Medical Council of Canada MCCQE Part 1 - MCCQE Exam Questions

QUESTION NO: 1
A 16-month-old boy is brought to your office because of red, itchy and crusted patches on his cheeks and chin. Physical examination also reveals similar patches in the flexor creases of both arms. The groin and axillae regions are clear. Which one of the following is most likely to contribute to this condition?

QUESTION NO: 2
You are a family physician caring for a healthy 60-year-old woman. Which one of the following preventative interventions is most useful?

QUESTION NO: 3
A 53-year-old man with a history of bipolar I disorder is brought to the office by his family. Recently, he has been sleeping for 4 to 5 hours per night, has been fidgety, and is increasingly preoccupied with his granddaughter ' s safety. Five days ago, he consulted with your physician colleague and was instructed to exercise and meditate. Last night, he was found running in the street and attempted to hit a relative who was trying to calm him down. His son is dissatisfied with your physician colleague ' s management. Which one of the following is the most appropriate response?

QUESTION NO: 4
A 29-year-old man comes to the office for an initial visit. He is being treated for schizophrenia and epilepsy.
He has a 20 pack-year history of smoking. His medications are carbamazepine, clozapine, and quetiapine. In the past year, he has gained a considerable amount of weight. Aside from a BMI of 32, the results of his physical examination are unremarkable. Which one of the following conditions should he be investigated for?

QUESTION NO: 5
A 25-year-old woman presents to the Emergency Department with a 4-hour history of severe left flank pain.
Her vital signs are as follows:
Heart rate: 94/min
Blood pressure: 130/80 mm Hg
Temperature: 37.3 °C
A non-contrast computed tomography shows a 6 mm stone in the distal left ureter with mild associated hydronephrosis. In addition to appropriate analgesia, which one of the following is the best next step?

QUESTION NO: 6
You are covering for your colleague who is on vacation this week. You receive the results from an ultrasonography that had been ordered for a 32-year-old woman, gravida 2, para 1, aborta 0. The ultrasonography-estimated fetal weight is below the fifth percentile for 30 weeks ' gestation; gestational age was confirmed by an earlier ultrasonogram. The amniotic fluid volume is within normal range. Her first child ' s birth weight was 2800 g at full term. Which one of the following is the best next step?

QUESTION NO: 7
There are many expenses which are considered part of providing care to patients. Under Canadian legislation, which one of the following is an acceptable means of covering these costs?

QUESTION NO: 8
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?

QUESTION NO: 9
An 18-year-old woman comes to the office because of fatigue. She tells you she is struggling in her first year of university. She mentions that she spends much of her time rewriting her notes and filing and organizing her study materials. She is doing all the work in her group assignments because she feels others cannot do the work to a high enough standard. She has abandoned all enjoyable activities and seems to be constantly working and worrying about her grades. Which one of the following is the most likely diagnosis?

QUESTION NO: 10
A 19-year-old primigravid woman presents to the office with a rapid increase of abdominal girth and shortness of breath. Her pregnancy is at 27 weeks' gestation, as confirmed by early ultrasonogram. The symphysis-fundal height is 45 cm. The fetal heart rate is 150/min (110-160). Which one of the following is the most likely diagnosis?

QUESTION NO: 11
A 35-year-old man comes to your office with a history of headaches that last 1 hour and are relieved by 1000 mg of acetaminophen. These headaches, which started 6 months ago after he got his first job as a lawyer, occur regularly. The patient wants a computed tomography scan of his head to rule out a tumour. Physical examination reveals no abnormality. Review of systems does not contribute any positive findings. Which one of the following is the best management?

QUESTION NO: 12
A 29-year-old concert pianist with severe chronic kidney disease presents with a 6-month history of loss of appetite and pruritus. Although the issue of initiating dialysis has been discussed with him and his questions answered, he has declined dialysis thus far. You understand his concerns that it will interfere with his concert tour and recording schedule. Which one of the following is the best next step?

QUESTION NO: 13
You are asked to see a 34-year-old patient at his long-term care facility for a 2-day history of fever. You diagnose a urinary tract infection. He has multiple sclerosis diagnosed 5 years ago and has lived in this long- term care facility for the past 2 years. He is bedbound and has an indwelling urinary catheter. For the past 3 months, he has been non-communicative. Prior to this, he had made it clear that he did not want any life- prolonging measures. Which one of the following is the best next step?