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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 27-year-old woman presents to her family physician ' s office and states that she is pregnant and would like to be referred for an abortion. She is at approximately 9 weeks ' gestation by dates. The family physician has personal conscience-based objections to the procedure. Which one of the following would be the best next step for this physician?

A) Refer the patient to another physician
B) Ask the patient to return in 2 weeks to give her time to consider her options
C) Recommend that the patient consider adoption
D) Explain their personal views about therapeutic abortion to the patient

2. A 45-year-old man with confusion is brought to the Emergency Department by ambulance. He has end-stage renal disease and has missed his last 3 dialysis appointments. He also has a past medical history of antisocial personality disorder and hepatitis C. On examination, he is in respiratory distress. His blood pressure is 170
/90 mm Hg, and his oxygen saturation is 84% on room air. His jugular venous pressure is 8 cm above the sternal angle, and he has crackles in his lungs bilaterally. A venous blood gas shows a bicarbonate of 11 mmol
/L (24-30) and potassium of 7.1 mmol/L (3.5-5.0). Which one of the following is the best next step?

A) Start urgent dialysis.
B) Discuss with his nephrologist the reasons why he missed his dialysis appointments.
C) Attempt to contact his family for consent to start dialysis.
D) Call psychiatry to evaluate his capacity to consent.
E) Prescribe morphine and furosemide.

3. A 6-year-old girl is found to have a blood pressure of 130/75 mm Hg. She was born prematurely at 32 weeks ' gestation and required ventilation. There is a family history of hypertension in 3 grandparents. Clinical examination reveals a grade 1/6 mid-systolic murmur, no renal bruits, and femoral pulses are difficult to feel.
Which one of the following is the most likely diagnosis?

A) Renal artery thrombosis
B) Aortic coarctation
C) Essential hypertension
D) Ventricular septal defect
E) Reflux nephropathy

4. An 80-year-old man is admitted to hospital with what turns out to be tuberculosis. The attending physician informs all staff at the hospital of the patient ' s identity and diagnosis. Which one of the following best describes privacy concerns in this situation?

A) Attending physicians may not disclose a patient ' s private health information to protect others.
B) Physicians ought only to reveal minimal patient-related information needed to protect others.
C) The patient must give consent before others are told of his illness.
D) The patient is not owed a right to privacy as he is a risk to others.
E) Physicians cannot be held liable if there is a breach of patient privacy.

5. A 65-year-old man presents to your clinic with a 2-month history of persistent erectile dysfunction. He reports having difficulties maintaining an erection. His last hemoglobin A1c level result was 6.4% (4.8-6.0). He had a negative result on his cardiac stress test 1 month ago. He has been taking stable dosages of citalopram, metformin, and ramipril for the past 2 years. His physical examination findings are normal, and his mood appears euthymic. Which one of the following investigations should be ordered before initiating treatment with sildenafil?

A) Prostate-specific antigen.
B) Echocardiography.
C) No further investigations.
D) Urine culture.
E) Complete blood count.

Solutions: