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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 38-year-old woman presents with diffuse nodularity in the outer upper quadrant of her right breast. There is no obvious dominant mass, nipple discharge, or skin dimpling. There are no palpable lymph nodes. Which one of the following is the most likely diagnosis?

A) Fibrocystic change
B) Paget disease
C) Intraductal carcinoma
D) Benign phyllodes tumour
E) Mastitis

2. A 3-week-old boy is brought by his parents to your clinic for a well-child visit. The newborn was born at term after an uncomplicated pregnancy. He is exclusively breastfed and is thriving. Physical examination findings are normal except for jaundice. Total bilirubin is 172 #mol/L (#100), and conjugated bilirubin is 4 #mol/L (#5). Results of a complete blood count and reticulocyte count are within the normal range. The results of a direct antiglobulin (Coombs) test were negative. Which one of the following, if any, is the most appropriate investigation?

A) Urine culture.
B) Test for galactosemia.
C) Liver enzymes and serum albumin.
D) No investigation required.
E) Hepatobiliary ultrasonography.

3. A 26-year-old man presents to the office with a tender mass in his right neck. He was recently treated for a dental infection but is otherwise well. On examination, there is a 2-cm tender, mobile lymph node in the right anterior cervical chain. No other lymphadenopathy or abnormalities are found on physical examination.
Which one of the following is the best next step?

A) Follow-up in 8 weeks
B) Ultrasonography of the spleen
C) Bone marrow biopsy
D) Lymph node biopsy
E) Computed tomography of the neck

4. A 26-year-old man presents to your office with fever, chills, and malaise. Aside from an episode of dysuria 8 weeks ago, which spontaneously resolved, he has been healthy. On examination, his left wrist and right ankle are tender. There is a cluster of vesiculopustular lesions on his right hand. Which one of the following is the most likely diagnosis?

A) Rheumatoid arthritis
B) Reactive arthritis
C) Primary HIV infection syndrome
D) Varicella
E) Disseminated gonococcemia

5. A 32-year-old woman, gravida 0, comes to your office for contraception counselling, specifically about insertion of a levonorgestrel-releasing intrauterine device. She has a past history of breast cancer and is presently on tamoxifen. Which one of the following is the best advice for your patient?

A) She has a high risk of irregular bleeding following insertion
B) She will require pre-procedure antibiotics
C) It may increase her risk of breast cancer recurrence
D) After consultation with her oncologist, she may choose this option
E) This device will increase her risk of future infertility

Solutions: