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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 58-year-old woman presents to your office with refractory bipolar I disorder. She is on the following medications: lithium carbonate, valproic acid, and olanzapine. She also takes acetaminophen for osteoarthritis and pantoprazole for gastroesophageal reflux. Lately, she has noticed she bruises very easily. Laboratory work displays a platelet count of 70 × 10#/L (normal 130-400). Which one of the following is most likely to induce this side effect?

A) Olanzapine
B) Acetaminophen
C) Lithium carbonate
D) Pantoprazole
E) Valproic acid

2. A 71-year-old man with stable chronic low back pain on hydromorphone (8 mg twice daily) presents upset, requesting an early refill. He reports his granddaughter has been stealing his medication and pressuring him for refills. Which one of the following is the best next step?

A) Increase the dispensed quantity of the patient's hydromorphone.
B) Provide an early refill of hydromorphone.
C) Arrange for daily dispensing of hydromorphone.
D) Begin tapering the hydromorphone.
E) Call the police and report the patient's granddaughter.

3. A same-sex couple asks to join a family physician's practice. The physician tells them that shedoes not treat same-sex couples and will refer them to a physician with more clinical experience with same-sex couples.
Which one of the following best describes the physician's obligation under the Canadian Charter of Rights and Freedoms?

A) No obligation to accept this couple because of her right not to act in a manner contrary to her personal values.
B) No obligation to accept this couple because of her inexperience caring for same-sex patients.
C) An obligation to accept this couple, as not doing so constitutes discrimination based on sexual orientation.
D) No obligation to accept this couple, but does need to refer to a colleague who will.
E) An obligation to accept this couple as patients because physicians must treat all patients.

4. On screening for dyslipidemia, a 45-year-old man is found to have a low high-density lipoprotein (HDL) cholesterol level. Which one of the following recommendations is the most appropriate?

A) Low-salt diet.
B) Vigorous exercise program.
C) Garlic supplementation.
D) Elimination of caffeine.
E) Alcohol cessation.

5. A 62-year-old man, who has not seen a physician in 20 years, presents to your clinic with a burning sensation in his feet. The symptoms have been progressing slowly over the last 6 months. There is no associated motor weakness or skin changes. He reports no significant past medical history and takes no medications. His alcohol intake is minimal. On examination, he has reduced pinprick/vibration sensation and proprioception in the ankles with absent ankle reflexes. Which one of the following blood tests would you expect to be abnormal?

A) Uric acid
B) Ferritin
C) Folate
D) Hemoglobin A1c
E) Anti-acetylcholine receptor antibodies

Solutions: