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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. You performed a surgical procedure on a 32-year-old woman for a herniated disk that was causing neurologic impairment. At the 8-month follow-up visit, she has healed well; however, she requests a prescription renewal of her narcotic analgesics (hydromorphone). Her pharmacy confirms that the patient adheres to the dosage you prescribed, that she has not consulted other physicians, and that her behavior has always been respectful.
You think that she no longer requires narcotic analgesics. Which one of the following approaches is most helpful to the patient?

A) Counsel the patient regarding substance use disorder and arrange follow-up with her family physician.
B) Replace short-acting hydromorphone with transdermal fentanyl.
C) Advise the provincial or territorial agency responsible for following patients who have potential substance use disorders.
D) Decline the renewal of further hydromorphone and discharge the patient.
E) Change the patient's prescription from short-acting hydromorphone to once-daily methadone.

2. A 71-year-old man is brought to the Emergency Department with sudden onset of shortness of breath and chest pain. He was discharged from hospital 1 week ago after a total hip arthroplasty. On examination, his respiratory rate is 32/min. There is visible respiratory distress, and chest auscultation is clear. Which one of the following is the most likely diagnosis?

A) Fat embolus
B) Pulmonary embolus
C) Aortic dissection
D) Myocardial infarction
E) Cholesterol embolus

3. A 22-year-old woman, gravida 1, para 0, aborta 0, comes to the office at 10 weeks ' gestation for her first prenatal visit. When you ask how she is doing, she becomes tearful and says she has had severe nausea and vomiting. She is not taking her prenatal vitamins regularly and feels very guilty about it. She is worried that she is harming the fetus. Which one of the following is the most appropriate management of this patient ' s case?

A) Prescribe ginger tablets to be taken 4 times daily
B) Suggest that she take cannabinoids 30 minutes before taking her prenatal vitamins
C) Tell her she should continue to take her prenatal vitamins daily regardless of nausea
D) Refer her for counselling to manage her feelings of guilt
E) Advise her to replace her vitamin with folic acid only until her nausea improves

4. A 38-year-old man is brought by his wife to the Emergency Department with fatigue, dizziness, and nausea after completing a hiking tour on a hot, humid day. His wife became worried after he had collapsed. He has been sweating heavily and vomited twice on the drive in. His medical history is unremarkable, and he takes no medications. His vital signs on arrival are as follows:
Blood pressure
85/57 mm Hg
Heart rate
120/min
Respiratory rate
18/min
Temperature
40.1 °C
Oxygen saturation
95%, room air
-
On physical examination, the patient ' s skin is dry, flushed, and warm to the touch. He has a diffuse erythematous papular rash. Findings of a thorough physical examination are otherwise unremarkable. An electrocardiogram shows sinus tachycardia. Which one of the following is the best next step?

A) Computed tomography of the head
B) Serum C-reactive protein test
C) Serum thyrotropin (thyroid-stimulating hormone)
D) Serum creatine kinase test
E) Blood cultures

5. A system administrator needs to install a GPU/DPU in a server. The server has a free PCI-e slot, there are enough free PCI-e lanes, and there is enough room for the card. Which procedure should be followed?

A) Ensure the server has enough power. Make sure the server is up and running with attached cables. Wear an ESD bracelet.
B) Ensure the server has enough power. Make sure the server is down to remove cables safely. Wear an ESD bracelet.
C) Ensure the server has enough power. Verify compatibility of cables with server ' s platform. Make sure the server is down to remove cables safely. Wear an ESD bracelet.
D) Ensure the server has enough power. Verify compatibility of cables with server ' s platform. Make sure the server is down to remove cables safely. Do not wear an ESD bracelet.

Solutions: