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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 70-year-old hypertensive woman with a history of congestive heart failure (CHF) secondary to left ventricular dysfunction presents to your office with a persistent dry hacking cough. She claims it began when she was started on ramipril. Which one of the following medications would be most appropriate to replace ramipril, to ensure that the risk of morbidity associated with CHF remains low?

A) Angiotensin II receptor blocker
B) Cox-2 inhibitor
C) Calcium channel blocker
D) Alpha-blocker
E) Nitrates

2. A 10-day-old boy is brought to the Emergency Department with a fever. The newborn looks well. Other than a rectal temperature of 38.6 °C, findings of the physical examination are unremarkable. When you list all the recommended testing their baby will have to undergo, the parents become upset at all the testing their baby will have to undergo. Which one of the following is the best approach?

A) Inform the parents that child protection services may be contacted if they refuse care.
B) Encourage the parents not to be present during the procedures.
C) Advise the parents that their child will not remember painful procedures.
D) Reassure the parents that their child will be given an appropriate analgesic.
E) Proceed with testing and address the parents ' concerns afterwards.

3. A 27-year-old man with a bowel obstruction secondary to a terminal ileum stricture has been on various medications since he was diagnosed with Crohn disease 8 years ago. You recommend a bowel resection, but he refuses this option because he is fearful of short bowel syndrome. He states that the only surgical procedure he will undergo is a bypass of the diseased segment so that the affected bowel will heal. You know that this is the wrong operation. Which one of the following is the best next step?

A) Obtain a formal competency assessment.
B) Administer a high dose of intravenous steroids for trial.
C) Decline to do the bypass but carefully explain why.
D) Transfer care to a colleague that you know is receptive to the patient's request.
E) Get consent for exploratory laparotomy and do a resection.

4. A 37-year-old man comes to the office for follow-up of his opioid use disorder. He receives opioid agonist treatment, including some take-home doses. At this follow-up visit, he reports some nonprescription opioid use since his last visit. Which one of the following is the best next step?

A) Prescribe a cannabinoid
B) Discontinue take-home doses
C) Slowly taper and discontinue the opioid agonist
D) Taper the dosage of the opioid agonist
E) Increase the frequency of follow-up visits

5. You have been asked to develop a program in your hospital for people who are at the highest risk of death by suicide. The hospital administrator asks you to describe the types of patients they should expect in the program. Which one of the following groups is the most likely prominent demographic?

A) Men aged 50 to 70 years who have limited social supports and alcohol use disorder
B) Women aged 20 to 40 years who have cluster B personality disorders and experience relationship losses
C) Patients of both sexes who have psychotic disorders
D) Women aged 14 to 20 years who have histories of being abused and who are experiencing financial hardships
E) Men aged 11 to 20 years who have histories of juvenile delinquency and narcotic use

Solutions: