# AMC MCQ Pharmacology Questions: 10 Free Practice MCQs

> 10 free AMC MCQ pharmacology questions with answers and explanations, from a bank of 129 pharmacology questions. Try them now, no sign up.

Canonical: https://medhub.one/practice/amc-mcq/pharmacology
Last updated: 2026-10-31

Pharmacology questions test prescribing as a clinical act. The AMC MCQ expects you to choose a drug for the indication, adjust for renal and hepatic function, and recognise interactions and adverse effects. The blueprint also covers therapeutic drug monitoring, antibiotic stewardship and the patient who is already taking several medicines. Questions often ask what to do next when a drug is causing harm, not which receptor it acts on.

## Where candidates lose marks

* Prescribing without checking renal function, pregnancy status or interacting medicines.
* Failing to recognise a classic adverse effect such as angioedema with an ACE inhibitor or bleeding with an anticoagulant.
* Continuing a drug that has caused harm instead of stopping it and documenting the reaction.
* Using a broad spectrum antibiotic where narrow cover is indicated by eTG.

**Guideline to follow:** The AMC MCQ follows eTG, the Australian Medicines Handbook and the Antimicrobial Stewardship Clinical Care Standard from the Australian Commission on Safety and Quality in Health Care.

Ten AMC MCQ-style pharmacology questions with the answer and the reasoning behind it. They come from the AU.med bank, which has 129 pharmacology questions and many more across every topic.

[Free timed mock exam](https://medhub.one/practice/amc-mcq/mock)

1. 1 / 10  
A 72-year-old postmenopausal woman is diagnosed with osteoporosis following a dual-energy X-ray absorptiometry (DEXA) scan that reveals a T-score of -2.8 at the femoral neck. She has no history of fractures, and her renal function is normal.  
Which of the following is the most appropriate first-line pharmacological treatment for this patient?  
Show answer

**Answer: A.** Oral Alendronate 70mg once weekly

**Why:** First-line pharmacotherapy for postmenopausal osteoporosis in Australia includes antiresorptive agents, primarily oral bisphosphonates (Alendronate or Risedronate) or subcutaneous Denosumab. Patients must be counseled on correct administration of oral bisphosphonates (take on an empty stomach with a full glass of water, remaining upright for 30 minutes) to prevent esophageal ulceration.

  * **B.** HRT is not recommended as first-line treatment for osteoporosis in women over 60 due to increased risks of stroke, DVT, and breast cancer.
  * **C.** Teriparatide is an anabolic agent reserved for severe osteoporosis with multiple fractures who have failed antiresorptive therapy.
  * **D.** Calcium and Vitamin D are necessary adjuncts, but they are insufficient as monotherapy to treat established osteoporosis with a T-score of -2.8.  
Sources: Healthy Bones Australia / RACGP Osteoporosis Clinical Guidelines; eTG complete, Rheumatology, Osteoporosis
2. 2 / 10  
A 29-year-old woman who is 3 weeks postpartum presents with a 24-hour history of a painful, red, and swollen right breast. She has associated fevers (38.4°C) and systemic flu-like symptoms. On examination, there is a wedge-shaped area of erythema on the outer quadrant of her right breast which is tender and warm to the touch. She is currently breastfeeding her infant.  
What is the most appropriate management?  
Show answer

**Answer: D.** Advise frequent feeding/expression from both breasts and initiate oral flucloxacillin

**Why:** Lactational mastitis is initially managed by ensuring efficient milk removal (frequent feeding starting on the affected breast, warm compresses before feeding). If systemic symptoms (fever, rigors) are present or if symptoms do not improve after 12-24 hours of conservative management, oral flucloxacillin (500 mg four times daily) is the first-line antibiotic choice. Breastfeeding is safe and should continue.

  * **A.** Breastfeeding should be continued to ensure milk drainage; stopping breastfeeding increases the risk of abscess formation.
  * **B.** Systematised symptoms and fever indicate infective mastitis, which requires prompt antibiotic treatment to prevent abscess development.
  * **C.** Incision and drainage are indicated for a breast abscess, which is characterised by a fluctuant mass, not simple mastitis.  
Sources: eTG Complete: Breast and Lactation Disorders; RACGP: Mastitis management
3. 3 / 10  
A 32-year-old woman in her third trimester of pregnancy (32 weeks gestation) is found to have a hemoglobin of 88 g/L (normal > 110) and a ferritin of 9 ug/L (normal > 30). She complains of severe fatigue but has no gastrointestinal symptoms and has struggled with nausea when taking oral iron tablets.  
Which of the following is the most appropriate management according to Australian obstetric and hematological guidelines?  
Show answer

**Answer: C.** Arrange for an intravenous iron carboxymaltose (Ferinject) infusion

**Why:** In the third trimester of pregnancy, rapid correction of iron deficiency anemia is crucial to prepare for potential blood loss at delivery. Intravenous iron carboxymaltose (Ferinject) is safe and effective in the second and third trimesters, and is indicated when oral iron is poorly tolerated, contraindicated, or unlikely to work in the remaining time.

  * **A.** Increasing the dose of oral iron will likely worsen her nausea and is unlikely to correct severe anemia before delivery.
  * **B.** Blood transfusion is reserved for severe, life-threatening anemia (usually Hb < 70 g/L) or symptomatic patients with cardiovascular compromise.
  * **D.** Intramuscular iron injections are painful, cause permanent skin staining, and have been replaced by modern intravenous iron infusions.  
Sources: National Blood Authority Australia Patient Blood Management Guidelines; RANZCOG Guidelines on Iron Deficiency in Pregnancy
4. Like these? AU.med has a bank of 1500 questions, plus timed mock exams. Free to start: [App Store](https://apps.apple.com/app/id6760537209?utm%5Fsource=medhub.one&utm%5Fmedium=owned%5Fweb&utm%5Fcampaign=practice&utm%5Fcontent=amc-mcq) · [Google Play](https://play.google.com/store/apps/details?id=com.medicinahub.aumed&utm%5Fsource=medhub.one&utm%5Fmedium=owned%5Fweb&utm%5Fcampaign=practice&utm%5Fcontent=amc-mcq)
5. 4 / 10  
A 21-year-old man presents with a 4 month history of persecutory delusions, auditory hallucinations and social withdrawal. He has never taken antipsychotic medication and has no cardiovascular or metabolic disease. He would prefer a tablet and has no strong preference about which drug is used.  
Which antipsychotic is the most appropriate to initiate in this first episode of psychosis?  
Show answer

**Answer: B.** Aripiprazole 10 mg daily

**Why:** The INTEGRATE algorithm begins first-episode psychosis with a low side-effect burden antipsychotic such as a D2 partial agonist, giving aripiprazole 10 mg as the example when the patient has no preference, with response assessed at 1 week and the dose titrated. Olanzapine at 20 mg, haloperidol and amisulpride all carry greater early metabolic or extrapyramidal burden, and amisulpride is positioned as a switch option once positive symptoms persist. Clozapine is deliberately reserved for illness that has failed two adequate trials and requires plasma level and haematological monitoring.

  * **A.** Beginning at the top of the olanzapine range loads a young first-episode patient with weight gain and metabolic risk before any benefit has been judged.
  * **C.** Amisulpride is named as an option when positive symptoms persist after an adequate trial, rather than as the starting drug in a new diagnosis.
  * **D.** A high potency typical antipsychotic at this dose exposes him to extrapyramidal effects before the response to treatment has been assessed.
  * **E.** Clozapine belongs to the treatment-resistant algorithm after two failed trials and needs regular blood monitoring, so it is not a first choice.  
Sources: RANZCP INTEGRATE: International guidelines for the algorithmic treatment of schizophrenia (Best Practice Resource, March 2025)
6. 5 / 10  
A 34-year-old man on Clozapine 400 mg daily presents with severe tachycardia (resting heart rate 125 bpm) and dyspnoea. He started Clozapine 3 weeks ago.  
What is the most critical and life-threatening complication that must be ruled out immediately?  
Show answer

**Answer: A.** Clozapine-induced Myocarditis

**Why:** Clozapine-induced myocarditis is a hypersensitivity reaction occurring in 0.1-3% of patients, usually in the first month. Australian guidelines mandate monitoring of CRP and Troponin at baseline and weekly for the first 4 weeks. If myocarditis is suspected, Clozapine must be stopped immediately and permanently.

  * **B.** While agranulocytosis is a risk, it presents with signs of infection (fever, sore throat) rather than isolated tachycardia and dyspnoea.
  * **C.** While Clozapine causes weight gain and dyslipidaemia, this is a long-term complication, not an acute emergency.
  * **D.** NMS causes severe rigidity and hyperthermia, which are not the primary symptoms here.  
Sources: RANZCP Clozapine Monitoring Guidelines; Cardiac Society of Australia and New Zealand (CSANZ) Clozapine Guidelines
7. 6 / 10  
A 68-year-old woman is diagnosed with major depressive disorder. She has a history of ischemic heart disease (myocardial infarction 6 months ago) and is on Aspirin and Metoprolol. She also has a history of falls.  
Which of the following antidepressants represents the safest and most appropriate first-line choice for this patient?  
Show answer

**Answer: B.** Sertraline

**Why:** Sertraline is considered the antidepressant of choice in patients with unstable angina or recent myocardial infarction due to robust safety data. TCAs are contraindicated in recent MI due to conduction prolongation risks. High doses of citalopram/escitalopram should be avoided due to QTc prolongation risks. All SSRIs increase the risk of bleeding when combined with Aspirin, which requires monitoring, but they remain first-line.

  * **A.** Tricyclic antidepressants (TCAs) like Amitriptyline have significant cardiotoxicity, cause orthostatic hypotension (increasing fall risk), and have strong anticholinergic side effects.
  * **C.** Citalopram at doses above 20 mg is associated with dose-dependent QTc prolongation and is contraindicated in patients with cardiac disease/elderly.
  * **D.** Monoamine oxidase inhibitors (MAOIs) like Phenelzine are third-line agents due to dietary restrictions (tyramine) and severe drug interaction profile.  
Sources: RANZCP Mood Disorders Guidelines; eTG Complete - Depression in Cardiac Patients
8. 7 / 10  
A 34-year-old G3P3 woman experiences a postpartum haemorrhage of 800 mL following a vaginal delivery of a 4.2 kg infant. She is noted to have a soft, boggy uterus. She has received active third stage management, including 10 IU of intramuscular oxytocin and a continuous infusion of IV oxytocin. Her blood pressure is 110/70 mmHg, but she has a history of moderate-to-severe asthma requiring daily preventer therapy. The uterus remains atonic, and bleeding continues.  
Which of the following uterotonic agents is contraindicated in this patient?  
Show answer

**Answer: A.** Carboprost

**Why:** Carboprost (prostaglandin F2-alpha) is used for refractory postpartum haemorrhage due to uterine atony but is contraindicated in patients with asthma due to the risk of inducing severe bronchospasm. Ergometrine is contraindicated in patients with hypertension.

  * **B.** Ergometrine is contraindicated in hypertension, but this patient's blood pressure is normal (110/70 mmHg).
  * **C.** Misoprostol is a prostaglandin E1 analogue that can be used safely in patients with asthma.
  * **D.** Tranexamic acid is an antifibrinolytic, not a uterotonic, and is safe to use in asthmatics.  
Sources: RANZCOG Postpartum Haemorrhage Guidelines; eTG Complete
9. 8 / 10  
A 12-year-old boy with supraventricular tachycardia at 220 beats per minute remains in tachycardia after a modified Valsalva manoeuvre. He is haemodynamically stable with no active wheeze, and the team plans intravenous adenosine.  
Which statement about adenosine administration is correct?  
Show answer

**Answer: A.** A rhythm strip should be recorded during the bolus, and a lower dose is required in a child taking dipyridamole

**Why:** Adenosine briefly blocks atrioventricular nodal conduction and has a half-life of 5 to 10 seconds, so it is given as a rapid bolus and a rhythm strip is recorded during administration because the response helps identify the mechanism even when the tachycardia does not terminate. It can cause flushing, chest tightness and bronchospasm, so it is avoided with severe bronchospasm or active wheeze, and a lower dose is needed in a child taking dipyridamole.

