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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 94-year-old woman with severe dementia is referred for vaginal bleeding and a persistent foul odour from the vagina. She lives in a long-term care facility. She has been using a ring pessary for the past 15 years. Her current pessary has not been replaced in 2 years. On examination, there is moderate vaginal atrophy. After removing the pessary, which one of the following is the best next step?

A) Arrange for a hysteroscopy and endometrial biopsy.
B) Prescribe vaginal metronidazole gel.
C) Wash the pessary and recommend a daily saline douche.
D) Perform a vaginal biopsy.
E) Start vaginal estrogen.

2. A 26-year-old woman, gravida 1, para 0, aborta 0, presents to your office at 10 weeks' gestation to review the results of her antenatal blood work. She tested positive for hepatitis C. Which one of the following is most advisable to share with her regarding the risks to her and her unborn child?

A) She will likely develop hepatocellular carcinoma.
B) The infant will need to be treated with an antiviral.
C) Pregnancy will increase her viral load.
D) She should terminate the pregnancy.
E) It is safe to breastfeed.

3. A 43-year-old man is referred to you for an incidental finding of elevated hemoglobin. Laboratory results are as follows:
Hemoglobin
185 g/L (130-170)
Mean corpuscular volume
92 fL (60-100)
White blood cells
7.8×1037.8×103 / L (4-10)
Platelets
250×103250×103 / L (130-400)
His BMI is 23. He has type 2 diabetes for which he takes gliclazide MR 60 mg daily. Which one of the following features on history could explain his laboratory abnormality?

A) Hypothyroidism
B) Central sleep apnea
C) Hypertension
D) Cirrhosis
E) Alcohol abuse

4. A 37-year-old woman diagnosed with schizophrenia comes to her family physician because she has been choking on her food lately. She has a history of mild spasmodic dysphonia. She was recently started on haloperidol for auditory hallucinations. Which one of the following is the best short-term management?

A) Arrange for an urgent laryngoscopy
B) Provide reassurance
C) Change the haloperidol to quetiapine
D) Start lorazepam
E) Begin dantrolene

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

Solutions: