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

2. A 32-year-old woman presents to the office and reports that she feels unwell and tired. She is worried about long-standing episodic diarrhea and vague abdominal discomfort. Laboratory investigations reveal a hemoglobin of 90 g/L (123-157), mean corpuscular volume of 75 fL (80-100), and serum ferritin level of 4 µg
/L (11-307). Which one of the following tests is most likely to produce a diagnosis?

A) Helicobacter pylori serology.
B) Total iron-binding capacity.
C) Fecal fat determination.
D) Immunoglobulin A tissue transglutaminase.
E) Stool for culture and sensitivity.

3. A 32-year-old primigravid woman is receiving magnesium sulfate for tocolysis. Her pregnancy is at 26 weeks
' gestation. You suspect magnesium sulfate toxicity. Which one of the following is the first sign of magnesium sulfate toxicity?

A) Absent patellar reflexes
B) Hypotension
C) Oliguria
D) Tachypnea
E) Tachycardia

4. An 18-year-old woman comes to the office because of fatigue. She tells you she is struggling in her first year of university. She mentions that she spends much of her time rewriting her notes and filing and organizing her study materials. She is doing all the work in her group assignments because she feels others cannot do the work to a high enough standard. She has abandoned all enjoyable activities and seems to be constantly working and worrying about her grades. Which one of the following is the most likely diagnosis?

A) Obsessive-compulsive disorder.
B) Generalized anxiety disorder.
C) Major depressive disorder.
D) Obsessive-compulsive personality disorder.

5. A 24-year-old man presents to your clinic with a 6-month history of fatigue. On examination, he is pale. His BMI is 16, and his blood pressure is 92/58 mm Hg. Initial laboratory work shows the following:
Creatinine: 64 µmol/L (49-93)
Potassium: 3.0 mmol/L (3.5-5.1)
Sodium: 138 mmol/L (136-146)
TSH: 2.40 mIU/L (0.34-5.60)
CBC: Normal
Which one of the following is the best next step?

A) Consult gastroenterology
B) Refer the patient to the emergency department
C) Ask permission to discuss the patient's weight
D) Advise increased caloric intake

Solutions: