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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 63-year-old woman presents to your office with a history of progressive abdominal discomfort over the past five months. She reports bloating and difficult digestion with constipation. She has no urinary symptoms and denies vaginal or rectal bleeding. An abdominal ultrasound shows a large complex pelvic mass with internal multiloculation and moderate ascites. The cancer antigen 125 (CA 125) is elevated at 1023 U/mL ( < 35 U
/mL). Which one of the following is the most likely diagnosis?

A) Ovarian hyperstimulation syndrome
B) Serous carcinoma of the ovary
C) Rectosigmoid adenocarcinoma
D) Metastatic uterine adenocarcinoma
E) Chronic hematosalpinx

2. A 59-year-old woman comes to the office because her 48-year-old sister was recently diagnosed with cervical cancer. Your patient thinks her mother may have also had cervical cancer. A Papanicolaou (Pap) test performed 16 months ago had normal results, as did all previous Pap tests. Which one of the following is the best next step?

A) Arrange for colposcopy.
B) Offer a repeat Pap test 3 years from the previous one.
C) Offer a repeat Pap test now.
D) Offer annual Pap testing for the next 5 years.
E) Arrange for human papillomavirus testing.

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

4. A 24-year-old woman with chronic anorexia nervosa presents to the Emergency Department with diarrhea, chest pain and palpitations. She is noted to have a BMI of 13, a heart rate of 48/min, significant orthostatic hypotension and a temperature of 35.9 °C. Her electrocardiogram shows frequent premature ventricular contractions. Her blood work indicates elevated liver transaminases and evidence of acute kidney injury from dehydration. She agrees to admission for medical stabilization only if she does not receive fluids either orally or intravenously, as they will cause her to gain weight and to feel bloated. Which one of the following is the best next step?

A) Start intravenous fluids and physically restrain if necessary
B) Assess her capacity to consent for medical treatment
C) Ask her if she has a substitute decision-maker
D) Obtain a psychiatric consultation
E) Refuse to admit her unless she agrees to full treatment

5. A 55-year-old man presents to the Emergency Department with intractable nausea and vomiting. He is diaphoretic, tremulous and tachycardic. In a private conversation with his spouse, you learn that for the last several weeks, he has been drinking 1.2 L of vodka daily. On questioning, he says that since he retired, he has been drinking socially and plans to continue doing so. With respect to his alcohol use, which one of the following best describes the patient's current stage of change?

A) Maintenance.
B) Contemplation.
C) Action.
D) Precontemplation.
E) Preparation.

Solutions: