AMC MCQ Prevention and screening Questions: 10 Free Practice MCQs
Prevention and screening questions test population logic applied to one patient. The AMC MCQ expects the national programmes and their age ranges: bowel, breast and cervical screening, plus immunisation and cardiovascular risk assessment. The blueprint also asks about behaviour change, brief intervention for smoking and alcohol, and the honest explanation of false positives and overdiagnosis.
Where candidates lose marks
- Screening outside the national age range or interval because the patient asked.
- Treating a screening result as a diagnosis without the confirmatory test.
- Missing the catch-up schedule for an adult or adolescent who is under immunised.
- Offering a test with no evidence instead of the funded national programme.
Guideline to follow: The AMC MCQ follows the Australian national screening programmes, the Australian Immunisation Handbook and the Royal Australian College of General Practitioners preventive activities guidance.
Ten AMC MCQ-style prevention and screening questions with the answer and the reasoning behind it. They come from the AU.med bank, which has 68 prevention and screening questions and many more across every topic.
1 / 10
A 58-year-old man was discharged from a psychiatric hospital three weeks ago and now attends his general practitioner, who is reviewing his risk of suicide.
Which factor places him at particular risk that should prompt case finding?
Show answer
Answer: C. Recent discharge from a psychiatric hospital
Why: Case finding for suicide risk means being alert to defined higher-risk situations rather than screening everyone. Recognised factors include mental illness, especially mood disorders and substance misuse, previous attempts or self-harm, access to harmful means, recent bereavement or other loss, legal or disciplinary problems, relationship conflict, bullying, family history of suicide, chronic or terminal illness, living alone, imprisonment, and discharge from a psychiatric hospital within the previous 12 months, along with women experiencing intimate partner violence. His recent discharge is the pertinent factor here.
- A. Being male raises population risk, but the specific high-risk factor here is his recent psychiatric hospital discharge.
- B. Weight gain is not among the recognised risk factors for suicide in this context.
- D. Living alone is the recognised risk factor; living with family is not a specific alerting feature.
Sources: RACGP Guidelines for preventive activities in general practice (Red Book), Suicide
2 / 10
A 16-year-old boy attends for a sports injury review. During the consultation he mentions that he has been sexually active with two partners in the past year and has not used condoms consistently. He has no symptoms.
What is the most appropriate action?
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Answer: B. Offer STI screening and prevention counselling based on a sexual history
Why: STI screening and prevention counselling should be offered opportunistically to all sexually active adolescents who present for healthcare, with the tests chosen from the sexual history, so his presentation is an opportunity rather than something to defer. Testing without a sexual history risks omitting the correct sites and the counselling that goes with screening, and disclosing to parents without his agreement breaches the legal right of adolescents to confidential care.
- A. Waiting for the young person to raise the topic misses the opportunistic screening that the guideline recommends for all sexually active adolescents presenting for healthcare.
- C. Testing without a sexual history means the correct sites are not sampled and he misses the prevention counselling that the guideline pairs with screening.
- D. Adolescents have a legal right to confidential healthcare, so disclosing to parents without his agreement breaches that right and may deter him from care.
Sources: RCH Clinical Practice Guidelines: Sexually transmitted infections (STIs) (2022)
3 / 10
A 26-year-old woman presents to a GP clinic for her routine cervical screening. She has no symptoms, is nulliparous, and has never had a cervical screen before. She asks if she can perform a self-collected vaginal swab instead of having a clinician-collected cervical sample.
What is the most appropriate advice under the Australian National Cervical Screening Program (NCSP) guidelines?
Show answer
Answer: A. Self-collection is equally sensitive for detecting HPV compared to clinician-collection
Why: Since July 2022, the National Cervical Screening Program (NCSP) offers self-collection as a first-line choice to all eligible screening participants (aged 25-74). Evidence shows that HPV detection in a self-collected vaginal sample is equivalent in sensitivity to a clinician-collected cervical sample.
- B. Self-collection is now offered as a first-line option to all eligible screening participants, regardless of their screening history.
- C. Any eligible screening participant aged 25 to 74 is permitted to choose self-collection under the current guidelines.
- D. The screening participant performs the swab herself in a private area, though it must be done under clinician supervision.
Sources: National Cervical Screening Program Guidelines, Cancer Council Australia
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4 / 10
A 68-year-old Aboriginal man presents to a rural hospital after a fall and is found to have a hip fracture. He is to be admitted for surgery and has no known cognitive impairment.
Which action is required by the Delirium Clinical Care Standard for this patient?
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Answer: B. Screen for cognitive impairment with a validated tool within 24 hours of presentation
Why: Quality statement 1 requires that a patient with any key risk factor for delirium is identified on presentation and that a validated tool is used to screen for cognitive impairment, with key risk factors including age 65 years or older and 45 years or older for Aboriginal and Torres Strait Islander people, known cognitive impairment or dementia, previous delirium, a severe medical illness and a current hip fracture. This man has two risk factors, so option B is correct, and screening supports both detection and the establishment of a baseline. Option A uses a medicine the standard advises against, option C misplaces the priority of imaging, and options D and E contradict the standard's preventive and timing requirements.
- A. Antipsychotics are neither recommended to prevent delirium nor to treat it routinely, so prophylaxis is contrary to the standard.
- C. Imaging is directed by the clinical assessment and is not the required first step in identifying delirium risk.
- D. Maintaining hydration and bladder function are preventive measures in the standard, so fluid restriction would increase rather than reduce risk.
- E. Screening is required within 24 hours of presentation for admitted patients, and post-operative risk of delirium rises rather than falls.
Sources: Australian Commission on Safety and Quality in Health Care, Delirium Clinical Care Standard (2021)
5 / 10
A 41-year-old nurse was involved in a fatal workplace incident two weeks ago. She has mild distress but no disorder. Her employer asks the general practitioner to arrange a single-session psychological debriefing for all staff who witnessed the event.
What is the most appropriate advice?
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Answer: B. Offer information, emotional support and practical assistance instead
Why: Australian guidelines recommend against both individual and group psychological debriefing for adults in the first three months after trauma, because it has not been shown to prevent later disorder and may cause harm. Instead, people should be offered information, emotional support and practical assistance, and those who develop symptoms should be screened and offered evidence-based care such as trauma-focused cognitive behavioural therapy. Prophylactic medication, including benzodiazepines, is not recommended after trauma. A stepped, collaborative care model allows support to be matched to the level of need.
- A. Australian trauma guidelines advise against group psychological debriefing within the first three months, as it has not been shown to help and may cause harm.
- C. Individual psychological debriefing is likewise not recommended in this early period; supportive contact is the preferred approach.
- D. Benzodiazepines are not recommended to prevent the development of post-traumatic stress disorder and may interfere with natural recovery.
Sources: Phoenix Australia. Australian Guidelines for the Prevention and Treatment of Acute Stress Disorder, Post-traumatic Stress Disorder and Complex PTSD (executive summary)
6 / 10
A 29-year-old woman with an uncomplicated singleton pregnancy has a positive home pregnancy test at 5 weeks. She has no medical history, takes no regular medicines and feels well. She asks when she should first see a health professional for antenatal assessment.
According to RANZCOG, by what stage of pregnancy should she first attend a health professional capable of assessing maternal and fetal risk?
Show answer
Answer: B. By 10 weeks gestation
Why: RANZCOG advises that all women attend a health professional capable of assessing maternal and fetal risk by 10 weeks of pregnancy. This allows confirmation of the pregnancy, the best estimate of gestational age and due date, a comprehensive clinical and psychosocial assessment, and general advice about common concerns in early pregnancy. For a low risk pregnancy there is no requirement for an ultrasound before 12 weeks, and no benefit from an earlier 6 week deadline, while delaying to 14 or 20 weeks would defer dating and risk assessment unnecessarily.
- A. Booking as early as 6 weeks is welcome but is earlier than required, and the college sets no deadline that early for a low risk pregnancy such as this one.
- C. Waiting until 14 weeks pushes the first assessment past the point at which dating and risk assessment are best completed.
- D. Attendance at 20 weeks coincides with the morphology scan but misses the early review that is recommended for every pregnancy.
Sources: RANZCOG Routine antenatal assessment in the absence of pregnancy complications (C-Obs 3b), March 2022
7 / 10
A clinical trial evaluates a new screening test for lung cancer. The screened group has a significantly longer survival time from the date of diagnosis compared to the unscreened group. However, the overall mortality rate at 10 years is identical in both groups.
What epidemiological phenomenon explains this discrepancy?
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Answer: C. Lead-time bias.
Why: Lead-time bias is the apparent increase in survival time when a disease is diagnosed earlier in its natural course (via screening) than it would have been with clinical presentation, without actually delaying death.
- A. Length-time bias detects slow-growing, less aggressive cases.
- B. Healthy volunteer bias relates to participant self-selection characteristics.
- D. Recall bias is systematic error in remembering past exposures.
Sources: Basic Epidemiology; RACGP Guidelines
8 / 10
A 47-year-old Aboriginal patient presents to a rural general practice clinic for a routine health assessment.
Which specific cancer screening is recommended earlier for this demographic compared to the general population?
Show answer
Answer: A. Bowel Cancer
Why: According to the RACGP Red Book guidelines for preventive health assessment in Aboriginal and Torres Strait Islander people, bowel cancer risk assessment and screening start at age 45 (or earlier if high risk), whereas the National Bowel Cancer Screening Program for the general population targets individuals starting from age 50. Prostate cancer, lung cancer, and melanoma do not have a lowered starting age for population screening in this protocol.
- B. Incorrect. National screening guidelines for prostate cancer rely on informed decision-making rather than a different population screening start age for Indigenous Australians.
- C. Incorrect. National population-based screening for lung cancer is not differentiated by a lower age threshold in standard routine health check protocols.
- D. Incorrect. Skin cancer screening is based on individual risk assessment rather than a lower population-wide screening age threshold.
Sources: RACGP Red Book
9 / 10
A 29-year-old woman has an HPV cervical screening test. The report shows that oncogenic HPV (not 16/18) was detected. Reflex liquid-based cytology is reported as Atypical Squamous Cells of Undetermined Significance (ASC-US).
What is the most appropriate management for this patient under NCSP guidelines?
Show answer
Answer: B. Repeat the HPV test in 12 months
Why: Under the Australian NCSP, if a patient is positive for oncogenic HPV (types other than 16/18) and the reflex cytology shows a low-grade abnormality (ASC-US or LSIL), the patient should have a repeat HPV test in 12 months. If the repeat test is positive for any HPV (even non-16/18) or shows any cytological abnormality, she is then referred for colposcopy.
- A. Immediate colposcopy is not indicated for low-grade cytology (ASC-US) with non-16/18 HPV on the first screening test.
- C. Surgical excision is reserved for high-grade histologically confirmed lesions, not low-grade cytological screening findings.
- D. Returning to routine screening is unsafe because HPV was detected, indicating active infection.
Sources: National Cervical Screening Program Guidelines, Cancer Council Australia
10 / 10
A 53-year-old asymptomatic woman presents for a general health check. She has no family history of breast cancer and asks about mammogram screening. Her vitals are normal.
What is the recommended breast cancer screening advice for this patient in Australia?
Show answer
Answer: A. Free 2-yearly mammograms are recommended and funded under BreastScreen Australia.
Why: BreastScreen Australia targets women aged 50-74 for free, 2-yearly screening mammograms. While women aged 40-49 and over 75 are eligible for free mammograms, they are not actively sent invitation letters.
- B. Annual screening and MRI are reserved for high-risk individuals, not average risk.
- C. Ultrasound is not the primary screening modality for breast cancer screening.
- D. BreastScreen Australia is a population screening program for all women aged 50-74.
Sources: BreastScreen Australia Guidelines; RACGP Red Book
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