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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 79-year-old woman presents to the Emergency Department with sudden-onset severe chest and back pain that started 1 hour ago. She has a history of hypertension and looks unwell. Her vital signs are as follows:
blood pressure 168/108 mm Hg, heart rate 110/min, respiratory rate 22/min, temperature 36.7°C. Findings of a physical examination of the chest and abdomen are normal. An urgent computed tomography (CT) scan of the chest and abdomen shows an aortic dissection extending from the descending thoracic aorta to the upper abdominal aorta. The branches of the abdominal aorta are patent. Following initial resuscitation, which one of the following is the best next step?

A) Immediate surgical repair.
B) Start thrombolytic therapy.
C) Insert an intra-aortic balloon pump.
D) Begin anticoagulation with heparin.
E) Begin intravenous beta-blocker therapy.

2. A 12-year-old girl presents to your office in late November with an exacerbation of asthma which has been well controlled since her diagnosis at age 5. The family has had cats for 3 years. Last June, they moved to a basement apartment. Which one of the following is the most likely cause of her asthma exacerbation?

A) Mold allergy
B) Cold intolerance
C) Pollen allergy
D) Fungal infection
E) Cat allergy

3. You are the emergency physician on duty in a rural hospital when heavy rains in the community cause a large landslide. There are multiple casualties expected to arrive in the emergency department. Your colleague has heard about the incident and arrives to help. Which one of the following is the best next step?

A) Ask your colleague to help triage incoming patients in the emergency department
B) Send your colleague to set up an emergency type O blood bank collecting unit
C) Ask your colleague to handle media inquiries
D) Send your colleague to the affected area to evaluate the health risks involved

4. A 16-month-old boy is brought to your office because of red, itchy and crusted patches on his cheeks and chin. Physical examination also reveals similar patches in the flexor creases of both arms. The groin and axillae regions are clear. Which one of the following is most likely to contribute to this condition?

A) Introduction of cereals before 6 months of age.
B) A family history of atopic reactions.
C) Vaccination for measles, mumps and rubella.
D) Recent use of oral amoxicillin.
E) Varicella-zoster infection.

5. A 66-year-old woman has a 3-month history of dry cough and weight loss. A new chest radiograph reveals a large 2-cm mass in her right upper lobe, which is consistent with carcinoma. You look at her previous films and realize that you had read her chest radiograph as normal 1 year ago, but now clearly see a faint opacity in precisely the same location as her current lesion. Which one of the following is the best next step?

A) Prepare a report only after communicating with your department head
B) Write a report only after communicating with your professional insurer
C) Create a report only after communicating with your medical regulatory authority
D) Comment on the previous chest radiograph and the new one in your report
E) Remark only on the new chest radiograph in your report

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