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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 54-year-old woman presents to your office to discuss breast cancer screening. She is asymptomatic with no history of breast cancer. She had a fibroadenoma removed when she was 24 years old. The patient is not on any medications. Her family history is significant for a great-aunt with breast cancer. The patient has not had genetic testing but had normal breast screening 2 years ago. Which one of the following is the best next step?

A) Breast magnetic resonance imaging.
B) Mammography.
C) Monthly self-breast examination.
D) Reassurance.
E) Positron emission tomography scan.

2. While covering for a colleague away on holidays, you receive the following laboratory results for one of her patients, a 24-year-old woman:
White blood cell count: 10 × 10#/L (4-10)
Hemoglobin: 80 g/L (123-157)
Mean corpuscular volume: 76 fL (80-100)
Platelet count: 150 × 10#/L (130-400)
You have arranged a follow-up appointment for the patient with your colleague. Which one of the following is the most likely diagnosis?

A) Iron deficiency anemia.
B) Anemia of chronic disease.
C) Thalassemia.
D) Leukemia.
E) Myelodysplasia.

3. You are asked to see a 34-year-old patient at his long-term care facility for a 2-day history of fever. You diagnose a urinary tract infection. He has multiple sclerosis diagnosed 5 years ago and has lived in this long- term care facility for the past 2 years. He is bedbound and has an indwelling urinary catheter. For the past 3 months, he has been non-communicative. Prior to this, he had made it clear that he did not want any life- prolonging measures. Which one of the following is the best next step?

A) Start antibiotics while waiting to contact the family.
B) Transfer him to the hospital.
C) Change his urinary catheter.
D) Call his family to consider antibiotics.
E) Prescribe antipyretics.

4. A 21-year-old man presents to the Emergency Department with a 6-month history of unusual behavior. He believes that he has been specially chosen to found a new religion. He says he has seen visions of angels in his bedroom. He appears disheveled and malodorous. On further inspection, you note that he drinks 2 liters daily.
Which one of the following is the most appropriate initial management?

A) Carbamazepine
B) Valproic acid
C) Electroconvulsive therapy
D) Cognitive behavior therapy
E) Risperidone

5. An 87-year-old man presents with a 2-week history of stiffness in both shoulders and both hips. On further questioning, he tells you that he has experienced a 2 kg unintentional weight loss over the last month. His past medical history is otherwise unremarkable and he is on no medications. On examination, he has limited range of motion due to pain in his shoulders and hips. The remainder of his examination, including muscle strength and joint exam, is normal. Which one of the following will you specifically ask about regarding his history?

A) Night sweats
B) Anhedonia
C) Unilateral headache
D) Tremor
E) Recent diarrheal illness

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