AMC MCQ · Surgery
AMC Surgery MCQ Practice — 100+ Questions for IMGs
Acute abdomen, hernia, vascular and post-op care — AMC MCQ surgical MCQs for IMGs.
135 questions in the full bank · 5 free samples below · Spaced repetition + AI explanations on the free tier.
Why Surgery matters in AMC MCQ
Surgery contributes 6–9 questions to AMC MCQ, focused on the acute abdomen (appendicitis, cholecystitis, diverticulitis, bowel obstruction), hernia recognition, breast lumps, vascular emergencies (AAA, acute limb ischaemia), perioperative care, and post-operative complications. Australian intern-level surgery is heavily protocolised, and AMC examiners expect IMGs to recognise surgical red flags and choose the right imaging modality.
Mostly Medicine’s surgery bank is mapped to RACS curriculum content, eTG (Therapeutic Guidelines), and ANZ surgical society guidelines. You’ll practise items on the Alvarado score for appendicitis, the timing of cholecystectomy after cholecystitis, the criteria for sigmoid volvulus decompression, AAA screening (one-off ultrasound for men 65–74 with risk factors), the 6 Ps of acute limb ischaemia, perioperative anticoagulant management, and ileus versus mechanical obstruction differentiation.
AMC surgical vignettes typically combine vital signs, abdominal exam findings and a key investigation result (lactate, lipase, ultrasound), then ask for the most appropriate immediate management or operation. Practising 125+ Australian-aligned surgical MCQs builds confidence with the surgical decision tree. Sign up free to unlock the full bank.
5 free Surgery sample MCQs
Below are five sample questions taken straight from the Mostly Medicine surgery bank. The correct answer is highlighted, with the worked explanation tucked inside a collapsed panel so you can self-test first.
A 65-year-old man with known diverticular disease presents with sudden onset severe generalised abdominal pain. He is febrile (38.8°C), tachycardic, and has board-like rigidity with rebound tenderness throughout the abdomen. Erect CXR shows free air under the diaphragm. What is the MOST appropriate management?
- A.IV antibiotics and CT abdomen to confirm diagnosis
- B.Resuscitation followed by emergency laparotomyCorrect
- C.Hartmann's procedure as elective surgery in 48 hours
- D.Nasogastric tube, IV fluids and nil by mouth
- E.Percutaneous CT-guided drainage of abscess
Show explanation
Free air under the diaphragm = viscus perforation with generalised peritonitis. This is a surgical emergency. Immediate resuscitation (IV fluids, IV antibiotics, analgesia, urinary catheter) followed by emergency laparotomy is required. CT may be used if the diagnosis is uncertain and the patient is stable, but this patient has clear peritonitis and should go directly to theatre after resuscitation.
A 22-year-old man presents with 24 hours of periumbilical pain migrating to the right iliac fossa, nausea, vomiting, and fever 38.1°C. Alvarado score is 8. CT abdomen confirms acute appendicitis with no perforation. What is the MOST appropriate treatment?
- A.IV antibiotics alone (non-operative management)
- B.Urgent laparoscopic appendicectomyCorrect
- C.Open appendicectomy via McBurney incision only
- D.Conservative management and interval appendicectomy in 6 weeks
- E.Ultrasound-guided drainage and delayed appendicectomy
Show explanation
Confirmed uncomplicated acute appendicitis: laparoscopic appendicectomy is the gold-standard surgical treatment. It has lower wound infection rates and faster recovery than open surgery. Antibiotic-only management has been studied (APPAC trial) as an alternative for uncomplicated cases but has a ~39% failure rate at 5 years. Surgery remains the recommended approach in most centres.
A 70-year-old woman who had an open hysterectomy 20 years ago presents with colicky abdominal pain, abdominal distension, vomiting, and absolute constipation. AXR shows dilated small bowel loops with multiple air-fluid levels in a 'step-ladder' pattern. What is the MOST likely cause?
- A.Sigmoid volvulus
- B.Colorectal carcinoma
- C.Adhesions from previous surgeryCorrect
- D.Strangulated inguinal hernia
- E.Ogilvie's syndrome
Show explanation
Small bowel obstruction (step-ladder pattern of dilated small bowel on AXR) in a patient with prior abdominal surgery — adhesions are the most common cause of SBO (accounting for ~60–70% of cases). Sigmoid volvulus and colorectal cancer cause large bowel obstruction. Ogilvie's syndrome is pseudo-obstruction of the colon. Hernia would require an external lump.
A 55-year-old man presents with a lump in the right groin that appeared below and lateral to the pubic tubercle, above the medial end of the inguinal ligament. It is non-tender, reducible, and has a cough impulse. What type of hernia is this?
- A.Direct inguinal hernia
- B.Indirect inguinal herniaCorrect
- C.Femoral hernia
- D.Obturator hernia
- E.Spigelian hernia
Show explanation
Indirect inguinal hernia: passes through the deep inguinal ring, travels along the inguinal canal, exits through the superficial ring — appears above and medial to the pubic tubercle, lateral to the inferior epigastric vessels. Direct hernias bulge through Hesselbach's triangle (medial to inferior epigastric). Femoral hernias appear below and lateral to the pubic tubercle, below the inguinal ligament.
A 45-year-old obese woman presents with severe right upper quadrant pain radiating to the right shoulder after a fatty meal, fever 38.5°C, and vomiting. Murphy's sign is positive. WCC 15.2, CRP 95, ALP mildly elevated, bilirubin normal. Ultrasound shows gallstones and thickened gallbladder wall. What is the MOST appropriate management?
- A.Analgesia and outpatient cholecystectomy in 6 weeks
- B.ERCP to clear the bile duct
- C.IV antibiotics, IV fluids, analgesia, and laparoscopic cholecystectomy within 72 hoursCorrect
- D.Percutaneous cholecystostomy only
- E.Ursodeoxycholic acid for gallstone dissolution
Show explanation
Acute cholecystitis: Tokyo Guidelines recommend early laparoscopic cholecystectomy within 72 hours of symptom onset for Grade I/II cholecystitis (preferred over delayed surgery at 6 weeks — lower complication rates, shorter hospital stay). IV antibiotics cover gram-negative organisms. ERCP is for choledocholithiasis (elevated bilirubin, dilated CBD). Bilirubin is normal here.
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Surgery FAQ
How is appendicitis tested?
Expect classical history (peri-umbilical to RIF migration), Alvarado score interpretation, USS first-line in children/pregnancy and CT in adults with diagnostic uncertainty, and laparoscopic appendicectomy as definitive treatment.
What bowel obstruction stems are common?
Differentiate small bowel (vomiting early, central pain, ladder pattern) from large bowel (distension, late vomiting, peripheral haustra). Volvulus, hernia incarceration and adhesions dominate. CT is the imaging of choice.
Is AAA screening tested?
Yes. Know the recommendation for one-off abdominal ultrasound in men aged 65–74 with cardiovascular risk factors. Symptomatic AAA ≥5.5 cm or rapidly expanding requires elective repair; ruptured AAA needs immediate theatre.
What perioperative anticoagulation should I know?
Bridge warfarin patients with LMWH for high-thrombosis risk (mechanical valves, recent VTE). DOACs are stopped 24–48 h pre-op based on renal function and bleeding risk. Aspirin is usually continued for cardiac stents.
How many surgical MCQs are free?
Five sample surgical MCQs with explanations on this page. The full 125+ bank unlocks with a free Mostly Medicine account.