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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. 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) Anti-acetylcholine receptor antibodies
D) Folate
E) Hemoglobin A1c

2. A 25-year-old woman presents to the Emergency Department with a 2-hour history of pelvic pain associated with no other symptoms. The first day of her last menstrual period was 14 days ago. On examination, her vital signs are as follows:
Blood pressure
108/72 mm Hg
Heart rate
110/min
Temperature
37 °C
Abdominal examination reveals rebound tenderness and guarding. Pelvic examination reveals exquisite left adnexal tenderness. Which one of the following is the most likely diagnosis?

A) Hemorrhagic ovarian cyst
B) Adenomyosis
C) Endometriosis
D) Appendicitis
E) Diverticulitis

3. A 58-year-old woman presents with a 1-year history of functional decline. She reports seeing rodents and little children invading her bedroom. Her partner tells you she has a slow, unsteady gait and tends to fall. On examination, she cannot sustain her attention during cognitive testing. Which one of the following is most likely to be found on brain imaging?

A) Cerebellar atrophy
B) Bilateral frontal atrophy
C) Medio-temporal atrophy
D) Subdural hematoma
E) No structural abnormality

4. A 22-year-old woman is brought to the Emergency Department by her boyfriend, who says that she is experiencing a fentanyl overdose. She is unresponsive and cyanotic. She regains consciousness after naloxone is injected intravenously and demonstrates no further respiratory depression during 8 hours of observation.
She states that she is 22 weeks ' pregnant and wants to stop using opioids. Which one of the following is the best next step?

A) Admit the patient for medically supervised detoxification
B) Refer the patient for opioid use disorder counselling
C) Prescribe medications for symptom control so that the patient can detoxify at home
D) Refer the patient for initiation of methadone

5. A 37-year-old woman diagnosed with schizophrenia comes to her family physician because she has been choking on her food lately. She has a history of mild spasmodic dysphonia. She was recently started on haloperidol for auditory hallucinations. Which one of the following is the best short-term management?

A) Provide reassurance
B) Arrange for an urgent laryngoscopy
C) Start lorazepam
D) Change the haloperidol to quetiapine
E) Begin dantrolene

Solutions: