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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 1-month-old boy is brought to your clinic after being born with asymmetric intrauterine growth restriction (third percentile at birth). He was born at 36 weeks' gestation. He has been breastfeeding well and continues to grow around the third percentile. Which one of the following would be the best next step?

A) Caloric-fortified feeding.
B) High-dose vitamin D supplementation.
C) Switch to a hydrolyzed formula.
D) Early introduction of solid foods.

2. You are providing medical care to a 78-year-old man and notice a skin lesion which you suspect is malignant melanoma. He has been living in a long-term care facility for 2 years because of incontinence, mobility and vision problems. He is well-liked by facility staff and residents, manages his own affairs and communicates clearly. He has designated his daughter to be his substitute decision-maker and has signed a Do Not Resuscitate (DNR) order. Which one of the following is the best next step in providing care to this patient for his skin lesion?

A) Respect his DNR wishes, and do nothing about the skin lesion.
B) Ask him whether you can discuss your diagnosis and care with his daughter.
C) Perform a biopsy to ensure an accurate diagnosis before discussing diagnosis and treatment.
D) Contact the daughter to inform her of your findings and discuss possible investigations.
E) Discuss your tentative diagnosis with him and ask about his preferences regarding investigations.

3. A 62-year-old woman is referred to your clinic for evaluation of hypercalcemia. She has a history of hypertension and vitamin D deficiency. Her medications include hydrochlorothiazide and vitamin D supplements. Laboratory investigations are as follows:
Calcium: 2.72 mmol/L (#)
Phosphate: 0.9 mmol/L (#)
Parathyroid hormone (PTH): 0.9 pmol/L (#)
25-hydroxy vitamin D: 80 nmol/L (normal)
Which one of the following is the best next step?

A) Order serum protein electrophoresis and urine for light chains
B) Refer for consideration of parathyroidectomy
C) Start calcitriol
D) Switch to a different antihypertensive medication
E) Order 24-hour urine calcium

4. A 35-year-old woman presents to your clinic for follow-up regarding her persistent primary immune thrombocytopenic purpura. She was admitted to hospital with a relapse and received treatment with dexamethasone, intravenous immunoglobulin, and rituximab. She was recently discharged from hospital with a platelet count of 55 × 10#/L (130-360), and also continues to take 10 mg of prednisone once daily. She is scheduled for a splenectomy in 4 weeks. Which one of the following is the best next step in preparation for the patient ' s surgical procedure?

A) Transfuse 5 units of platelets 1 week preoperatively
B) Arrange for preoperative vaccination
C) Start calcium and vitamin D supplementation
D) Stop prednisone 2 weeks preoperatively
E) Prescribe daily azithromycin 1 week preoperatively

5. A 72-year-old woman presents with swelling of her right leg that developed overnight. She had an abdominal hysterectomy 10 days ago. On examination, there is pitting edema of the leg that extends from the foot to the groin. The calf is 3 cm larger in diameter than the calf on the left leg. Which one of the following is the most likely diagnosis?

A) Inadvertent ligation of the iliac vein.
B) Superficial thrombophlebitis.
C) Iliofemoral vein thrombosis.
D) Angioedema of the leg.
E) Phlegmasia cerulea dolens.

Solutions: