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Medical Council of Canada MCCQE Exam Syllabus Topics:

Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 79-year-old woman presents to the Emergency Department with sudden-onset severe chest and back pain that started 1 hour ago. She has a history of hypertension and looks unwell. Her vital signs are as follows:
blood pressure 168/108 mm Hg, heart rate 110/min, respiratory rate 22/min, temperature 36.7°C. Findings of a physical examination of the chest and abdomen are normal. An urgent computed tomography (CT) scan of the chest and abdomen shows an aortic dissection extending from the descending thoracic aorta to the upper abdominal aorta. The branches of the abdominal aorta are patent. Following initial resuscitation, which one of the following is the best next step?

A) Initiate intravenous labetalol.
B) Start intravenous heparin.
C) Conduct open repair of the thoracic and abdominal aorta.
D) Admit the patient to the Intensive Care Unit and repeat CT in 6 hours.
E) Perform endovascular repair of the thoracic and abdominal aorta.

2. A 36-year-old woman presents to the office with a 2-month history of multiple asymptomatic bumps on her vulva. She is not currently sexually active but has had 2 male sexual partners in the past, with the most recent relationship ending 1 year ago. On examination, she appears to have genital warts. She has not received the human papillomavirus (HPV) vaccine and is not interested in any treatment that is not absolutely necessary.
Which of the following is the best next step?

A) HPV vaccine.
B) Cryotherapy.
C) Contact tracing.
D) Excisional biopsy.
E) Papanicolaou test.

3. An 18-month-old girl is brought in with a 3-day history of frequently passing loose stools. The stools are not bloody, but when she passes the stools, she is in obvious pain. She started vomiting earlier today, but she is still wetting diapers. On examination, she is mildly dehydrated but active and alert. Physical examination findings are otherwise normal. Which one of the following is the best management of this patient's case?

A) Combination of apple juice and chicken broth.
B) Regular diet only when the diarrhea is resolved.
C) Oral rehydration solution.
D) No dairy for 2 weeks.
E) Loperamide.

4. A 42-year-old woman presents to your clinic requesting an increase in her stimulant dosage for the treatment of her adult attention-deficit/hyperactivity disorder. Her medical history includes hypertension and type 1 diabetes with associated nephropathy. She has been taking methylphenidate daily for 15 years. Which one of the following would need to be addressed before the dosage can be increased?

A) Random glucose level that is often higher than 18.0 mmol/L (4.0-11.0).
B) Estimated glomerular filtration rate of less than 30 mL/min/1.73 m² (#60).
C) Average home blood pressure reading of 150/80 mm Hg.

5. A 70-year-old woman presents to the Emergency Department with a 2-day history of dysuria and right flank pain. Upon arrival, she is quite unwell. Her vital signs are as follows: blood pressure 70/38 mm Hg, heart rate
130/min, respiratory rate 24/min, temperature 39.4 °C.
Due to difficulty obtaining peripheral access, a central line is inserted. There is a lot of ongoing bleeding around the line insertion site. Her blood work shows:
White blood cell count: 19.8 × 10#/L (4-10)
Hemoglobin: 101 g/L (123-157)
Platelets: 85 × 10#/L (130-400)
Blood film: schistocytes
INR: 1.9 (0.9-1.2)
Fibrinogen: < 1 g/L (2-4)
Which one of the following is the most likely cause of her ongoing bleeding?

A) Heparin-induced thrombocytopenia.
B) Idiopathic thrombocytopenic purpura.
C) Disseminated intravascular coagulation.
D) Vitamin K deficiency.
E) Thrombotic thrombocytopenic purpura.

Solutions: