Medical Council of Canada MCCQE Questions Answers

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Medical Council of Canada MCCQE Sample Questions

Question # 1

You perform a literature search of journal articles on the effectiveness of a newantihypertensive for first-line treatment of people aged 35 to 50. You find reports of 4 goodquality studies. Three of them show that statistically, the new drug is significantly moreeffective than the standard treatment, and one shows no difference. Before you concludethat the new antihypertensive is more effective in this group of patients, which one of thefollowing concepts must be given consideration?

A. Random error  
B. Systematic error  
C. Publication bias  
D. The power of the studies  
E. Information bias  

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Question # 2

The parents of a 12-year-old boy present to your clinic to discuss their son’s submersioninjury. The patient was seen in hospital for 6 months after being pulled unresponsive from alake at his friend’s house; he had been submerged for an estimated 20 minutes. Afterextended resuscitation and a 2-month stay in the intensive care unit, he remains in apersistent vegetative state but needs no respiratory or cardiac support. When evaluatingthe discharge from hospital, which one of the following is most appropriate?

A. Advocate for home care support so that the parents can care for their son safely at home
B. Recommend placement in a palliative care facility  
C. Plan for a progressive return to school with a home caregiver  
D. Organize scheduled readmissions to hospital to provide the family with respite care  
E. Continue intensive rehabilitation in the acute care hospital for the best chance of recovery

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Question # 3

A 51-year-old man comes to your clinic for follow-up regarding his type 1 diabetes. Hishemoglobin A1c is 12.5% (normal 4–6%). He has never had such high blood sugar results.He drinks 2 beers per night to help with sleep. He is not well rested because he has beensleeping on a friend’s couch since losing his job last year. Which one of the following is thebest next step?

A. Ensure that he has the finances to adequately monitor his diabetes.  
B. Prescribe an antidepressant to improve his energy and motivation.  
C. Send him for thyroid function testing.  
D. Ask him to create a food journal and refer him to a dietitian.  

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Question # 4

A 42-year-old man presents with a history of fatigue and weight loss. He looks unwell, hasa darker than usual complexion and his liver is enlarged. He is also found to have markedglycosuria. Which one of the following is the most useful diagnostic test?

A. Hemoglobin A1c  
B. Serum cortisol  
C. Serum alpha-1 antitrypsin  
D. Serum ferritin  
E. Serum amylase  

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Question # 5

A couple is diagnosed with primary infertility secondary to azoospermia. They are not  interested in in vitro fertilization techniques, so you recommend insemination with a sperm onor. The male partner is hesitant. He thinks he might have difficulty accepting raising achild who is not biologically his. Which one of the following is the best next step?

A. Arranging a consultation with a psychologist  
B. Tell the couple adoption is a better option  
C. Suggest transfer of care to another physician  
D. Propose a trial of ovulation induction with gonadotropins  
E. Recommend that the donor be a person who is known and significant to the couple  

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Question # 6

A 40-year-old man presents to the emergency department with a 24-hour history of severeabdominal pain and recurrent vomiting. He has a long-term history of alcohol use disorder.His blood pressure is 90/60 mm Hg, and his heart rate is 120/min. The pain is locatedmostly in the epigastrium but radiates to the right upper quadrant and to his back.Radiographs of the abdomen and chest reveal some distended small bowel loops in hisupper abdomen. Laboratory work results are pending. After fluid resuscitation, which one ofthe following is the best next step?

A. Immediate laparotomy  
B. Ultrasonography  
C. Computed tomography  
D. Upper gastrointestinal endoscopy  
E. Sengstaken-Blakemore tube  

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Question # 7

A 43-year-old man comes to your office for the first time. He has not seen a doctor in over5 years and has no known past medical history. On examination, his blood pressure is120/70 mm Hg, and the remainder of his examination is normal. As part of the initial visit,you order some screening blood work that reveals a fasting blood glucose of 6.3 mmol/L(3.3–5.8) and a hemoglobin A1c of 6.1% (4–6). Which one of the following is the best nextstep?

A. Order thyrotroph (thyroid-stimulating hormone) level.  
B. Test capillary blood glucose 4 times a day.  
C. Order a urine albumin:creatinine ratio.  
D. Perform a 75 g oral glucose tolerance test.  
E. Order an exercise stress test.  

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Question # 8

A 9-year-old girl is brought to the Emergency Department because she has generalizedurticaria, abdominal cramping, and postural dizziness 30 minutes after eating at a friend’sbirthday party. Which one of the following is the most appropriate route of administration forepinephrine?

A. Intravenous  
B. Intramuscular  
C. Subcutaneous  
D. Intranasal  
E. Inhaled  

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Question # 9

A 25-year-old woman presents to the Emergency Department with a 2-hour history ofpelvic pain associated with no other symptoms. The first day of her last menstrual periodwas 14 days ago. On examination, her vital signs are as follows:Blood pressure108/72 mm HgHeart rate110/minTemperature37 °CAbdominal examination reveals rebound tenderness and guarding. Pelvic examinationreveals exquisite left adnexal tenderness. Which one of the following is the most likelydiagnosis?

A. Diverticulitis  
B. Appendicitis  
C. Adenomyosis  
D. Endometriosis  
E. Hemorrhagic ovarian cyst  

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Question # 10

A 60-year-old woman presents with a 7-day history of bloody diarrhea and diffuse mildabdominal tenderness. Stool tests (culture, ova/parasites) are negative. Which one of thefollowing is the best next step?

A. Prescribe broad-spectrum antibiotics.  
B. Order a diagnostic colonoscopy.  
C. Recommend symptomatic observation.  
D. Recommend a trial of loperamide.  
E. Prescribe tapered-dose steroids.  

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Question # 11

You are covering for your colleague who is on vacation this week. You receive the resultsfrom an ultrasonography that had been ordered for a 32-year-old woman, gravida 2, para 1,aborta 0. The ultrasonography-estimated fetal weight is below the fifth percentile for 30weeks' gestation; gestational age was confirmed by an earlier ultrasonogram. The amnioticfluid volume is within normal range. Her first child's birth weight was 2800 g at full term.Which one of the following is the best next step?

A. Reassure the patient that the fetus is probably at the lower range of normal weight  
B. Plan a follow-up appointment as soon as your colleague is back from vacation  
C. Ask the patient to present to the obstetrics ward for further fetal assessment  
D. Discuss the benefits of acetylsalicylic acid  
E. Schedule an urgent uterine artery Doppler ultrasonography  

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Question # 12

A 34-year-old man sustained a blunt testicular trauma 2 hours ago. On physicalexamination, the patient has a 1.5-cm tall scrotal hematoma. You cannot palpate thetesticle. Which one of the following is the best initial management? 

A. Observe for 24 hours and discharge if stable  
B. Plan surgical exploration  
C. Order ultrasonography of the scrotum  
D. Order a technetium 99m pertechnetate scan  
E. Discharge with analgesics  

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Question # 13

A 29-year-old woman presents with vaginal spotting after 6 weeks of amenorrhea. She isasymptomatic otherwise. Serum -hCG is 2150 IU/L, and pelvic ultrasound shows an emptyuterus. She has been trying to conceive for 7 months. Which one of the following is thebest next step?

A. Repeat pelvic ultrasonography in 10 days.  
B. Perform dilatation and curettage for chorionic villi.  
C. Administer intramuscular methotrexate.  
D. Arrange exploratory laparoscopy.  
E. Repeat serum -hCG test in 48 hours.  

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Question # 14

A 55-year-old woman presents with a 6-month history of poor memory and impairedconcentration. She has bipolar I disorder that has been treated with lithium carbonate for 4years. She has gained a lot of weight since starting lithium. Physical examination findingsare otherwise normal. She is concerned about her memory issues, but there are no otherperception, mood, or cognition abnormalities. Which one of the following tests is most likelyto have abnormal findings?

A. Liver function tests  
B. Serum thyrotropin (thyroid-stimulating hormone) level  
C. Creatinine clearance  
D. Serum sodium level  
E. Parathyroid hormone  

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Question # 15

You are being consulted for a 79-year-old man who is about to undergo a total hiparthroplasty. His orthopedic surgeon is aware of the diagnosis of Alzheimer disease andwould like your suggestions to help avoid acute postsurgical delirium. To that end, whichone of the following is the most effective strategy?

A. Avoid medications with anticholinergic potential  
B. Refrain from prescribing opiate analgesics to treat postoperative pain  
C. Screen the patient with the Mini-Mental Status Examination prior to surgery  
D. Treat postsurgical insomnia with benzodiazepines  
E. Keep family visits to a minimum to avoid postsurgical overstimulation  

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Medical Council of Canada MCCQE Reviews