Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 25-year-old woman presents to the Emergency Department with a 4-hour history of severe left flank pain.
Her vital signs are as follows:
Heart rate: 94/min
Blood pressure: 130/80 mm Hg
Temperature: 37.3 °C
A non-contrast computed tomography shows a 6 mm stone in the distal left ureter with mild associated hydronephrosis. In addition to appropriate analgesia, which one of the following is the best next step?

A) Administer an alpha blocker
B) Refer for urology consultation
C) Increase intravenous fluids
D) Provide reassurance
E) Prescribe antibiotics

2. A 35-year-old maintenance worker presents to your office because he thinks he has been exposed to asbestos and is afraid of developing asbestosis. He has no respiratory symptoms and is a non-smoker. Which one of the following is the best next step?

A) Order a chest radiograph.
B) Provide reassurance, since he is asymptomatic.
C) Order pulmonary function testing.
D) Refer him to a respirologist.
E) Ask him further about his work.

3. Following a potluck supper organized by the residency director of your training program, many of your fellow residents and other guests fall ill with gastroenteritis. Which one of the following is the best way to identify the source of this food-borne outbreak?

A) Perform a cohort study
B) Culture the stool of guests
C) Calculate food-specific attack rates
D) Culture leftover food samples
E) Perform a hazard analysis of critical control points

4. A 72-year-old woman is brought to the Emergency Department by her daughter because of significant functional decline and progressive shortness of breath. She has widespread metastatic breast cancer and recently stopped chemotherapy due to progression and intolerance. She has been bedridden for 4 weeks. On examination:
BP: 100/70 mm Hg with pulsus paradoxus of 20 mm Hg
HR: 99/min
Temp: 36.5°C
SpO#: 94% room air
JVP: elevated
Heart sounds: muffled
Chest X-ray: large globular heart
Labs:
Hemoglobin: 90 g/L
Sodium: 118 mmol/L
Creatinine: 94 µmol/L
Which one of the following is the best next step?

A) Discussion on goals of care
B) Blood transfusion
C) Pericardiocentesis
D) Normal saline infusion
E) Consult with the Intensive Care Unit

5. A 37-year-old man presents with chronic back, neck, and shoulder pain following a workplace injury 4 years ago. He has a history of alcohol misuse and PTSD related to the incident. Current medications (acetaminophen, naproxen, amitriptyline, gabapentin) provide inadequate pain relief. He requests oxycodone after self-trialing it with temporary benefit. After history and physical assessment, which one of the following is the best next step?

A) Referring the patient to substance use and mental health support services.
B) Ordering repeat imaging of the spine and shoulder to confirm the diagnosis.
C) Prescribing cannabis.
D) Prescribing a low-dose, long-acting opioid and reassessing in 1 week for effectiveness.
E) Prescribing a short course of a short-acting opioid to be used only as needed.

Solutions: