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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 71-year-old man with stable chronic low back pain on hydromorphone (8 mg twice daily) presents upset, requesting an early refill. He reports his granddaughter has been stealing his medication and pressuring him for refills. Which one of the following is the best next step?

A) Call the police and report the patient's granddaughter.
B) Increase the dispensed quantity of the patient's hydromorphone.
C) Arrange for daily dispensing of hydromorphone.
D) Begin tapering the hydromorphone.
E) Provide an early refill of hydromorphone.

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

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

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

4. A 67-year-old farmer presents with a 6-month history of progressive weakness in both arms. He now has difficulty in climbing but says he can still drive his tractor. Examination shows slight but definite atrophy of muscles of pectoral girdle, especially over his scapula. Fasciculations are visible. There is hyperreflexia of most tendon reflexes of arms and legs, left ankle clonus and left Babinski reflex. Which one of the following is the most likely diagnosis?

A) Cerebellar degeneration.
B) Amyotrophic lateral sclerosis.
C) Multiple sclerosis.
D) Astrocytoma of pons.
E) Parkinson disease.

5. A 36-year-old woman presents to the office with a 2-month history of multiple asymptomatic bumps on her vulva. She is not currently sexually active but has had 2 male sexual partners in the past, with the most recent relationship ending 1 year ago. On examination, she appears to have genital warts. She has not received the human papillomavirus (HPV) vaccine and is not interested in any treatment that is not absolutely necessary.
Which of the following is the best next step?

A) Contact tracing.
B) Papanicolaou test.
C) Cryotherapy.
D) HPV vaccine.
E) Excisional biopsy.

Solutions: