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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. You are evaluating a 75-year-old man with recently diagnosed prostate cancer and 2 painful metastases of the lumbar spine. Which one of the following therapeutic options is the most appropriate?

A) Fentanyl patch and breakthrough opioids
B) Oral anti-androgen plus gonadotropin-releasing hormone agonist
C) Intrathecal steroid injection
D) Surgical castration (orchidectomy)
E) Palliative radiotherapy to the lumbar spine

2. A 46-year-old woman with a palpable breast lump underwent diagnostic mammography that revealed a suspicious mass in her right breast. The radiologist recommended a breast biopsy. The referring physician did not see the mammogram report or the recommendation for biopsy. One year later, invasive breast cancer is diagnosed in the patient. Which one of the following is most likely to prevent this issue from happening again?

A) Having a tracking system for all investigative reports.
B) Notifying patients only if there is an abnormal finding.
C) Booking return appointments with the referring physician to follow up every result.
D) Requiring radiologists to phone the referring physician with every result.
E) Asking patients to call laboratories and imaging centres for their test results.

3. 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) Arrange a retrograde outpatient arthrography.
D) Order complete blood count and coagulation studies.
E) Ask the mother to leave the room and ask the patient if someone abused her.

4. You have been asked to develop a program in your hospital for people who are at the highest risk of death by suicide. The hospital administrator asks you to describe the types of patients they should expect in the program. Which one of the following groups is the most likely prominent demographic?

A) Men aged 50 to 70 years who have limited social supports and alcohol use disorder
B) Women aged 14 to 20 years who have histories of being abused and who are experiencing financial hardships
C) Women aged 20 to 40 years who have cluster B personality disorders and experience relationship losses
D) Patients of both sexes who have psychotic disorders
E) Men aged 11 to 20 years who have histories of juvenile delinquency and narcotic use

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

Solutions: