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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 55-year-old man presents to the Emergency Department with intractable nausea and vomiting. He is diaphoretic, tremulous and tachycardic. In a private conversation with his spouse, you learn that for the last several weeks, he has been drinking 1.2 L of vodka daily. On questioning, he says that since he retired, he has been drinking socially and plans to continue doing so. With respect to his alcohol use, which one of the following best describes the patient's current stage of change?

A) Precontemplation.
B) Action.
C) Preparation.
D) Contemplation.
E) Maintenance.

2. A 42-year-old man presents to your office with acute left knee pain and difficulty walking. He denies any trauma. He reports 2 painful episodes involving his right great toe in the last year. He smokes half a pack of cigarettes a day and drinks at least 3 beers daily. He has a temperature of 38.2°C and has a red, swollen and warm left knee. Which one of the following is the best next step?

A) Start acetaminophen.
B) Order blood cultures.
C) Aspirate the knee joint.
D) Order radiography of the knee.
E) Start indomethacin.

3. A 78-year-old man presents to the office with urinary hesitancy, straining to void his bladder, and a sensation of incomplete bladder emptying. On history, he has a BMI of 36 and type 2 diabetes. Which one of the following medications would most likely help the patient's symptoms?

A) Fesoterodine.
B) Empagliflozin.
C) Nitrofurantoin.
D) Tamsulosin.
E) Hydrochlorothiazide.

4. A 78-year-old woman is brought to the Emergency Department by her son because she has a sodium level of
124 mmol/L (136-146). The sodium was checked as part of a blood work panel ordered by her primary health care provider to investigate symptoms of urinary frequency, fatigue, and thirst. Today, she has a blood glucose level of 44.0 mmol/L (4.0-11.0). The original blood work done by her primary health care provider did not include glucose. The patient is treated for hyperglycemia and dehydration and begins insulin. The patient and her son repeatedly express their frustration that their primary health care provider missed the diagnosis. Which one of the following is the best next step?

A) Call the primary health care provider to alert them to their oversight
B) Explain that routine glucose screening was not indicated
C) Offer to find an alternate health care provider to assume the patient's primary care
D) Report the primary health care provider to the provincial or territorial medical regulatory authority
E) Empathize with the patient and her son and agree that the health care provider did not meet the standard of care

5. A 55-year-old woman presents with a 6-month history of poor memory and impaired concentration. She has bipolar I disorder that has been treated with lithium carbonate for 4 years. She has gained a lot of weight since starting lithium. Physical examination findings are otherwise normal. She is concerned about her memory issues, but there are no other perception, mood, or cognition abnormalities. Which one of the following tests is most likely to have abnormal findings?

A) Liver function tests
B) Creatinine clearance
C) Parathyroid hormone
D) Serum thyrotropin (thyroid-stimulating hormone) level
E) Serum sodium level

Solutions: