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Medical Council of Canada MCCQE Exam Syllabus Topics:

Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 67-year-old farmer presents with a 6-month history of progressive weakness in both arms. He now has difficulty in climbing but says he can still drive his tractor. Examination shows slight but definite atrophy of muscles of pectoral girdle, especially over his scapula. Fasciculations are visible. There is hyperreflexia of most tendon reflexes of arms and legs, left ankle clonus and left Babinski reflex. Which one of the following is the most likely diagnosis?

A) Astrocytoma of pons.
B) Cerebellar degeneration.
C) Parkinson disease.
D) Multiple sclerosis.
E) Amyotrophic lateral sclerosis.

2. A previously well 4-year-old boy is brought to your office by his mother. She is concerned by his behaviour.
Shortly after falling asleep, he awakens, screams loudly and cries. He appears frightened and does not respond to his mother's efforts to calm him. During these episodes, he appears agitated and flushed. After 15-20 minutes, he settles back to sleep. Physical examination is unremarkable. Which one of the following is the most likely diagnosis?

A) Nightmare disorder.
B) Temper tantrums.
C) Nocturnal seizures.
D) Non-rapid eye movement sleep arousal disorder.
E) Panic disorder.

3. A 67-year-old man underwent his first endoscopy. He has long-term reflux and heartburn, treated intermittently with antacids. Biopsies of the distal esophagus reveal Barrett epithelium. Which one of the following is most important in determining the frequency of surveillance endoscopy?

A) Depth of intestinal metaplasia
B) Family history of gastrointestinal malignancy
C) Length of Barrett segment
D) Grade of dysplasia
E) Stricture formation

4. A 26-year-old woman, gravida 1, para 0, aborta 0, consults you at 36 weeks' gestation regarding newborn care. She has HIV. Which one of the following is the best advice regarding reducing the risk for transmission of HIV to her newborn?

A) Formula-feed her newborn.
B) Avoid kissing her newborn.
C) Bottle-feed her newborn boiled expressed breast milk.
D) Bottle-feed her newborn expressed breast milk.
E) Breastfeed her newborn during the colostrum period only.

5. A 72-year-old woman is brought to the Emergency Department by her daughter because of significant functional decline and progressive shortness of breath. She has widespread metastatic breast cancer and recently stopped chemotherapy due to progression and intolerance. She has been bedridden for 4 weeks. On examination:
BP: 100/70 mm Hg with pulsus paradoxus of 20 mm Hg
HR: 99/min
Temp: 36.5°C
SpO#: 94% room air
JVP: elevated
Heart sounds: muffled
Chest X-ray: large globular heart
Labs:
Hemoglobin: 90 g/L
Sodium: 118 mmol/L
Creatinine: 94 µmol/L
Which one of the following is the best next step?

A) Consult with the Intensive Care Unit
B) Normal saline infusion
C) Pericardiocentesis
D) Discussion on goals of care
E) Blood transfusion

Solutions: