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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 67-year-old man presents to the clinic because of elevated liver enzymes. He is asymptomatic. His medical history is significant for type 2 diabetes, which is being treated with metformin. On physical examination, he looks well. His blood pressure is 125/75 mm Hg, his heart rate is 80/min, and his BMI is 35. Findings of the remainder of the examination are normal. His blood work results are as follows:
Platelet count: 170 × 10#/L (130-380)
Creatinine: normal
GGT: 75 µmol/L (49-93)
ALT: 146 IU/L (15-85)
AST: 101 IU/L (17-63)
Bilirubin (total): 17 µmol/L (3-17)
INR: 1.2 (0.9-1.2)
Which one of the following is the most likely diagnosis?

A) Carcinoma of the pancreas
B) Acute hepatitis B infection
C) Nonalcoholic steatohepatitis
D) Metformin effect
E) Hepatocellular carcinoma

2. An otherwise healthy 43-year-old woman presents to your clinic for a left breast mass. Six months ago, she underwent a bilateral breast magnetic resonance imaging (MRI) after watching a television program on breast cancer prevention. An ultrasound-guided biopsy of a 1.5 cm mass confirmed, at the time, that she had fibroadenoma. The follow-up ultrasound now reveals a mass measuring 1.7 cm. Which one of the following is the best next step in the management of this patient?

A) Proceed with needle-localized left lumpectomy.
B) Reassure the patient and reassess in 12 months.
C) Order a MRI of both breasts to rule out anything else.
D) Repeat the biopsy to confirm the diagnosis.
E) Administer prophylactic tamoxifen to decrease the risk of cancer.

3. A 34-year-old man presents to your office with a 2-week history of headaches and double vision when he looks to the right. On physical examination, you note that he is unable to gaze laterally with his right eye.
Which one of the following cranial nerves is most likely affected?

A) Oculomotor.
B) Optic.
C) Trochlear.
D) Trigeminal.
E) Abducens.

4. You are asked to see a 34-year-old patient at his long-term care facility for a 2-day history of fever. You diagnose a urinary tract infection. He has multiple sclerosis diagnosed 5 years ago and has lived in this long- term care facility for the past 2 years. He is bedbound and has an indwelling urinary catheter. For the past 3 months, he has been non-communicative. Prior to this, he had made it clear that he did not want any life- prolonging measures. Which one of the following is the best next step?

A) Call his family to consider antibiotics.
B) Transfer him to the hospital.
C) Prescribe antipyretics.
D) Start antibiotics while waiting to contact the family.
E) Change his urinary catheter.

5. You are 1 of 3 physicians on an interdisciplinary brain injury team at a hospital. The team ' s physiotherapist has concerns regarding a patient ' s medication. Which one of the following is the most appropriate course of action for communicating with the physiotherapist?

A) Contact the patient to confirm that you are allowed to answer the physiotherapist ' s question.
B) Do not discuss the patient ' s medication unless you have written consent from the patient.
C) Discuss the medication with the physiotherapist even if you are not the physician most responsible for the patient.
D) Do not discuss the patient ' s medication because the physiotherapist is not involved in prescribing medications.

Solutions: