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Medical Council of Canada MCCQE Exam Syllabus Topics:

Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 58-year-old woman presents to your office with heavy vaginal bleeding. She has a history of type 2 diabetes and hypertension. Some active bleeding is visible on speculum examination. Ultrasound reveals an endometrial thickness of 12 mm. Endometrial biopsy shows complex hyperplasia with atypia. Which one of the following is the best next step?

A) Arrange endometrial ablation
B) Organize hysteroscopy
C) Obtain consent for dilatation and curettage
D) Prescribe topical progesterone
E) Refer for hysterectomy and bilateral salpingo-oophorectomy

2. A 40-year-old woman presents with a 3-month history of discharge from her right nipple. The discharge was initially milky white, but over the last 2 weeks, the patient has noted blood stains on her bra. There is mild discomfort in the same breast around the time of menses periods. On physical examination, the upper outer quadrant of the breast is tender, but there are no palpable lumps. You are able to express fluid from the nipple which is in fact blood-tinged. Which one of the following is the most likely diagnosis?

A) Intraductal papilloma.
B) Staphylococcal infection.
C) Ductal carcinoma in situ.
D) Paget disease.
E) Mammary duct ectasia.

3. A 20-year-old woman from a remote northern community presents to the office with a 2-week history of malaise and a 2-day history of disabling pain in her left elbow. She had a sore throat 4 weeks ago. She also notes that she has had 2 weeks of pain and swelling in her right knee, followed by pain and swelling in her left elbow. On examination, you note 0.5-cm to 1-cm nodules just above both her elbows. You find no active joint swelling. An electrocardiogram shows a prolonged PR interval. Which one of the following is the most appropriate investigation?

A) Echocardiography.
B) Rheumatoid factor.
C) Pharyngeal culture.
D) Excisional biopsy of nodules.
E) Antistreptolysin O titre.

4. A 31-year-old man presents to the office with concerns about his heart. Three months ago, his father died of a myocardial infarction at age 58 years. He states that since the death of his father, he has experienced episodes in which his heart will start racing, causing him to feel short of breath, dizzy, and nauseous. He is afraid that he will die during these episodes. Findings from a physical examination, electrocardiogram, Holter monitoring, echocardiogram, and complete blood count are normal. Serum electrolyte level, troponin level, and thyroid function studies are all within normal limits. Which one of the following options is the most appropriate?

A) Cardiac stress test
B) Lorazepam at bedtime
C) Grief therapy
D) Metoprolol

5. A 79-year-old woman presents to the Emergency Department with sudden-onset severe chest and back pain that started 1 hour ago. She has a history of hypertension and looks unwell. Her vital signs are as follows:
blood pressure 168/108 mm Hg, heart rate 110/min, respiratory rate 22/min, temperature 36.7°C. Findings of a physical examination of the chest and abdomen are normal. An urgent computed tomography (CT) scan of the chest and abdomen shows an aortic dissection extending from the descending thoracic aorta to the upper abdominal aorta. The branches of the abdominal aorta are patent. Following initial resuscitation, which one of the following is the best next step?

A) Begin anticoagulation with heparin.
B) Immediate surgical repair.
C) Start thrombolytic therapy.
D) Insert an intra-aortic balloon pump.
E) Begin intravenous beta-blocker therapy.

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