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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 6-year-old girl is found to have a blood pressure of 130/75 mm Hg. She was born prematurely at 32 weeks ' gestation and required ventilation. There is a family history of hypertension in 3 grandparents. Clinical examination reveals a grade 1/6 mid-systolic murmur, no renal bruits, and femoral pulses are difficult to feel.
Which one of the following is the most likely diagnosis?

A) Ventricular septal defect
B) Essential hypertension
C) Aortic coarctation
D) Renal artery thrombosis
E) Reflux nephropathy

2. A 24-year-old woman with chronic anorexia nervosa presents to the Emergency Department with diarrhea, chest pain and palpitations. She is noted to have a BMI of 13, a heart rate of 48/min, significant orthostatic hypotension and a temperature of 35.9 °C. Her electrocardiogram shows frequent premature ventricular contractions. Her blood work indicates elevated liver transaminases and evidence of acute kidney injury from dehydration. She agrees to admission for medical stabilization only if she does not receive fluids either orally or intravenously, as they will cause her to gain weight and to feel bloated. Which one of the following is the best next step?

A) Ask her if she has a substitute decision-maker
B) Refuse to admit her unless she agrees to full treatment
C) Assess her capacity to consent for medical treatment
D) Start intravenous fluids and physically restrain if necessary
E) Obtain a psychiatric consultation

3. A 14-month-old boy is brought to see you for a well-baby check-up and is noted to have only one testis.
Ultrasound confirms an undescended testis. Which one of the following is the best next step?

A) Hormonal therapy with gonadotropins
B) Surgical removal of the undescended testis
C) Hormonal therapy with testosterone
D) Observation for a year
E) Surgical orchiopexy

4. You are examining a newborn in the delivery room. He was born at full term by spontaneous vaginal delivery.
On examination, he is active, and his vital signs are within normal range. His head circumference is at the third percentile, with height and weight at the 10th percentile. Auscultation of his chest is clear with normal cardiovascular examination findings. The abdomen is protuberant with a liver edge palpable at 4 cm below the costal margin and mild splenomegaly. Which one of the following is the most likely diagnosis?

A) Trisomy 21
B) Cephalic molding
C) Congenital viral infection
D) Lipid storage disease
E) Cystic fibrosis

5. A 52-year-old man presents to the Emergency Department with a history of back, neck, and shoulder pain sustained from a workplace incident 4 years ago. He is under observation by a multidisciplinary pain clinic, and his next appointment is not for another 4 weeks. He does not report any recent change in his symptoms.
His medications are as follows:
Acetaminophen
1000 mg orally 4 times daily
Naproxen
500 mg orally twice daily
Amitriptyline
25 mg orally at bedtime
Acetaminophen 1000 mg orally four times daily
Naproxen 500 mg orally twice daily
Amitriptyline 25 mg orally at bedtime
The patient has not taken his medications for several weeks because he thinks they are not working. He requests a prescription for oxycodone because he tried some that a friend sold him, and it worked very well.
After completing an assessment and providing counseling, which one of the following is the best next step?

A) Provide a naloxone kit.
B) Prescribe a short course of tramadol.
C) Offer to prescribe cannabis.
D) Obtain a urine toxicology screen.

Solutions: