic for 2 years. What is the MOST appropriate action regarding her lithium?
- A.Continue lithium — benefits outweigh risks
- B.Abruptly stop lithium immediately
- C.Switch to sodium valproate as safer in pregnancy
- D.Discuss risks with patient and psychiatrist; consider slow taper or continuation with informed consentCorrect
- E.Switch to quetiapine as it is completely safe in pregnancy
Show explanation
Lithium in pregnancy: increased risk of Ebstein's anomaly (small absolute risk ~0.1%). Risk of relapse after stopping is high (~50–85% relapse). Decision requires shared decision-making with patient and psychiatrist, weighing relapse risk vs teratogenicity. Valproate is highly teratogenic (neural tube defects, developmental delay) — CONTRAINDICATED in pregnancy. Quetiapine has limited safety data. Abrupt cessation increases rebound mania.
A 21-year-old man presents with a 6-month history of auditory hallucinations (hearing voices commenting on his actions), persecutory delusions, social withdrawal, and decline in academic function. There is no history of substance use. What is the FIRST-LINE pharmacological treatment?
- A.Haloperidol (typical antipsychotic)
- B.Clozapine
- C.An atypical antipsychotic (e.g. risperidone or olanzapine)Correct
- D.Lithium
- E.Benzodiazepine to reduce anxiety
Show explanation
First-episode psychosis/schizophrenia: first-line is an atypical (second-generation) antipsychotic (risperidone, olanzapine, quetiapine, aripiprazole). Atypicals have fewer extrapyramidal side effects than typical antipsychotics. Clozapine is reserved for treatment-resistant schizophrenia (failed 2 adequate antipsychotic trials) due to risk of agranulocytosis. Refer to Early Psychosis Prevention and Intervention Centre (EPPIC) if available.
Want the other 308+ psychiatry MCQs?
The full psychiatry bank, AI-generated follow-up questions, weak-area analytics and spaced repetition are free to access — no credit card required.
Psychiatry FAQ
How is suicide risk assessment tested?
Expect vignettes asking you to grade risk (low/moderate/high) based on intent, plan, means, prior attempts, and protective factors, then choose between outpatient follow-up, urgent CATT review, or inpatient admission under the Mental Health Act.
What antidepressant choices are first-line?
SSRIs (sertraline, escitalopram) are first-line for major depression in adults and adolescents. Mirtazapine is preferred when sleep or appetite is poor. Avoid SSRIs in mania; switch to mood stabilisers for bipolar depression.
Are antipsychotics heavily tested?
Yes. Know first-line atypicals (olanzapine, risperidone, aripiprazole), metabolic monitoring intervals, clozapine indication after 2 failed antipsychotic trials, and clozapine’s major adverse effects (agranulocytosis, myocarditis, constipation).
Do I need to know the Mental Health Act?
AMC tests broad principles, not state-specific clauses. Know the criteria for involuntary admission (mental illness, risk to self/others, no less restrictive option) and that decisions must be reviewed by an authorised psychiatrist within 24–72 hours depending on jurisdiction.
How many psychiatry MCQs are free?
Five sample psychiatry MCQs with explanations on this page. The full 200+ bank unlocks with a free Mostly Medicine account.