  * **B.** The half-life is only 5 to 10 seconds, which is why adenosine is given as a rapid bolus rather than as an infusion.
  * **C.** Adenosine can cause bronchospasm, so it is avoided when there is severe bronchospasm or active wheeze.
  * **D.** Adenosine is a standard treatment for stable supraventricular tachycardia, with dose adjustments rather than absolute avoidance, apart from specific situations such as a denervated transplant heart.  
Sources: RCH Clinical Practice Guideline: Supraventricular tachycardia (The Royal Children's Hospital Melbourne, last updated January 2022)
10. 9 / 10  
A 15-year-old adolescent has an acute asthma exacerbation requiring oral corticosteroids. The adolescent weighs 42 kg and has no contraindication.  
What dose regimen does the handbook recommend for adolescents?  
Show answer

**Answer: C.** Prednisone or prednisolone 1 mg/kg orally once daily, up to 50 mg, for 3 to 5 days

**Why:** For adolescents, the handbook recommends prednisone or prednisolone 1 mg/kg orally once daily, to a maximum of 50 mg, for 3 to 5 days. Reassess the person's clinical response, risk factors, reliever use and inhaled corticosteroid-containing preventer plan.

  * **A.** A fixed adult dose of 100 mg twice daily is not recommended by the Australian Asthma Handbook for this scenario.
  * **B.** One dose of 1 mg total is not recommended by the Australian Asthma Handbook for this scenario.
  * **D.** Avoid oral corticosteroids in every adolescent is not recommended by the Australian Asthma Handbook for this scenario.  
Sources: Australian Asthma Handbook, acute asthma in adults and adolescents
11. 10 / 10  
A 3-year-old boy weighing 15 kg has a paracetamol concentration above the nomogram line 4 hours after ingesting 250 mg/kg of immediate release tablets. The toxicology service advises starting acetylcysteine.  
Which acetylcysteine regimen should be prescribed?  
Show answer

**Answer: C.** 200 mg/kg over the first 4 hours, then 100 mg/kg over the next 16 hours

**Why:** Acetylcysteine is given as a 2 stage infusion with a total dose of 300 mg/kg. The first stage gives 200 mg/kg over 4 hours and the second gives 100 mg/kg over the next 16 hours, each diluted in a crystalloid solution with the acetylcysteine volume included in the total bag volume. A single rapid dose is not used, the older 3 bag regimen has been replaced, and reversing the two stages would under-treat the early phase when the antidote matters most.

  * **A.** The total dose of 300 mg/kg is given as a 2 stage infusion rather than as one rapid dose.
  * **B.** That is the older 3 bag regimen, whereas the current protocol uses 2 stages with a total dose of 300 mg/kg.
  * **D.** The larger portion belongs in the first stage, so 200 mg/kg is given first and 100 mg/kg in the second stage.  
Sources: RCH Clinical Practice Guideline: Paracetamol poisoning (The Royal Children's Hospital Melbourne, last updated July 2023)

## Explore the 1500-question bank in AU.med

Timed practice, spaced repetition and AI clinical simulations that grade you like an examiner. Free to start.

[App Store](https://apps.apple.com/app/id6760537209?utm%5Fsource=medhub.one&utm%5Fmedium=owned%5Fweb&utm%5Fcampaign=practice&utm%5Fcontent=amc-mcq)[Google Play](https://play.google.com/store/apps/details?id=com.medicinahub.aumed&utm%5Fsource=medhub.one&utm%5Fmedium=owned%5Fweb&utm%5Fcampaign=practice&utm%5Fcontent=amc-mcq)

## More topics

* [Respiratory62 questions in the app](https://medhub.one/practice/amc-mcq/respiratory)
* [Cardiology86 questions in the app](https://medhub.one/practice/amc-mcq/cardiology)
* [Psychiatry152 questions in the app](https://medhub.one/practice/amc-mcq/psychiatry)
* [Emergency medicine185 questions in the app](https://medhub.one/practice/amc-mcq/emergency-medicine)
* [Diabetes84 questions in the app](https://medhub.one/practice/amc-mcq/diabetes)

[Free AMC MCQ Practice Questions by Topic](https://medhub.one/practice/amc-mcq) · [Free timed mock exam](https://medhub.one/practice/amc-mcq/mock)  
[The AMC and AHPRA standard pathway](https://medhub.one/platforms/au-med/amc-standard-pathway-guide)

Exam-style questions written by MedHub for practice. They are not official exam questions.