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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 24-year-old man is brought to the Emergency Department by ambulance with a severe pelvic fracture from a motor vehicle collision. After resuscitation and stabilization, he is noted to have a bloody penile discharge.
Which one of the following is the best next step?

A) Transrectal ultrasound.
B) Sonography of penis.
C) Foley catheter and continuous bladder irrigation.
D) Retrograde urethrography.
E) Voiding cystography.

2. A new patient, a 19-year-old man, presents to your office with low back pain. He has a history of opioid dependence and is now on a methadone maintenance treatment program. He is requesting opiate analgesics.
After examination, you decide not to prescribe opiates for pain control. The patient gets upset and threatens to file a complaint with your licensing authority. Which one of the following is the best next step?

A) Call the police to have the patient removed from the office.
B) Give a single opiate injection.
C) Prescribe a small amount of oral opiate.
D) Send him for a lumbar spinal radiography.
E) Direct him to his methadone management program.

3. An 88-year-old married man is admitted following a cardiac arrest at home. He was not expected to recover, and after 2 weeks, he remains in a coma. His wife states, " I cannot let him go. That would be murder. " As the attending physician looking after her husband, which one of the following is the best next course of action?

A) Remove him from life support as this would not be murder
B) Seek advice from the provincial or territorial public guardian
C) Encourage her to imagine what her husband would have wanted
D) Say nothing further and wait until she comes around to accepting his state
E) Emphasize that the duration of his stay in the Intensive Care Unit will be limited

4. An otherwise healthy 43-year-old woman presents to your clinic for a left breast mass. Six months ago, she underwent a bilateral breast magnetic resonance imaging (MRI) after watching a television program on breast cancer prevention. An ultrasound-guided biopsy of a 1.5 cm mass confirmed, at the time, that she had fibroadenoma. The follow-up ultrasound now reveals a mass measuring 1.7 cm. Which one of the following is the best next step in the management of this patient?

A) Reassure the patient and reassess in 12 months.
B) Proceed with needle-localized left lumpectomy.
C) Order a MRI of both breasts to rule out anything else.
D) Administer prophylactic tamoxifen to decrease the risk of cancer.
E) Repeat the biopsy to confirm the diagnosis.

5. 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) Hepatobiliary ultrasonography.
C) Test for galactosemia.
D) No investigation required.
E) Liver enzymes and serum albumin.

Solutions: