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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 2.5-year-old boy is brought to the Emergency Department after he consumed a button-shaped battery. Chest and abdomen radiographies are performed. Which one of the following locations mandates urgent removal of the battery?

A) Esophagus
B) Ileum
C) Duodenum
D) Stomach
E) Jejunum

2. A 24-year-old woman has had several episodes of left lower lobe pneumonia. She has a chronic productive cough with occasional blood-streaked sputum. Physical examination is normal except for rales at the left base.
Chest radiograph shows a linear infiltrate in this area. Which one of the following is the most likely diagnosis?

A) Pulmonary infarction
B) Mitral stenosis
C) Bronchiectasis
D) Chronic bronchitis
E) Pulmonary tuberculosis

3. A 40-year-old woman has not left her house for 6 months. She says that she is trying to avoid the intense anxiety, palpitations, tremors, sweating, dizziness, choking sensation, and breathlessness that develops when she leaves home. Which one of the following is the best next step?

A) Hospitalization for observation.
B) Encouragement to take walks of increasing distance.
C) Reassurance that this is not a serious disorder.
D) Prescription of chlorpromazine in moderate doses.
E) A trial of lithium carbonate.

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

5. A 70-year-old woman presents to the Emergency Department with a 2-day history of dysuria and right flank pain. Upon arrival, she is quite unwell. Her vital signs are as follows: blood pressure 70/38 mm Hg, heart rate
130/min, respiratory rate 24/min, temperature 39.4 °C.
Due to difficulty obtaining peripheral access, a central line is inserted. There is a lot of ongoing bleeding around the line insertion site. Her blood work shows:
White blood cell count: 19.8 × 10#/L (4-10)
Hemoglobin: 101 g/L (123-157)
Platelets: 85 × 10#/L (130-400)
Blood film: schistocytes
INR: 1.9 (0.9-1.2)
Fibrinogen: < 1 g/L (2-4)
Which one of the following is the most likely cause of her ongoing bleeding?

A) Thrombotic thrombocytopenic purpura.
B) Disseminated intravascular coagulation.
C) Heparin-induced thrombocytopenia.
D) Idiopathic thrombocytopenic purpura.
E) Vitamin K deficiency.

Solutions: