Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 42-year-old businessman known to have type 2 diabetes and ischemic heart disease is admitted to hospital with acute coronary syndrome. He admits to drinking 4 beers a day for the last 6 years and to binge drinking twice a year when his school buddies are in town. Your chart review reveals that he had a seizure secondary to alcohol withdrawal during his last admission. Which one of the following elements of his history puts him at highest risk of having another such seizure?

A) The number of years he has consumed alcohol.
B) His binge drinking.
C) His medical comorbidities.
D) The quantity of alcohol he consumes daily.
E) His previous episode of alcohol withdrawal.

2. A 26-year-old man presents with pain, numbness, and weakness in his right upper extremity. He works as a computer programmer, and his BMI is 32. Symptoms have worsened since he started spending more time on the keyboard. He reports that his right hand feels clumsier while he is typing. Physical examination reveals mild weakness in the intrinsic muscles of that hand, with a positive Tinel sign at the ulnar nerve. Which one of the following is the best next step?

A) Nerve conduction studies to localize the level of the lesion.
B) Physiotherapy.
C) Wrist splint to test for carpal tunnel.
D) Magnetic resonance imaging of the cervical spine.
E) Elbow extension brace for use during sleep.

3. A 26-year-old woman, gravida 1, para 0, aborta 0, consults you at 36 weeks' gestation regarding newborn care. She has HIV. Which one of the following is the best advice regarding reducing the risk for transmission of HIV to her newborn?

A) Breastfeed her newborn during the colostrum period only.
B) Bottle-feed her newborn expressed breast milk.
C) Bottle-feed her newborn boiled expressed breast milk.
D) Avoid kissing her newborn.
E) Formula-feed her newborn.

4. A 61-year-old man presents to the office for follow-up of recent laboratory test results. He has hypertension for which he takes amlodipine daily. His blood pressure is 148/94 mm Hg. His creatinine level is 140 µmol/L (normal 70-120), and his urine protein-to-creatinine ratio is persistently elevated. You would like to prescribe ramipril, but he refuses to take any additional medication. Which one of the following is the best next step?

A) Agree to stop the patient's amlodipine if he takes ramipril.
B) Determine why the patient is refusing to take more medication.
C) Provide the patient with free samples of ramipril.
D) Explain to the patient the importance of preventing the progression of his chronic kidney disease.
E) Inform the patient that he eventually may need dialysis if he refuses the medication.

5. A 10-year-old girl is brought to the Emergency Department by her mother because her daughter is crying and says she " can't pee. " Her daughter fell on the monkey bars at school earlier that day. On examination, there is a large vulvar bruise anteriorly. Which one of the following is the best next step?

A) Discharge the patient home to do sitz baths.
B) Consult gynecology if bladder catheterization is difficult.
C) Order complete blood count and coagulation studies.
D) Arrange a retrograde outpatient arthrography.
E) Ask the mother to leave the room and ask the patient if someone abused her.

Solutions: