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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 37-year-old woman presents to your clinic with frequent palpitations. She has no other symptoms and is quite active. Physical examination and resting electrocardiogram findings are normal. Which one of the following is the best next step?

A) Holter monitoring
B) Treadmill exercise test
C) Echocardiogram
D) #-Blocker

2. A 32-year-old woman, gravida 1, para 0, aborta 1, and her partner present to the office for follow-up regarding a spontaneous abortion that occurred 6 weeks ago. On history, the patient smokes tobacco cigarettes occasionally. On examination, she is healthy and has a BMI of 25. Ultrasonography findings reveal an empty uterus with a 2-cm subserosal fibroid. The couple is planning another pregnancy and would like information on how to increase her chances of carrying a pregnancy to full term. Which one of the following is the best advice?

A) The patient should undergo excision of her fibroid.
B) The patient and her partner should abstain from sexual intercourse in the first trimester.
C) The patient should take 5 mg of folic acid daily.
D) The patient should defer conception for 6 months.
E) The patient should stop smoking.

3. A previously well 4-year-old boy is brought to your office by his mother. She is concerned by his behaviour.
Shortly after falling asleep, he awakens, screams loudly and cries. He appears frightened and does not respond to his mother's efforts to calm him. During these episodes, he appears agitated and flushed. After 15-20 minutes, he settles back to sleep. Physical examination is unremarkable. Which one of the following is the most likely diagnosis?

A) Panic disorder.
B) Temper tantrums.
C) Nightmare disorder.
D) Nocturnal seizures.
E) Non-rapid eye movement sleep arousal disorder.

4. A 34-year-old woman, gravida 2, para 1, aborta 0, presents to the labor and delivery ward at 32 weeks ' gestation with a 24-hour history of worsening frontal headache, photophobia, and neck stiffness. Vitals:
BP: 121/78 mm Hg
HR: 90 bpm
Temp: 38°C
Neuro exam reveals a 2-beat ankle clonus. Tone and power are otherwise normal. No localizing signs or papilledema. Abdomen is soft, fetus is cephalic.
Which one of the following is the best next investigation?

A) Urine protein to creatinine ratio
B) Lumbar puncture
C) Amniocentesis with culture
D) Computed tomography of the head
E) Fetal ultrasonography

5. A 24-year-old man presents to your clinic with a 6-month history of fatigue. On examination, he is pale. His BMI is 16, and his blood pressure is 92/58 mm Hg. Initial laboratory work shows the following:
Creatinine: 64 µmol/L (49-93)
Potassium: 3.0 mmol/L (3.5-5.1)
Sodium: 138 mmol/L (136-146)
TSH: 2.40 mIU/L (0.34-5.60)
CBC: Normal
Which one of the following is the best next step?

A) Ask permission to discuss the patient's weight
B) Advise increased caloric intake
C) Refer the patient to the emergency department
D) Consult gastroenterology

Solutions: