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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 6-year-old boy is brought to the Emergency Department with a 2-day history of a limp. On examination, he looks well, has a temperature of 38 °C and is able to weight-bear. His hip examination reveals mild decreased range of motion. Radiographs of his hip and pelvis show no abnormality. His C-reactive protein level is 8 mg
/L (< 6). Which one of the following is the most likely diagnosis?

A) Trochanteric bursitis
B) Osteomyelitis
C) Transient synovitis
D) Septic arthritis
E) Juvenile rheumatoid arthritis

2. A mother brings her 10-year-old son for his well-child check-up. She mentions that her 38-year-old husband has just had a heart attack due to high cholesterol levels and wants information regarding prevention of cardiovascular disease for her son. Which one of the following is the best approach to managing this problem?

A) Prescribe a low-fat diet for the son
B) Reassure the mother as children do not have elevated lipid levels
C) Prescribe a weight-lifting exercise program for her son
D) Send the son for a lipid profile test
E) Request a serum homocysteine and hemoglobin A1c

3. A 30-year-old woman presents to your office with a 6-week history of left lower quadrant pain and dyspareunia. A pelvic ultrasound is normal. Which one of the following is the most important immediate investigation?

A) Hysterosalpingography
B) Cervical swabs
C) Laparoscopy
D) Endometrial biopsy
E) Magnetic resonance imaging

4. A 62-year-old woman is referred to your clinic for evaluation of hypercalcemia. She has a history of hypertension and vitamin D deficiency. Her medications include hydrochlorothiazide and vitamin D supplements. Laboratory investigations are as follows:
* Calcium: 2.72 mmol/L (#)
* Phosphate: 0.9 mmol/L (#)
* Parathyroid hormone (PTH): 0.9 pmol/L (#)
* 25-hydroxy vitamin D: 80 nmol/L (normal)
Which one of the following is the best next step?

A) Order 24-hour urine calcium
B) Refer for consideration of parathyroidectomy
C) Switch to a different antihypertensive medication
D) Start calcitriol
E) Order serum protein electrophoresis and urine for light chains

5. A 69-year-old woman with long-standing hypertension presents to the emergency department with a 2-hour history of persistent chest and back pain. A posteroanterior chest radiograph shows suspicious widening of the mediastinal shadow. Which one of the following is most likely to yield a clinical diagnosis?

A) Pulmonary angiography
B) Computed tomography of the chest
C) Transthoracic echocardiography
D) Ventilation-perfusion lung scan
E) Electrocardiography

Solutions: