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AMC MCQ · Endocrinology

AMC Endocrinology MCQ Practice — 250+ Questions for IMGs

Diabetes, thyroid, adrenal and pituitary disease — AMC MCQ endocrinology MCQs aligned with Australian guidelines.

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

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Why Endocrinology matters in AMC MCQ

Endocrinology contributes around 10 questions to the AMC MCQ paper, with type 2 diabetes management, thyroid disease, adrenal insufficiency and osteoporosis dominating the blueprint. Australian examiners are particularly strict on which medications are PBS-subsidised at which HbA1c thresholds — a quirk that catches many IMGs trained in other systems.

The Mostly Medicine endocrinology bank is mapped to the RACGP General Practice Management of Type 2 Diabetes handbook, the Australian Diabetes Society (ADS) algorithms, the Endocrine Society of Australia thyroid guidance, and Therapeutic Guidelines: Endocrinology. You’ll practise items on metformin contraindications, GLP-1 agonist and SGLT2 inhibitor sequencing, hypothyroidism dosing in pregnancy, the short Synacthen test interpretation, primary hyperaldosteronism screening (aldosterone:renin ratio), and pheochromocytoma plasma metanephrine testing.

AMC endocrine vignettes tend to combine a biochemistry result (TSH, free T4, HbA1c, calcium, cortisol) with a clinical presentation, then ask for the next investigation or treatment. Practising 200+ Australian-aligned endocrinology MCQs cements the patterns. Sign up free to unlock the full bank with worked explanations and spaced-repetition review.

5 free Endocrinology sample MCQs

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

Question 1Diabetes · easy

According to RACGP Red Book guidelines, which of the following is recommended for a 52-year-old man with well-controlled Type 2 Diabetes?

  1. A.HbA1c every 6 months, annual retinal review, annual foot examCorrect
  2. B.HbA1c annually, biennial retinal review, 5-yearly foot exam
  3. C.HbA1c every 3 months, 6-monthly retinal review, annual foot exam
  4. D.HbA1c every 6 months, biennial retinal review, annual foot exam
  5. E.HbA1c annually, annual retinal review, annual foot exam
Show explanation

RACGP Red Book: HbA1c 6-monthly for T2DM. Annual dilated retinal exam (biennial if well-controlled and no retinopathy). Annual comprehensive foot examination. Annual urine ACR and eGFR.

Question 2Thyroid · easy

A 38-year-old woman presents with weight loss, palpitations, heat intolerance, and a fine tremor. TSH <0.01, free T4 elevated. Eye examination shows proptosis. What is the most likely diagnosis?

  1. A.Toxic multinodular goitre
  2. B.Graves' diseaseCorrect
  3. C.De Quervain's thyroiditis
  4. D.Hashimoto's thyroiditis
  5. E.Toxic adenoma
Show explanation

Graves' disease is the only cause of hyperthyroidism associated with ophthalmopathy (proptosis, lid lag). It is autoimmune (TSH receptor antibodies). De Quervain's is painful subacute thyroiditis. Toxic MNG and adenoma don't cause eye disease.

Question 3Diabetes · medium

A 52-year-old man with T2DM has HbA1c 8.9% on metformin 2g/day. He has cardiovascular disease (prior MI). eGFR is 72. Which second agent provides the most cardiovascular and renal benefit?

  1. A.Sulfonylurea (gliclazide)
  2. B.DPP-4 inhibitor (sitagliptin)
  3. C.SGLT2 inhibitor (empagliflozin or dapagliflozin)Correct
  4. D.Insulin glargine
  5. E.Acarbose
Show explanation

SGLT2 inhibitors in T2DM with CVD: empagliflozin (EMPA-REG) and canagliflozin (CANVAS) reduce MACE, heart failure hospitalisation, and CKD progression. GLP-1 receptor agonists (liraglutide, semaglutide) also have CV benefit. SGLT2i preferred when heart failure or CKD present. Can be used down to eGFR 30 for CV/renal protection (not for glucose lowering at eGFR <45).

Question 4Diabetes · medium

A 45-year-old woman presents with DKA (glucose 32, pH 7.15, bicarbonate 8, ketones 5.2 mmol/L, anion gap 22). She is mildly confused. What is the most important immediate treatment priority?

  1. A.Insulin infusion immediately
  2. B.IV fluid resuscitation (normal saline)Correct
  3. C.Bicarbonate infusion to correct acidosis
  4. D.IV potassium immediately
  5. E.Oral rehydration
Show explanation

DKA management priority: IV fluid resuscitation FIRST (1 L normal saline bolus then 1 L/hour). Fluids restore volume and reduce glucose/ketones. Insulin only after K+ ≥3.5 mEq/L (insulin drives K+ intracellularly → fatal hypokalaemia). Bicarbonate only if pH <6.9. Monitor K+ every hour. FIXED-RATE insulin infusion 0.1 units/kg/hour after fluids and K+ correction.

Question 5Thyroid · medium

A 35-year-old woman presents with 3 months of weight loss, heat intolerance, palpitations, and tremor. She has proptosis bilaterally and a diffuse goitre. TSH <0.01, FT4 elevated, FT3 elevated. TRAb antibodies positive. What is the diagnosis and preferred treatment in Australia?

  1. A.Toxic multinodular goitre — radioactive iodine (RAI)
  2. B.Graves' disease — antithyroid drugs (carbimazole) first-lineCorrect
  3. C.Toxic adenoma — surgery
  4. D.Graves' disease — surgery first-line
  5. E.Subacute thyroiditis — NSAIDs
Show explanation

Graves' disease: TRAb positive, diffuse goitre, orbitopathy, pretibial myxoedema. First-line in Australia: antithyroid drugs (carbimazole 20–40 mg/day) for 12–18 months → 50% remission. Add propranolol for symptomatic relief. Definitive therapy: RAI or thyroidectomy. Graves' orbitopathy worsens with RAI — consider surgery or antithyroid drugs. Pregnancy: propylthiouracil in first trimester.

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Endocrinology FAQ

How is type 2 diabetes management tested?

Expect stems on metformin first-line therapy, second-line choice based on cardiovascular and renal risk (SGLT2i, GLP-1 RA), HbA1c targets (general 53 mmol/mol; tighter or relaxed in specific groups), and PBS authority criteria for newer agents.

What thyroid topics are high-yield?

Subclinical hypothyroidism management thresholds, levothyroxine titration in pregnancy (increase by 25–30% in T1), thyroid storm management, and the differential between Graves’ disease, toxic multinodular goitre and silent thyroiditis using uptake scans.

Are adrenal disorders tested heavily?

Two–three questions per paper typically: Addisonian crisis management with IV hydrocortisone + fluids, screening for primary hyperaldosteronism in resistant hypertension, and pheochromocytoma work-up with plasma free metanephrines.

What about osteoporosis?

Know the indications for DXA scanning, the FRAX tool, when to start bisphosphonates (T-score ≤ −2.5 or after a minimal-trauma fracture), and the duration before considering a drug holiday (5 years oral, 3 years IV zoledronate).

How many endocrinology MCQs are free?

Five sample endocrinology MCQs with explanations on this page. The full 200+ bank unlocks with a free Mostly Medicine account.