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Medical Council of Canada MCCQE Exam Syllabus Topics:

Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 42-year-old man presents to your office with acute left knee pain and difficulty walking. He denies any trauma. He reports 2 painful episodes involving his right great toe in the last year. He smokes half a pack of cigarettes a day and drinks at least 3 beers daily. He has a temperature of 38.2°C and has a red, swollen and warm left knee. Which one of the following is the best next step?

A) Aspirate the knee joint.
B) Start acetaminophen.
C) Start indomethacin.
D) Order blood cultures.
E) Order radiography of the knee.

2. A 79-year-old woman presents to the Emergency Department with sudden-onset severe chest and back pain that started 1 hour ago. She has a history of hypertension and looks unwell. Her vital signs are as follows:
blood pressure 168/108 mm Hg, heart rate 110/min, respiratory rate 22/min, temperature 36.7°C. Findings of a physical examination of the chest and abdomen are normal. An urgent computed tomography (CT) scan of the chest and abdomen shows an aortic dissection extending from the descending thoracic aorta to the upper abdominal aorta. The branches of the abdominal aorta are patent. Following initial resuscitation, which one of the following is the best next step?

A) Begin intravenous beta-blocker therapy.
B) Begin anticoagulation with heparin.
C) Start thrombolytic therapy.
D) Insert an intra-aortic balloon pump.
E) Immediate surgical repair.

3. A 65-year-old man presents to your clinic with a 2-month history of persistent erectile dysfunction. He reports having difficulties maintaining an erection. His last hemoglobin A1c level result was 6.4% (4.8-6.0). He had a negative result on his cardiac stress test 1 month ago. He has been taking stable dosages of citalopram, metformin, and ramipril for the past 2 years. His physical examination findings are normal, and his mood appears euthymic. Which one of the following investigations should be ordered before initiating treatment with sildenafil?

A) Prostate-specific antigen.
B) Echocardiography.
C) No further investigations.
D) Urine culture.
E) Complete blood count.

4. A 36-year-old woman, gravida 1, para 0, aborta 0, presents to the Labour and Delivery unit of a primary care hospital. She is at 40 weeks' gestation. She is having contractions and leaking fluid. She is fearful and does not want to deliver vaginally. Which one of the following is the best next step?

A) Offer to organize a cesarean delivery.
B) Ask a colleague for a second opinion.
C) Explain that a cesarean delivery is not an option.
D) Explore her concerns and explain pain management options.
E) Suggest intravenous analgesia.

5. A 16-year-old girl presents to the clinic with concerns about her toenails. The lesions, as shown in the attached image, have been present for 2 to 3 months. She is otherwise healthy and is in training for a triathlon.
Which one of the following is the best next step?

A) Recommend that the patient's running shoes provide adequate toe space.
B) Arrange for biopsy of the lesions.
C) Prescribe daily antifungal cream application.
D) Suggest that the patient avoid swimming pools and hot tubs.
E) Advise the patient to carefully wash and dry feet after all activity.

Solutions: