Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 24-year-old man presents to your clinic with a 6-month history of fatigue. On examination, he is pale. His BMI is 16, and his blood pressure is 92/58 mm Hg. Initial laboratory work shows the following:
Creatinine: 64 µmol/L (49-93)
Potassium: 3.0 mmol/L (3.5-5.1)
Sodium: 138 mmol/L (136-146)
TSH: 2.40 mIU/L (0.34-5.60)
CBC: Normal
Which one of the following is the best next step?

A) Advise increased caloric intake
B) Ask permission to discuss the patient's weight
C) Consult gastroenterology
D) Refer the patient to the emergency department

2. You are working in a busy family practice. Your colleague ' s 48-year-old female patient presents with a 6- month history of fatigue and gastrointestinal symptoms. A recent colonoscopy was normal. Her chart indicates multiple investigations for similar symptoms over the past 2 years, all of which have been non- revealing. Your working diagnosis is somatic symptom disorder. Which one of the following is the most appropriate treatment?

A) Exposure and response prevention therapy
B) Risperidone 0.5 mg daily
C) Citalopram 20 mg daily
D) Cognitive behavioral therapy
E) Amitriptyline 10 mg at bedtime

3. A 43-year-old man comes to your office for the first time. He has not seen a doctor in over 5 years and has no known past medical history. On examination, his blood pressure is 120/70 mm Hg, and the remainder of his examination is normal. As part of the initial visit, you order some screening blood work that reveals a fasting blood glucose of 6.3 mmol/L (3.3-5.8) and a hemoglobin A1c of 6.1% (4-6). Which one of the following is the best next step?

A) Order a urine albumin:creatinine ratio.
B) Test capillary blood glucose 4 times a day.
C) Order thyrotroph (thyroid-stimulating hormone) level.
D) Perform a 75 g oral glucose tolerance test.
E) Order an exercise stress test.

4. A 17-year-old boy is brought by his 2 roommates to the emergency department (ED) after a party where he had been drinking and smoking cannabis. He reportedly was having a good time when he suddenly wanted to jump out of a window. His roommates describe him as "normal prior to a breakup with his girlfriend a week ago." He has since become anxious and unable to sleep. On examination, he is somnolent and appears intoxicated. Which one of the following is the most appropriate initial management?

A) Arrange for an involuntary admission to psychiatry.
B) Observe the patient in the ED for several hours.
C) Call the patient's parents to take him home.
D) Prescribe chlordiazepoxide and start an intravenous line.

5. One of your patients presents to your clinic for a consultation regarding their recurrent hemoptysis. On review of their chart, you realize that although you had ordered chest radiography 2 months ago, the result cannot be found in the chart. You call the radiology department and are relieved to find that the chest radiography was done and that it did not reveal any pathology. After informing the patient of this lapse in reporting, which one of the following is the best next step?

A) Review your clinic ' s filing procedures and make any needed improvements.
B) Remind the patient that they are responsible for calling for outstanding test results.
C) Send a letter of complaint to the radiology department for not sending a report.
D) Reassure the patient that this is a rare occurrence in your clinic.

Solutions: