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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. An 18-year-old woman presents to the Emergency Department with a 3-day history of vomiting and right upper quadrant pain. She is alert but appears unwell and jaundiced. She was previously healthy and has not travelled recently. She has no risk factors for blood-borne pathogens. She denies hematemesis or hematochezia. On further history, she reports that she took a full bottle of pills that she found in her parents' medicine cabinet several hours before she started vomiting. Without intervention, which one of the following is the most likely outcome?

A) Acute renal failure
B) Fulminant hepatic failure
C) Ventricular fibrillation
D) Rapid-onset cerebral edema
E) Status epilepticus

2. You are examining a newborn in the delivery room. He was born at full term by spontaneous vaginal delivery.
On examination, he is active, and his vital signs are within normal range. His head circumference is at the third percentile, with height and weight at the 10th percentile. Auscultation of his chest is clear with normal cardiovascular examination findings. The abdomen is protuberant with a liver edge palpable at 4 cm below the costal margin and mild splenomegaly. Which one of the following is the most likely diagnosis?

A) Trisomy 21
B) Cephalic molding
C) Congenital viral infection
D) Lipid storage disease
E) Cystic fibrosis

3. You are providing medical care to a 78-year-old man and notice a skin lesion which you suspect is malignant melanoma. He has been living in a long-term care facility for 2 years because of incontinence, mobility and vision problems. He is well-liked by facility staff and residents, manages his own affairs and communicates clearly. He has designated his daughter to be his substitute decision-maker and has signed a Do Not Resuscitate (DNR) order. Which one of the following is the best next step in providing care to this patient for his skin lesion?

A) Perform a biopsy to ensure an accurate diagnosis before discussing diagnosis and treatment.
B) Ask him whether you can discuss your diagnosis and care with his daughter.
C) Discuss your tentative diagnosis with him and ask about his preferences regarding investigations.
D) Contact the daughter to inform her of your findings and discuss possible investigations.
E) Respect his DNR wishes, and do nothing about the skin lesion.

4. A 42-year-old woman presents with a 2-day history of a low-grade fever and a painful left breast mass. On examination, there is a fluctuant erythematous tender mass with surrounding induration in the left breast and enlarged lymph nodes in the left axilla. An ultrasound shows a loculated cystic mass. Which one of the following is the most likely diagnosis?

A) Abscess
B) Fibroadenoma
C) Ductal ectasia
D) Fibrocystic changes
E) Inflammatory breast cancer

5. You are meeting an otherwise healthy 10-year-old boy in your office for the first time. His BMI is at the 80th percentile. He has no symptoms and his physical examination is normal. Which one of the following is the best next step?

A) Thyroid function testing
B) Fasting lipid profile
C) No investigations
D) Morning serum cortisol
E) Hemoglobin A1c

Solutions: