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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 39-year-old man presents to your clinic 4 months after a motor vehicle collision. He is trying to return to work but is having a difficult time because his job requires him to drive. He used to love his job, but he is worried about going back because every time he gets into a car, he is filled with dread, gets dizzy, and feels faint. He has regular nightmares about the incident. Which one of the following is the most likely diagnosis?

A) Generalized anxiety disorder.
B) Panic disorder.
C) Malingering.
D) Posttraumatic stress disorder.

2. A 76-year-old man is brought to the emergency department in an unresponsive state. He has a history of chronic kidney disease with a baseline serum creatinine level of 300 µmol/L (49-93) and a history of dilated cardiomyopathy with an ejection fraction of 30%. On assessment, he has no pulse or blood pressure. Cardiac monitor demonstrates a wide complex tachycardia. Which one of the following recently started medications is the most likely cause of this arrhythmia?

A) Spironolactone
B) Metoprolol
C) Clopidogrel
D) Diltiazem
E) Hydrochlorothiazide

3. A 45-year-old woman presents to your clinic for follow-up regarding her asthma. She is planning to attend a cultural event that includes ceremonial burning of tobacco. Which one of the following is the best next step?

A) Update the chart to indicate that the patient smokes.
B) Advise the patient to avoid tobacco exposure.
C) Ask if tobacco smoke triggers the patient's asthma.
D) Counsel the patient on the health effects of tobacco.

4. An 85-year-old woman who is your patient has advanced metastatic lung cancer. You are visiting her at her home for palliative care. She has previously indicated to you and her family that she hoped to die at home and that comfort is her priority. She is now weak to get out of bed and has had no oral intake for 2 days. She is confused most of the time, with brief lucid episodes. Despite attentive symptom management, her family reports that she is suffering and asks that you increase her medications to expedite her death. Which one of the following is the best next step?

A) Acknowledge the family ' s distress and offer support.
B) Obtain written consent from the family to expedite the patient ' s death.
C) Add midazolam to ensure the patient is completely sedated.
D) Contact the regional medical assistance in dying (MAID) team to assist in the family ' s request.

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

Solutions: