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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 53-year-old man with a history of bipolar I disorder is brought to the office by his family. Recently, he has been sleeping for 4 to 5 hours per night, has been fidgety, and is increasingly preoccupied with his granddaughter ' s safety. Five days ago, he consulted with your physician colleague and was instructed to exercise and meditate. Last night, he was found running in the street and attempted to hit a relative who was trying to calm him down. His son is dissatisfied with your physician colleague ' s management. Which one of the following is the most appropriate response?

A) Point out that exercise and meditation have been proven useful in managing bipolar I disorder.
B) Share that you would have prescribed a medication after the first assessment.
C) Explain that you will now assess the father and that your goal is to treat him.
D) Encourage the son to file a complaint.
E) Acknowledge your physician colleague ' s mistake and apologize.

2. A 39-year-old man presents to a psychiatrist. He says, " It often seems to me that I am not part of this world.
My voice sounds strange to me, and other people seem like figures in a dream. " He has had these feelings intermittently for about 2 years. There is no history of hallucinations, and there are no current indications of disorganized thinking. Which one of the following is the most likely diagnosis?

A) Schizophrenia.
B) Delusional disorder.
C) Conversion disorder.
D) Persistent depressive disorder.
E) Depersonalization/derealization disorder.

3. You are covering for your colleague who is on vacation this week. You receive the results from an ultrasonography that had been ordered for a 32-year-old woman, gravida 2, para 1, aborta 0. The ultrasonography-estimated fetal weight is below the fifth percentile for 30 weeks ' gestation; gestational age was confirmed by an earlier ultrasonogram. The amniotic fluid volume is within normal range. Her first child ' s birth weight was 2800 g at full term. Which one of the following is the best next step?

A) Reassure the patient that the fetus is probably at the lower range of normal weight
B) Schedule an urgent uterine artery Doppler ultrasonography
C) Discuss the benefits of acetylsalicylic acid
D) Ask the patient to present to the obstetrics ward for further fetal assessment
E) Plan a follow-up appointment as soon as your colleague is back from vacation

4. An 85-year-old man is transferred from an acute care hospital to your long-term care (LTC) facility. He has a fever, fatigue, myalgia, and malaise. His test result is positive for influenza A virus. Two other residents and 1 LTC staff member have experienced the same symptoms. Which one of the following is the best next step to prevent further infections at the LTC facility?

A) Ask all visitors to wear a mask.
B) Order symptomatic LTC staff to stay home.
C) Ensure that all visitors are immunized.
D) Enforce mandatory influenza vaccination for LTC staff.

5. A 45-year-old man is brought to the Emergency Department with chest pain. He has no significant medical history. He is anxious and agitated, and he reports severe central chest pain that began about 90 minutes ago.
His vital signs are as follows: blood pressure 200/110 mm Hg, heart rate 140/min, respiratory rate 30/min, oxygen saturation 98% on supplemental oxygen. Physical examination reveals a restless and slightly tremulous man. Pupils are 7 mm reactive. There are no focal neurologic signs. Cardiopulmonary examination is normal. The 12-lead electrocardiogram reveals sinus tachycardia; findings are otherwise normal. Which one of the following is the most likely cause of this clinical presentation?

A) Cannabis.
B) Alcohol.
C) Oxycodone.
D) Heroin.
E) Cocaine.

Solutions: