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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 31-year-old man presents to the office with concerns about his heart. Three months ago, his father died of a myocardial infarction at age 58 years. He states that since the death of his father, he has experienced episodes in which his heart will start racing, causing him to feel short of breath, dizzy, and nauseous. He is afraid that he will die during these episodes. Findings from a physical examination, electrocardiogram, Holter monitoring, echocardiogram, and complete blood count are normal. Serum electrolyte level, troponin level, and thyroid function studies are all within normal limits. Which one of the following options is the most appropriate?

A) Metoprolol
B) Lorazepam at bedtime
C) Grief therapy
D) Cardiac stress test

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

3. A 30-year-old man comes to the office and asks you to write him a note for his employer that recommends a stress leave. He says he feels entitled to a rest. He comes across as irritable and impulsive. He appears to show little regard for the law and admits to recently embezzling $5,000 from his employer. He justifies his actions and shows no remorse. He has a history of attention-deficit/hyperactivity disorder as a child. Which one of the following is the most likely diagnosis?

A) Bipolar II disorder.
B) Antisocial personality disorder.
C) Klinefelter syndrome.
D) Narcissistic personality disorder.
E) Borderline personality disorder.

4. A 38-year-old marathon runner presents to your office with a 6-month history of increasing right hip pain.
The pain is worse with acclivity and has prevented him from running for the last 4 months. He denies fever or chills. His wife adds that she is concerned because he is increasingly disengaged with the family and not interested in other activities he usually enjoys, including sex. Which one of the following is the best next step in management?

A) Further inquiry into depressive symptoms.
B) Magnetic resonance imaging of the pelvis and right hip.
C) Physiotherapy for hip strengthening.
D) Short course of anti-inflammatory medications.
E) Blood work including inflammatory markers.

5. A 26-year-old woman, gravida 2, para 1, presents with a positive pregnancy test. Her previous pregnancy was associated with preeclampsia, and she delivered a 1000 g boy at 34 weeks' gestation. Her blood pressure is 130
/86 mm Hg. Which one of the following is the best recommendation for this pregnancy?

A) Accurate dating by ultrasound.
B) Prophylactic labetalol.
C) Complete bed rest starting at 20 weeks' gestation.
D) Amniocentesis for karyotyping.
E) Genetic assessment and counseling.

Solutions: