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AMC MCQ General Medicine 2026: The Complete High-Yield Topic Guide

Last reviewed: May 2026 | Written by the MplusX Editorial Team

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– General Medicine is ~30% of the AMC MCQ — approximately 36 scored questions. The single most important domain.

– Covers cardiovascular, respiratory, endocrinology, gastroenterology, neurology, renal, musculoskeletal, and infectious diseases.

– Every topic is tested through the lens of Australian clinical guidelines — eTG prescribing, RACGP preventive standards, and Australian public health frameworks.

– Primary CTA: Try MplusX free — filter to General Medicine and work through the highest-yield category on the exam.

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Thirty percent.

Thirty-six scored questions. The biggest domain by a long stretch.

If you master General Medicine, you have a structural advantage over candidates who distribute their study equally across all six domains. If you underperform in General Medicine, no amount of excellence in other domains will fully compensate.

This is not a domain you can afford to approach casually.

This guide is the most comprehensive publicly available breakdown of AMC MCQ General Medicine high-yield topics. Use it alongside MplusX QBank practice — the topics here align directly with the clinical scenarios you will encounter in the question bank and on exam day.

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Cardiovascular Medicine (Highest Yield)

Cardiovascular questions represent the densest cluster within General Medicine. Expect 8 to 10 of your 36 General Medicine questions to come from this area.

Chest Pain Differential

The AMC MCQ loves chest pain presentations — because they require systematic clinical reasoning across multiple diagnoses simultaneously.

High-yield differentials and their distinguishing features:

Diagnosis	Key Features	Initial Management
STEMI	ST elevation in ≥2 leads, troponin rise	Primary PCI within 90 min (door-to-balloon). Aspirin + P2Y12 inhibitor.
NSTEMI/UA	ST depression or T-wave changes, troponin rise or normal	Aspirin + anticoagulation. Risk stratify. Cardiology referral.
Aortic Dissection	Tearing/ripping pain, radiates to back, BP difference between arms	Immediate CT angiography. IV labetalol. Surgical consult. Do NOT thrombolyse.
PE	Pleuritic pain, dyspnoea, risk factors, haemoptysis	CTPA (gold standard). Start anticoagulation if pre-test probability high.
Pericarditis	Sharp, positional (worse lying flat, better sitting forward), friction rub	NSAIDs + colchicine first-line.
GORD	Burning, worse after meals, no radiation to arm	PPI trial first-line.

AMC trap — aortic dissection: Do NOT administer thrombolytics if dissection is the diagnosis. The question may present a chest pain scenario that initially appears to be STEMI. The clue to dissection is the tearing quality, back radiation, and BP differential between arms. Always consider dissection before thrombolysing.

Heart Failure

HFrEF (EF <40%) management — the ABCDE framework:

• A — ACE inhibitor or ARB (ramipril/perindopril first-line; sacubitril-valsartan if still symptomatic)

• B — Beta-blocker (carvedilol, bisoprolol, metoprolol succinate)

• C — Candesartan (ARB if ACE intolerant due to cough)

• D — Diuretic (furosemide for fluid overload)

• E ” SGLT2 inhibitor (empagliflozin, dapagliflozin — now standard of care for HFrEF)

AMC trap: SGLT2 inhibitors are now part of the core HFrEF treatment framework in Australia — this is a relatively recent guideline change. Older study materials may not include them. Any question asking about optimal HFrEF management that does not have SGLT2 inhibitor in the correct answer should raise a guideline-currency flag.

Atrial Fibrillation

Rate vs rhythm control:

• Rate control: Beta-blocker or digoxin (preferred in patients with HF). Target resting HR <110 bpm.
• Rhythm control: Cardioversion or antiarrhythmic drugs (amiodarone, sotalol). For patients with symptoms or AF of recent onset.

Anticoagulation (CHA2DS2-VASc score):

• Score 0 (male) or 1 (female): No anticoagulation
• Score ≥1 (male) or ≥2 (female): Anticoagulation recommended — DOACs (apixaban, rivaroxaban) preferred over warfarin in most cases

AMC trap: The CHA2DS2-VASc score uses female sex as a risk modifier (+1). It does NOT mean all women with AF require anticoagulation — the score must still be ≥2 for a woman to warrant anticoagulation.

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Respiratory Medicine

Community-Acquired Pneumonia

eTG first-line antibiotic protocol (the most commonly tested prescribing question in Respiratory):

Severity	Setting	First-Line Antibiotic
Mild	Outpatient (community)	Amoxicillin 500mg TDS – 5 days
Moderate	Hospital	Amoxicillin-clavulanate + doxycycline IV/oral
Severe	ICU	Piperacillin-tazobactam + azithromycin

Severity assessment: CURB-65 score — Confusion, Urea >7 mmol/L, Respiratory rate ≥30, BP <90/60, Age ≥65. Score 0 -1: outpatient. Score 2: consider hospital. Score ≥3: hospital, consider ICU.

COPD Management

Stable COPD stepup (GOLD Guidelines adapted for Australia):

• GOLD A (low risk, low symptoms): SABA prn

• GOLD B (low risk, high symptoms): LAMA or LABA

• GOLD C (high risk, low symptoms): LAMA

• GOLD D (high risk, high symptoms): LAMA + LABA ± ICS

Acute exacerbation of COPD management:

• Controlled oxygen (target SpO2 88 -92% — not 100%)

• Bronchodilators (salbutamol + ipratropium)

• Systemic corticosteroids (prednisolone 30 -40mg for 5 days)

• Antibiotics if purulent sputum or clear infection trigger

• NIV (BiPAP) if hypercapnic respiratory failure

AMC trap — oxygen targets: In COPD, high-flow oxygen to achieve SpO2 >95% risks hypercapnic respiratory failure. Target 88 -92%. This is tested directly and candidates from non-Australian training backgrounds frequently select the wrong oxygen target.

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Endocrinology

Type 2 Diabetes

HbA1c targets (Australian guidelines):

• General target: HbA1c <53 mmol/mol (<7%)

• Elderly/multiple comorbidities/hypoglycaemia risk: HbA1c <64 mmol/mol (<8%)

• Younger patients with longer life expectancy: HbA1c <48 mmol/mol (<6.5%)

Treatment stepup (Australian guidelines):

1. Lifestyle modification alone (if newly diagnosed, mild elevation)

2. Metformin (first pharmacological agent — if tolerated)

3. Add second agent — SGLT2 inhibitor (empagliflozin/dapagliflozin) preferred if CVD risk or HF present; GLP-1 agonist if obesity is primary concern

4. Add third agent or insulin if not at target

AMC trap: SGLT2 inhibitors are not just glucose-lowering — they have proven cardiovascular and renal protection benefits that make them preferred second agents in patients with established cardiovascular disease or CKD. Questions may test this indication specifically.

Hypothyroidism

• First-line treatment: Levothyroxine (T4)

• Dosing: Start low in elderly patients and those with cardiovascular disease (12.5 -25 mcg daily, titrating slowly to avoid precipitating angina or AF)

• Monitoring: TSH at 6 to 8 weeks after any dose change

AMC trap: Levothyroxine should be taken on an empty stomach (30 minutes before food) — absorption is reduced by food, calcium, iron supplements, and antacids.

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Gastroenterology

Peptic Ulcer Disease

H. pylori eradication regimen (eTG): First-line: Triple therapy — PPI (standard dose) + clarithromycin 500mg + amoxicillin 1g, all twice daily for 7 days.

If penicillin allergy: PPI + clarithromycin + metronidazole 400mg twice daily for 7 days.

Test of cure: Urea breath test 4 weeks after completing eradication therapy (not H. pylori serology — serology remains positive after treatment).

Colorectal Cancer Screening

National Bowel Cancer Screening Programme (NBCSP):

• iFOBT every 2 years, ages 45 to 74 (start age updated to 45 in 2024)

• Positive iFOBT ‘ colonoscopy referral

AMC trap: A positive iFOBT on national screening requires colonoscopy — not a repeat iFOBT, not CT colonography as first response.

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Neurology

Stroke and TIA

Thrombolysis criteria for ischaemic stroke:

• Within 4.5 hours of symptom onset

• No contraindications (haemorrhagic stroke excluded by imaging, no recent surgery, no anticoagulation, no significant bleeding history)

• tPA (alteplase) is the agent

AMC trap: Thrombolysis requires haemorrhagic stroke to be excluded first by CT imaging. Never thrombolyse before imaging. TIA management:

• ABCD2 score ≥4: urgent hospitalisation and investigation

• Dual antiplatelet for 21 days (aspirin + clopidogrel), then single antiplatelet long-term

• Anticoagulation (not antiplatelet) if AF is identified as the cause

Epilepsy and Driving

Post-seizure driving restrictions (general Australian guideline):

• First unprovoked seizure: minimum 6-month driving cessation (private vehicle)

• Established epilepsy with breakthrough seizure: 12 months seizure-free required before return to driving

• Commercial vehicles: stricter — typically 5 years seizure-free

AMC trap: You must advise the patient of their driving restriction and document this advice. If the patient refuses to comply and continues driving, you have an obligation to report to the relevant transport authority in most Australian states.

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Renal Medicine

CKD Management

eGFR thresholds and management:

eGFR	Stage	Key Actions
≥90	Stage 1	Risk factor management, BP control
60 -89	Stage 2	Monitor annually, address cardiovascular risk
30 -59	Stage 3	Nephrology referral if deteriorating, manage complications
15 -29	Stage 4	Nephrology referral, prepare for renal replacement
<15	Stage 5	Renal replacement therapy (dialysis or transplant)

ACE inhibitors/ARBs in CKD: Reduce proteinuria and slow progression — but monitor K and creatinine. Rise in creatinine of up to 30% is acceptable after initiation. Hyperkalaemia (K >6.0 mmol/L) requires dose reduction or cessation.

Drug dose adjustments in CKD: Metformin is contraindicated in eGFR <30. NSAIDs should be avoided in CKD (worsen renal function and increase hyperkalaemia risk). These are frequently tested.

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Study Strategy for General Medicine

Allocate 35% of total QBank time to General Medicine — slightly above its blueprint proportion, reflecting its topic breadth and the high density of Australian-context clinical rules.

Start with Cardiovascular ” the highest-density sub-specialty. Build your clinical rules for ACS, HF, and AF before moving to other sub-specialties.

Use the clinical rules notebook actively ” General Medicine generates more clinical rules than any other domain. By the end of your preparation, you should have 80 to 100 General Medicine rules in your notebook.

Cross-reference eTG for every wrong prescribing answer. Cardiovascular and Respiratory prescribing questions are both high-frequency and Australian-specific. Every wrong prescribing answer gets a direct eTG reference check, not just a QBank explanation read.

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Frequently Asked Questions

What is the highest-yield sub-specialty within General Medicine?

Cardiovascular is the most question-dense sub-specialty within General Medicine — expect 8 to 10 scored questions from this area. ACS management, heart failure drug therapy (including SGLT2 inhibitors), and AF anticoagulation decisions are the three highest-yield cardiovascular topics.

Are SGLT2 inhibitors important for the 2026 AMC MCQ?

Yes. SGLT2 inhibitors (empagliflozin, dapagliflozin) are now incorporated into both Type 2 diabetes management and HFrEF management as standard-of-care agents in Australian guidelines. Questions about optimal diabetes management with cardiovascular risk and optimal heart failure management both have SGLT2 inhibitors as part of the correct answer in 2026. Pre-2023 study materials may not reflect this change.

How do I study General Medicine efficiently without getting overwhelmed?

Focus by sub-specialty. Spend 1 week on Cardiovascular, 4 to 5 days on Respiratory, 3 to 4 days each on Endocrinology and Gastroenterology, then 2 to 3 days each on the smaller sub-specialties. Write clinical rules after every wrong answer and review your rules notebook weekly.

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References

• John Murtagh’s General Practice (8th Edition): Chapter 9: A safe diagnostic model; Chapter 26: Undifferentiated illness.
• RACGP Red Book (10th edition): Chapter 8: Prevention of vascular and metabolic disease.
• Therapeutic Guidelines (eTG): Clinical Prescribing Principles.

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Disclaimer: This article is written for AMC MCQ examination preparation and general informational purposes only. It does not constitute medical advice, diagnosis, or treatment recommendations. Clinical decisions should always be based on individual patient assessment, current Australian Therapeutic Guidelines (eTG), and consultation with qualified healthcare professionals. MplusX is an exam preparation platform and is not a substitute for supervised clinical training.