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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 33-year-old man with severe bacterial meningitis is intubated and unresponsive in the Intensive Care Unit.
If he receives immediate treatment, his prognosis is excellent. If he does not, he will likely die. Three years ago, the patient had Huntington disease diagnosed, but he has been asymptomatic since then. His advance directive, which was made before this hospitalization, states that he should be allowed to die if he contracts a life-threatening illness. His parents demand that he be treated for the meningitis. Which one of the following is the best next step?

A) Consult a second physician for an opinion on emergent treatment
B) Do not provide any treatment other than comfort measures
C) Initiate treatment, using the parents as substitute decision-makers
D) Order an electroencephalography
E) Ask for a current mental capacity assessment

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

3. An 8-year-old girl is brought by her father to the office with a 2-week history of red, itchy, and watery eyes.
She is otherwise healthy. On examination, there is no discharge or difficulty with vision. Pupil examination findings are normal. The patient's eyes are shown in the referenced photo. Which one of the following topical therapies is the best recommendation?

A) Glucocorticoid.
B) Antiviral.
C) Antifungal.
D) Antihistamine.
E) Antibiotic.

4. You are providing medical care to a 78-year-old man and notice a skin lesion which you suspect is malignant melanoma. He has been living in a long-term care facility for 2 years because of incontinence, mobility and vision problems. He is well-liked by facility staff and residents, manages his own affairs and communicates clearly. He has designated his daughter to be his substitute decision-maker and has signed a Do Not Resuscitate (DNR) order. Which one of the following is the best next step in providing care to this patient for his skin lesion?

A) Discuss your tentative diagnosis with him and ask about his preferences regarding investigations.
B) Contact the daughter to inform her of your findings and discuss possible investigations.
C) Perform a biopsy to ensure an accurate diagnosis before discussing diagnosis and treatment.
D) Ask him whether you can discuss your diagnosis and care with his daughter.
E) Respect his DNR wishes, and do nothing about the skin lesion.

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

Solutions: