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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 34-year-old man with trisomy 21 is brought to the Emergency Department because of a painful, red great toe. He is accompanied by an older woman who begins giving you the history as you enter the room. The patient is sitting on the examination table with the foot exposed, but he does not speak. Which one of the following is the best next step?

A) Ask the woman to provide legal documentation of her responsibility for the patient.
B) Have a nurse attend with you in case the patient needs restraint.
C) Allow the woman to continue with the history to expedite the patient encounter.
D) Establish the relationship between the woman and the patient and direct questions to the patient.
E) Examine the uncovered foot immediately to provide comfort to the patient sooner.

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 42-year-old woman presents with a 2-day history of a low-grade fever and a painful left breast mass. On examination, there is a fluctuant erythematous tender mass with surrounding induration in the left breast and enlarged lymph nodes in the left axilla. An ultrasound shows a loculated cystic mass. Which one of the following is the most likely diagnosis?

A) Ductal ectasia
B) Inflammatory breast cancer
C) Fibrocystic changes
D) Abscess
E) Fibroadenoma

4. A 40-year-old woman presents to your clinic for follow-up regarding her major depressive disorder, which is being treated with the starting dosage of escitalopram. Most of her symptoms have now improved. However, she has noted anorgasmia since taking this medication. This has significantly affected her relationship with her wife. Which one of the following is the best next step?

A) Switch escitalopram to venlafaxine
B) Increase the patient's dosage of escitalopram
C) Add bupropion
D) Maintain the current medication

5. A 2-month-old infant is brought by his parents to your clinic with concerns regarding his frequent crying spells. He has been crying for more than 3 hours daily for many weeks. The infant has reached all age-specific developmental milestones. Which one of the following is the most important to share with the parents regarding this situation?

A) There is an increased risk for dependent personality traits in adulthood
B) This is a self-limited condition
C) Resolution of the crying spells is expected between ages 6 and 12 months
D) Most infants respond well to low-dose sedative medications
E) Investigations are required to confirm a diagnosis

Solutions: