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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. You are working in a busy family practice. Your colleague ' s 48-year-old female patient presents with a 6- month history of fatigue and gastrointestinal symptoms. A recent colonoscopy was normal. Her chart indicates multiple investigations for similar symptoms over the past 2 years, all of which have been non- revealing. Your working diagnosis is somatic symptom disorder. Which one of the following is the most appropriate treatment?

A) Amitriptyline 10 mg at bedtime
B) Citalopram 20 mg daily
C) Cognitive behavioral therapy
D) Exposure and response prevention therapy
E) Risperidone 0.5 mg daily

2. A 27-year-old woman, gravida 2, para 1, aborta 0, presents to the office seeking guidance on the management of her baby once it is born. The patient is in renal failure and has been taking methadone for 3 years to manage her opioid use disorder. During her pregnancy, she has been taking a stable dose of 80 mg of methadone once daily. Which one of the following is the most appropriate next step?

A) Recommend hospitalization for at least 3 days to observe for neonatal abstinence.
B) Discuss risks of newborn opioid exposure and discourage its use to avoid neonatal opioid dependence.
C) Discuss the need for a test dose of naloxone and provide supportive care if required.
D) Discharge home after birth because neonatal withdrawal is unlikely on a stable maternal methadone dose.
E) Recommend formula feeding to prevent ongoing exposure through breast milk.

3. A 42-year-old woman, gravida 2, para 2, aborta 0, comes to the office for the first time. She reports a 6-month history of thirst, urinary frequency, and recurrent vaginitis. Aside from a BMI of 28, her physical examination findings are unremarkable. She takes no medications. Which one of the following would support the most likely diagnosis?

A) High-risk sexual behaviours.
B) Dry eyes.
C) Recent antibiotic use.
D) Family history of hypertension.
E) Delivery of a macrosomic newborn.

4. A 32-year-old woman, gravida 0, comes to your office for contraception counselling, specifically about insertion of a levonorgestrel-releasing intrauterine device. She has a past history of breast cancer and is presently on tamoxifen. Which one of the following is the best advice for your patient?

A) This device will increase her risk of future infertility
B) She has a high risk of irregular bleeding following insertion
C) She will require pre-procedure antibiotics
D) It may increase her risk of breast cancer recurrence
E) After consultation with her oncologist, she may choose this option

5. A 34-year-old man with trisomy 21 is brought to the Emergency Department because of a painful, red great toe. He is accompanied by an older woman who begins giving you the history as you enter the room. The patient is sitting on the examination table with the foot exposed, but he does not speak. Which one of the following is the best next step?

A) Ask the woman to provide legal documentation of her responsibility for the patient.
B) Allow the woman to continue with the history to expedite the patient encounter.
C) Have a nurse attend with you in case the patient needs restraint.
D) Establish the relationship between the woman and the patient and direct questions to the patient.
E) Examine the uncovered foot immediately to provide comfort to the patient sooner.

Solutions: