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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 33-year-old primigravid woman presents to the office with gestational hypertension. Her pregnancy is at 37 weeks' gestation. The ultrasound findings are as follows:
Head circumference: 5th percentile
Biparietal diameter: 10th percentile
Abdominal circumference: 5th percentile
Femur length: 25th percentile
Amniotic fluid volume: 5.0 cm
Umbilical Doppler: Reversed end-diastolic flow
Which one of the following is the best next step?

A) Induction of labour on the due date.
B) Immediate delivery.
C) Biophysical profile in 1 week.
D) Biometry in 2 weeks.
E) Twice-weekly nonstress tests.

2. A 3-year-old boy is brought to the office because he has progressive weight gain and short stature. He has marked truncal obesity, hypertrichosis of the upper lip, and facial swelling. Which one of the following is a physical examination most likely to reveal?

A) Thyroid goiter
B) Hypertension
C) Acanthosis
D) Hepatomegaly
E) Cafe-au-lait spots

3. A 12-year-old boy is brought by his mother to your clinic with a history of attention-deficit/hyperactivity disorder. His mother reports that he has been taking immediate-release methylphenidate for 2 years. Although the medication was initially effective, it no longer seems to work. The teachers say he is disorganized and fidgety, verbally interrupts class, and does not complete his work. His mother tells you that he does listen at home. Which one of the following is the most important next step in management?

A) Order an electroencephalogram.
B) Switch the methylphenidate to atomoxetine and see the patient in 2 weeks.
C) Increase the methylphenidate and see the patient in 2 weeks.
D) Complete rating scales and increase methylphenidate.
E) Add risperidone and see the patient in 2 weeks.

4. An 84-year-old woman is brought by ambulance to the emergency department after she was found by a neighbour. She had fallen, sustained a hip fracture, and was unable to move for the past 2 days. After starting rehydration, she reports hip pain and numbness and tingling in both her legs. Physical examination reveals faint pulses in both legs and severely swollen lower legs that are painful to palpation. The urine in the Foley catheter bag seems to be darker than normal. Which one of the following is the best next step?

A) Compartment pressure measurements of the lower legs.
B) Bilateral angiography of the lower legs.
C) Surgical fixation of the patient ' s hip fracture.
D) Myoglobin urine test.
E) Bilateral Doppler ultrasonography of the legs.

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

Solutions: