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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. An 85-year-old man is transferred from an acute care hospital to your long-term care (LTC) facility. He has a fever, fatigue, myalgia, and malaise. His test result is positive for influenza A virus. Two other residents and 1 LTC staff member have experienced the same symptoms. Which one of the following is the best next step to prevent further infections at the LTC facility?

A) Ensure that all visitors are immunized.
B) Order symptomatic LTC staff to stay home.
C) Ask all visitors to wear a mask.
D) Enforce mandatory influenza vaccination for LTC staff.

2. A 63-year-old man presents to the office with a 2-year history of episodic swallowing problems that have been increasing in frequency. He states that food seems to stick in his throat, and these episodes are often associated with coughing or regurgitating undigested food. Physical examination reveals that the patient has halitosis; otherwise, findings are normal. Which one of the following is the best next step to confirm the most likely diagnosis?

A) Barium swallow.
B) 24-hour esophageal pH monitoring.
C) Trial of a proton pump inhibitor.
D) Computed tomography of the chest.
E) Endoscopy.

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

4. A 29-year-old woman, gravida 1, para 0, aborta 0, presents to your clinic. Her pregnancy is at 22 weeks' gestation. Her blood pressure is 158/96 mm Hg. Which one of the following antihypertensive medications is contraindicated for this patient?

A) Methyldopa
B) Labetalol
C) Ramipril
D) Hydralazine
E) Nifedipine

5. A 12-year-old boy is brought by his mother to your clinic with a history of attention-deficit/hyperactivity disorder. His mother reports that he has been taking immediate-release methylphenidate for 2 years. Although the medication was initially effective, it no longer seems to work. The teachers say he is disorganized and fidgety, verbally interrupts class, and does not complete his work. His mother tells you that he does listen at home. Which one of the following is the most important next step in management?

A) Switch the methylphenidate to atomoxetine and see the patient in 2 weeks.
B) Complete rating scales and increase methylphenidate.
C) Order an electroencephalogram.
D) Add risperidone and see the patient in 2 weeks.
E) Increase the methylphenidate and see the patient in 2 weeks.

Solutions: