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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 28-year-old woman presents because of spotting mid-menstrual cycle. Speculum examination reveals an ulcerated endocervical polyp. Which one of the following is the most appropriate management?

A) Colposcopy.
B) Cryotherapy.
C) Serial cytology.
D) Punch biopsy.
E) Polypectomy.

2. A 36-year-old woman presents to the office with a 2-month history of multiple asymptomatic bumps on her vulva. She is not currently sexually active but has had 2 male sexual partners in the past, with the most recent relationship ending 1 year ago. On examination, she appears to have genital warts. She has not received the human papillomavirus (HPV) vaccine and is not interested in any treatment that is not absolutely necessary.
Which of the following is the best next step?

A) Excisional biopsy.
B) Cryotherapy.
C) HPV vaccine.
D) Papanicolaou test.
E) Contact tracing.

3. A 45-year-old woman presents with a 2-week history of a sore left breast. It has become red and swollen. She was previously well, and her menstrual cycles are regular. She has no history of breast cancer, and she has no children. On examination, she has a red, tender, indurated area in her left breast that has only partially responded to oral antibiotics after 10 days. Which one of the following is the most appropriate next step?

A) Proceed with incision and drainage.
B) Start intravenous antibiotics.
C) Start nonsteroidal anti-inflammatory agents.
D) Change the oral antibiotic.
E) Perform a breast biopsy.

4. A 4-year-old girl is brought to the family practice by her father. The child has a 2-week history of low-grade fever, fatigue, and sore throat. She has also developed several small, round, mildly tender lumps bilaterally in her neck. She was previously well. Which one of the following is most likely to be found on abdominal examination?

A) Renal mass
B) Palpable spleen
C) Generalized tenderness
D) Shifting dullness
E) Abdominal bruit

5. You performed a surgical procedure on a 32-year-old woman for a herniated disk that was causing neurologic impairment. At the 8-month follow-up visit, she has healed well; however, she requests a prescription renewal of her narcotic analgesics (hydromorphone). Her pharmacy confirms that the patient adheres to the dosage you prescribed, that she has not consulted other physicians, and that her behavior has always been respectful.
You think that she no longer requires narcotic analgesics. Which one of the following approaches is most helpful to the patient?

A) Advise the provincial or territorial agency responsible for following patients who have potential substance use disorders.
B) Replace short-acting hydromorphone with transdermal fentanyl.
C) Decline the renewal of further hydromorphone and discharge the patient.
D) Counsel the patient regarding substance use disorder and arrange follow-up with her family physician.
E) Change the patient's prescription from short-acting hydromorphone to once-daily methadone.

Solutions: