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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 29-year-old man comes to the office for an initial visit. He is being treated for schizophrenia and epilepsy.
He has a 20 pack-year history of smoking. His medications are carbamazepine, clozapine, and quetiapine. In the past year, he has gained a considerable amount of weight. Aside from a BMI of 32, the results of his physical examination are unremarkable. Which one of the following conditions should he be investigated for?

A) Type 2 diabetes
B) Chronic obstructive pulmonary disease
C) Cushing disease
D) Sleep apnea
E) Acromegaly

2. You are treating a 78-year-old man for recent onset of diarrhea, tenesmus, and minor bleeding when he wipes.
He has a history of prostate cancer that was treated by radiotherapy. Rectal examination findings are normal.
Colonoscopy reveals a pale rectum with ulcerations and areas of mucosal hemorrhage. Which one of the following is the most likely explanation for this clinical presentation?

A) Ulcerative colitis
B) Diverticulosis
C) Radiation proctitis
D) Rectal cancer
E) Recurrent prostate cancer

3. A mumps outbreak is occurring in your community, with higher attack rates among post-secondary students.
Which one of the following is the most effective intervention?

A) Closing of the community's post-secondary institution.
B) Exclusion of clinical cases from the school and workplace.
C) Administration of immunoglobulin to contacts.
D) Exclusion of contacts from the school and workplace before symptoms develop.
E) Organization of clinics to rapidly treat suspected cases with antivirals.

4. A 56-year-old woman is admitted to hospital with gastrointestinal bleeding. Her hemoglobin level is low and the physician who saw her in the Emergency Department has recommended a blood transfusion. You attend her on the unit and tell her that a blood transfusion will help her feel better. Which one of the following is the best next step?

A) Give the patient a blood transfusion before her condition becomes unstable.
B) Review the patient's chart to see if she consented to transfusions in the past.
C) Ask a colleague to see the patient and make the same recommendation.
D) Discuss with the patient the potential risks and benefits of having a transfusion.
E) Withhold the transfusion to avoid any risk for liability.

5. You receive a note from a pharmacist about your 82-year-old patient who is taking oxycodone extended- release 20 mg 3 times daily for spinal stenosis. The pharmacist suggests that you consider tapering the medication. Your patient has been taking his current dosage for 1 year. When you saw him a month ago, he was functioning well with no adverse effects from the medication. Which one of the following is the best next step?

A) Reassess the patient.
B) Refer the patient to a pain specialist to help you decide on the best management.
C) Refer the patient for physiotherapy and acupuncture.
D) Prescribe a lower dosage of oxycodone.

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