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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 40-year-old man presents to the emergency department with a 24-hour history of severe abdominal pain and recurrent vomiting. He has a long-term history of alcohol use disorder. His blood pressure is 90/60 mm Hg, and his heart rate is 120/min. The pain is located mostly in the epigastrium but radiates to the right upper quadrant and to his back. Radiographs of the abdomen and chest reveal some distended small bowel loops in his upper abdomen. Laboratory work results are pending. After fluid resuscitation, which one of the following is the best next step?

A) Sengstaken-Blakemore tube
B) Computed tomography
C) Ultrasonography
D) Immediate laparotomy
E) Upper gastrointestinal endoscopy

2. A 20-year-old woman from a remote northern community presents to the office with a 2-week history of malaise and a 2-day history of disabling pain in her left elbow. She had a sore throat 4 weeks ago. She also notes that she has had 2 weeks of pain and swelling in her right knee, followed by pain and swelling in her left elbow. On examination, you note 0.5-cm to 1-cm nodules just above both her elbows. You find no active joint swelling. An electrocardiogram shows a prolonged PR interval. Which one of the following is the most appropriate investigation?

A) Antistreptolysin O titre.
B) Pharyngeal culture.
C) Echocardiography.
D) Excisional biopsy of nodules.
E) Rheumatoid factor.

3. A 42-year-old man comes to your family practice. He has started seeing a reflexologist to help manage his chronic back pain. He presents to you a letter from the reflexologist outlining the weekly necessary treatments, each costing $300, and a list of blood tests for the patient to have done. The patient asks you to order the laboratory testing and send the results to his "other doctor." Which one of the following is the best next step?

A) Report the reflexologist to the medical regulatory authority.
B) Report the reflexologist to the regulatory authority for alternative and complementary practitioners.
C) Decline to order the tests but inquire further about his back pain.
D) Tell your patient to stop seeing this practitioner.
E) Order the tests and arrange to send them to the reflexologist.

4. An 80-year-old woman presents to your office with weight loss and generalized weakness. Her husband calls you after the appointment and asks that his wife not be told if she is diagnosed with cancer as hearing this will likely " kill her. " Investigations subsequently show that she has metastatic lung cancer. Which one of the following is the best next step?

A) Arrange an urgent consultation with her children to confirm her wishes.
B) Tell the patient she requires a computed tomography scan of the chest.
C) Tell her husband she has metastatic lung cancer.
D) Telephone her to inform her she has a bad pneumonia and prescribe antibiotics.
E) Book an immediate appointment with your patient.

5. A 60-year-old man is admitted to hospital, and lung cancer is diagnosed. When his family physician reviews the discharge summary, she reviews the patient's chart and finds a chest radiograph report from 1 year ago that mentions a suspicious nodule and recommends a computed tomography scan. The family physician recalls seeing this report and did not order the scan. Which one of the following is the family physician's best next step?

A) Discipline the office staff for not bringing the report to her attention.
B) Do not disclose at this time.
C) Communicate with the patient and arrange to disclose this information to him.
D) Forward the report to the oncology team that will be treating him.
E) Call the radiologist who issued the report and determine why the patient was not contacted directly.

Solutions: