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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 70-year-old woman presents to the Emergency Department with a 2-day history of dysuria and right flank pain. Upon arrival, she is quite unwell. Her vital signs are as follows: blood pressure 70/38 mm Hg, heart rate
130/min, respiratory rate 24/min, temperature 39.4 °C.
Due to difficulty obtaining peripheral access, a central line is inserted. There is a lot of ongoing bleeding around the line insertion site. Her blood work shows:
White blood cell count: 19.8 × 10#/L (4-10)
Hemoglobin: 101 g/L (123-157)
Platelets: 85 × 10#/L (130-400)
Blood film: schistocytes
INR: 1.9 (0.9-1.2)
Fibrinogen: < 1 g/L (2-4)
Which one of the following is the most likely cause of her ongoing bleeding?

A) Disseminated intravascular coagulation.
B) Idiopathic thrombocytopenic purpura.
C) Thrombotic thrombocytopenic purpura.
D) Vitamin K deficiency.
E) Heparin-induced thrombocytopenia.

2. A 77-year-old woman is brought to the Emergency Department by ambulance because she has severe heel ulcers and dehydration. Her husband reports that she has been sick for the past 6 to 8 weeks with a cough and congestion. He shares that he has tried to bring her to medical attention on several occasions, but she refused.
The paramedics reported that her bed at home was soiled and that they could hardly reach her room due to clutter. On questioning, her answers seem reasonable. Which one of the following is the most critical next step?

A) Find out whether the husband has a criminal record
B) Assess the risk of financial abuse by her husband
C) Assess the patient's decision-making ability
D) Obtain pictures to confirm the state of their house
E) Determine whether the patient has alcohol or substance use disorder

3. A 35-year-old maintenance worker presents to your office because he thinks he has been exposed to asbestos and is afraid of developing asbestosis. He has no respiratory symptoms and is a non-smoker. Which one of the following is the best next step?

A) Refer him to a respirologist.
B) Order pulmonary function testing.
C) Order a chest radiograph.
D) Ask him further about his work.
E) Provide reassurance, since he is asymptomatic.

4. A 32-year-old woman presents to the office and reports that she feels unwell and tired. She is worried about long-standing episodic diarrhea and vague abdominal discomfort. Laboratory investigations reveal a hemoglobin of 90 g/L (123-157), mean corpuscular volume of 75 fL (80-100), and serum ferritin level of 4 µg
/L (11-307). Which one of the following tests is most likely to produce a diagnosis?

A) Stool for culture and sensitivity.
B) Helicobacter pylori serology.
C) Immunoglobulin A tissue transglutaminase.
D) Total iron-binding capacity.
E) Fecal fat determination.

5. On screening for dyslipidemia, a 45-year-old man is found to have a low high-density lipoprotein (HDL) cholesterol level. Which one of the following recommendations is the most appropriate?

A) Vigorous exercise program.
B) Alcohol cessation.
C) Elimination of caffeine.
D) Low-salt diet.
E) Garlic supplementation.

Solutions: