Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 65-year-old woman presents to the office for follow-up regarding vaginal bleeding. Her last visit was 2 months ago. At that visit, the results of a pelvic examination and a Papanicolaou test were normal. She also had an endometrial biopsy but there was " insufficient material for diagnosis. " She reports that she is still losing small amounts of blood almost every day. On history, she has been taking continuous combined hormone replacement therapy for 10 years because of vasomotor symptoms. Which one of the following is the most appropriate next step in management?

A) Refer for a hysterectomy.
B) Decrease the dosage of progestin.
C) Organize a hysteroscopy.
D) Order a colposcopy.
E) Change hormones to a selective estrogen receptor modulator.

2. A 35-year-old woman presents to your clinic with double vision and a gritty sensation in her eyes for the past several weeks. On examination, you notice her eyes are bulging. There is inflammation of her conjunctivae and swelling around her eyes. Which one of the following is the most likely diagnosis?

A) Myasthenia gravis
B) Graves ophthalmopathy
C) Periorbital cellulitis
D) Orbital pseudotumor
E) Allergic conjunctivitis

3. A 42-year-old businessman known to have type 2 diabetes and ischemic heart disease is admitted to hospital with acute coronary syndrome. He admits to drinking 4 beers a day for the last 6 years and to binge drinking twice a year when his school buddies are in town. Your chart review reveals that he had a seizure secondary to alcohol withdrawal during his last admission. Which one of the following elements of his history puts him at highest risk of having another such seizure?

A) His binge drinking.
B) His previous episode of alcohol withdrawal.
C) The number of years he has consumed alcohol.
D) His medical comorbidities.
E) The quantity of alcohol he consumes daily.

4. A 56-year-old woman comes to your office because she has not been herself since her husband died in a car crash 6 weeks ago. She has no prior psychiatric history. Her son is concerned because she cries frequently, has a poor appetite, rarely leaves home and is distraught. Her sadness fluctuates and increases when she thinks of her husband. She often thinks about death, and she wishes she could join her deceased husband. Which one of the following is the best next step?

A) Admit to day hospital.
B) Refer to a social worker.
C) Arrange for family systems therapy.
D) Offer reassurance.

5. Your colleague ' s receptionist asks you to assess her 4-year-old daughter who has had 2 episodes of acute otitis media in the last month. The mother wants you to arrange a consultation with an ear, nose and throat (ENT) specialist to get a tympanostomy before her daughter starts school. You do not believe there is a surgical indication at this time. Which one of the following is the best next step?

A) Call the ENT consultant on call to discuss your dilemma.
B) Suggest that the next time they go to the Emergency Department for quicker access to the ENT consultant.
C) Explain that there is no indication for the surgery but refer her daughter for consultation.
D) Decline to send her daughter for consultation and explain your decision.
E) Ask another family physician to see the daughter due to a conflict of interest.

Solutions: