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Medical Council of Canada MCCQE Part 1 Sample Questions:

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

2. A 94-year-old woman with severe dementia is referred for vaginal bleeding and a persistent foul odour from the vagina. She lives in a long-term care facility. She has been using a ring pessary for the past 15 years. Her current pessary has not been replaced in 2 years. On examination, there is moderate vaginal atrophy. After removing the pessary, which one of the following is the best next step?

A) Arrange for a hysteroscopy and endometrial biopsy.
B) Wash the pessary and recommend a daily saline douche.
C) Perform a vaginal biopsy.
D) Prescribe vaginal metronidazole gel.
E) Start vaginal estrogen.

3. A 10-year-old girl is brought to the Emergency Department by her mother because her daughter is crying and says she " can't pee. " Her daughter fell on the monkey bars at school earlier that day. On examination, there is a large vulvar bruise anteriorly. Which one of the following is the best next step?

A) Arrange a retrograde outpatient arthrography.
B) Consult gynecology if bladder catheterization is difficult.
C) Order complete blood count and coagulation studies.
D) Ask the mother to leave the room and ask the patient if someone abused her.
E) Discharge the patient home to do sitz baths.

4. A 26-year-old man presents with pain, numbness, and weakness in his right upper extremity. He works as a computer programmer, and his BMI is 32. Symptoms have worsened since he started spending more time on the keyboard. He reports that his right hand feels clumsier while he is typing. Physical examination reveals mild weakness in the intrinsic muscles of that hand, with a positive Tinel sign at the ulnar nerve. Which one of the following is the best next step?

A) Elbow extension brace for use during sleep.
B) Physiotherapy.
C) Nerve conduction studies to localize the level of the lesion.
D) Magnetic resonance imaging of the cervical spine.
E) Wrist splint to test for carpal tunnel.

5. A 62-year-old man (wealthy philanthropist) with emphysema from smoking and a 21-year-old woman (elementary teacher) with cystic fibrosis are both compatible matches for a lung transplant. Which criterion determines organ allocation?

A) The patient's value and contributions to society.
B) The patient has family members who rely on them for income.
C) Whether the underlying condition is due to self-induced illness.
D) The clinical severity of the patient's pulmonary disease.
E) The date the patient was placed on the waiting list.

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