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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 10-year-old boy and his mother present to your office with a concern about handwashing. The mother explains that her son has been at a new school for the past month and that teachers have noticed that he is washing his hands all day. He has also hidden hand sanitizer in his desk. The hand-cleaning is a response to a constant anxiety that his hands are dirty, and that he might pass an infection to someone. Which one of the following is the most appropriate initial management?

A) Risperidone 0.5 mg PO QHS.
B) Exposure and response prevention therapy.
C) Return to his previous school.
D) Recommendation of a teaching assistant.
E) Fluoxetine 20 mg PO OD.

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

3. A 62-year-old man (wealthy philanthropist) with emphysema from smoking and a 21-year-old woman (elementary teacher) with cystic fibrosis are both compatible matches for a lung transplant. Which criterion determines organ allocation?

A) The patient's value and contributions to society.
B) The patient has family members who rely on them for income.
C) Whether the underlying condition is due to self-induced illness.
D) The clinical severity of the patient's pulmonary disease.
E) The date the patient was placed on the waiting list.

4. An 88-year-old man is admitted to hospital with an upper gastrointestinal bleed. He is confused on admission, but his sensorium clears with resuscitation and stabilization. The patient lives in his own home with assistance from his children. Work-up shows metastatic gastric carcinoma for which no curative treatment can be offered. The family insists that the patient not be told the diagnosis because they fear he will have a "mental breakdown." Which one of the following is the best next step?

A) Accept the family's request and do not tell the patient the diagnosis.
B) Be direct and tell the patient the diagnosis.
C) Ask the patient if he wants to know the diagnosis.
D) Consult palliative care.

5. A previously well 2-year-old girl is brought to the Emergency Department with difficulty breathing that has been gradually worsening over the last 24 hours. Her parents say she has a sore throat. On examination, you note that she appears ill. She has stridor and is in moderate respiratory distress, drooling and emitting a muffled voice. Vital signs are as follows: respiratory rate 34/min, heart rate 160/min, temperature 40.2°C.

Which one of the following is the most likely diagnosis?

A) Acute viral bronchiolitis.
B) Retropharyngeal abscess.
C) Airway foreign body.
D) Laryngomalacia.
E) Croup.

Solutions: