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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 54-year-old man presents to the office because of progressively severe frontal headaches that are worse in the morning. He also has a chronic productive cough. He has a 30 pack-year history of smoking tobacco cigarettes. His blood pressure is 160/95 mm Hg. Which one of the following is the best next step?

A) Arrange for serial home blood pressure monitoring.
B) Order computed tomography of the head.
C) Give a prescription for serotonin 5-HT receptor agonist (Triptan).
D) Refer for urgent temporal artery biopsy.
E) Start a calcium channel blocker.

2. A 45-year-old man with confusion is brought to the Emergency Department by ambulance. He has end-stage renal disease and has missed his last 3 dialysis appointments. He also has a past medical history of antisocial personality disorder and hepatitis C. On examination, he is in respiratory distress. His blood pressure is 170
/90 mm Hg, and his oxygen saturation is 84% on room air. His jugular venous pressure is 8 cm above the sternal angle, and he has crackles in his lungs bilaterally. A venous blood gas shows a bicarbonate of 11 mmol
/L (24-30) and potassium of 7.1 mmol/L (3.5-5.0). Which one of the following is the best next step?

A) Discuss with his nephrologist the reasons why he missed his dialysis appointments.
B) Attempt to contact his family for consent to start dialysis.
C) Prescribe morphine and furosemide.
D) Call psychiatry to evaluate his capacity to consent.
E) Start urgent dialysis.

3. A 42-year-old woman is admitted to the Intensive Care Unit with a massive pulmonary embolism. Her condition is stabilized with intubation, hydration, inotropic support, and intravenous administration of heparin. Her partner provides you with a list of her medications. A combination oral contraceptive pill was recently prescribed. She smokes tobacco cigarettes, and her BMI is 36. Which one of the following is the best next step?

A) Discuss the case with the hospital ethics committee
B) Report the prescribing physician to the provincial or territorial medical regulatory authority
C) Inform the patient ' s partner that the oral contraceptive pill may have caused her condition
D) Tell her partner that the physician should not have prescribed the oral contraceptive pill
E) Advise the patient ' s partner to seek legal advice

4. A 22-year-old woman is brought to the Emergency Department by her boyfriend, who says that she is experiencing a fentanyl overdose. She is unresponsive and cyanotic. She regains consciousness after naloxone is injected intravenously and demonstrates no further respiratory depression during 8 hours of observation.
She states that she is 22 weeks ' pregnant and wants to stop using opioids. Which one of the following is the best next step?

A) Admit the patient for medically supervised detoxification
B) Prescribe medications for symptom control so that the patient can detoxify at home
C) Refer the patient for opioid use disorder counselling
D) Refer the patient for initiation of methadone

5. The developers of a urinary protein dipstick test have indicated that they have reduced the problem of false positive results by changing the test so that it becomes positive at a higher concentration of protein. Which one of the following statements best describes how this screening test will be affected?

A) The validity of the test will be reduced.
B) There will be more false negatives.
C) Both sensitivity and specificity will improve.
D) The accuracy of the test will be reduced.
E) The positive predictive value will remain the same.

Solutions: