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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. You are caring for a 78-year-old man admitted to hospital for heart failure. On your rounds, he asks why he is not getting better. He has a history of heart failure, hypertension, and type 2 diabetes. He has an implantable cardioverter-defibrillator. This is his fourth admission in the past 6 months for acute decompensation of his heart failure. Between hospital admissions, he reports worsening shortness of breath and a progressive decline in function. Which one of the following is the next best step?

A) Explain the end-stage nature of the patient ' s illness
B) Advise the patient to have his defibrillator deactivated
C) Reassure the patient that his condition will improve with proper medication adherence

2. A 1-month-old breastfed baby is brought to your office by his parents for his well-baby check-up. He was born at 32 weeks' gestation. Growth parameters at birth revealed head circumference, weight and length at the
50th percentile. Today, his weight is at the 10th percentile. Which one of the following is the most appropriate plan of action?

A) Reassure the parents.
B) Obtain serology for celiac disease.
C) Observe the infant while feeding.
D) Supplement with formula feeding.
E) Order a sweat chloride test.

3. A 52-year-old man presents to the Emergency Department with a history of back, neck, and shoulder pain sustained from a workplace incident 4 years ago. He is under observation by a multidisciplinary pain clinic, and his next appointment is not for another 4 weeks. He does not report any recent change in his symptoms.
His medications are as follows:
Acetaminophen
1000 mg orally 4 times daily
Naproxen
500 mg orally twice daily
Amitriptyline
25 mg orally at bedtime
Acetaminophen 1000 mg orally four times daily
Naproxen 500 mg orally twice daily
Amitriptyline 25 mg orally at bedtime
The patient has not taken his medications for several weeks because he thinks they are not working. He requests a prescription for oxycodone because he tried some that a friend sold him, and it worked very well.
After completing an assessment and providing counseling, which one of the following is the best next step?

A) Obtain a urine toxicology screen.
B) Prescribe a short course of tramadol.
C) Offer to prescribe cannabis.
D) Provide a naloxone kit.

4. A 72-year-old woman presents with swelling of her right leg that developed overnight. She had an abdominal hysterectomy 10 days ago. On examination, there is pitting edema of the leg that extends from the foot to the groin. The calf is 3 cm larger in diameter than the calf on the left leg. Which one of the following is the most likely diagnosis?

A) Iliofemoral vein thrombosis.
B) Inadvertent ligation of the iliac vein.
C) Phlegmasia cerulea dolens.
D) Angioedema of the leg.
E) Superficial thrombophlebitis.

5. A 54-year-old woman presents to your office to discuss breast cancer screening. She is asymptomatic with no history of breast cancer. She had a fibroadenoma removed when she was 24 years old. The patient is not on any medications. Her family history is significant for a great-aunt with breast cancer. The patient has not had genetic testing but had normal breast screening 2 years ago. Which one of the following is the best next step?

A) Reassurance.
B) Positron emission tomography scan.
C) Mammography.
D) Monthly self-breast examination.
E) Breast magnetic resonance imaging.

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