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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 24-year-old man presents to your clinic with a 6-month history of fatigue. On examination, he is pale. His BMI is 16, and his blood pressure is 92/58 mm Hg. Initial laboratory work shows the following:
Creatinine: 64 µmol/L (49-93)
Potassium: 3.0 mmol/L (3.5-5.1)
Sodium: 138 mmol/L (136-146)
TSH: 2.40 mIU/L (0.34-5.60)
CBC: Normal
Which one of the following is the best next step?

A) Refer the patient to the emergency department
B) Consult gastroenterology
C) Advise increased caloric intake
D) Ask permission to discuss the patient's weight

2. An 18-year-old woman comes to the office because of fatigue. She tells you she is struggling in her first year of university. She mentions that she spends much of her time rewriting her notes and filing and organizing her study materials. She is doing all the work in her group assignments because she feels others cannot do the work to a high enough standard. She has abandoned all enjoyable activities and seems to be constantly working and worrying about her grades. Which one of the following is the most likely diagnosis?

A) Obsessive-compulsive personality disorder.
B) Major depressive disorder.
C) Generalized anxiety disorder.
D) Obsessive-compulsive disorder.

3. A 32-year-old primigravid woman is receiving magnesium sulfate for tocolysis. Her pregnancy is at 26 weeks
' gestation. You suspect magnesium sulfate toxicity. Which one of the following is the first sign of magnesium sulfate toxicity?

A) Absent patellar reflexes
B) Tachycardia
C) Hypotension
D) Tachypnea
E) Oliguria

4. A 62-year-old woman is referred to your clinic for evaluation of hypercalcemia. She has a history of hypertension and vitamin D deficiency. Her medications include hydrochlorothiazide and vitamin D supplements. Laboratory investigations are as follows:
Calcium: 2.72 mmol/L (#)
Phosphate: 0.9 mmol/L (#)
Parathyroid hormone (PTH): 0.9 pmol/L (#)
25-hydroxy vitamin D: 80 nmol/L (normal)
Which one of the following is the best next step?

A) Refer for consideration of parathyroidectomy
B) Order 24-hour urine calcium
C) Switch to a different antihypertensive medication
D) Order serum protein electrophoresis and urine for light chains
E) Start calcitriol

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

Solutions: