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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 32-year-old woman, gravida 0, comes to your office for contraception counselling, specifically about insertion of a levonorgestrel-releasing intrauterine device. She has a past history of breast cancer and is presently on tamoxifen. Which one of the following is the best advice for your patient?

A) It may increase her risk of breast cancer recurrence
B) She will require pre-procedure antibiotics
C) After consultation with her oncologist, she may choose this option
D) This device will increase her risk of future infertility
E) She has a high risk of irregular bleeding following insertion

2. A 61-year-old man presents to the office for follow-up of recent laboratory test results. He has hypertension for which he takes amlodipine daily. His blood pressure is 148/94 mm Hg. His creatinine level is 140 µmol/L (normal 70-120), and his urine protein-to-creatinine ratio is persistently elevated. You would like to prescribe ramipril, but he refuses to take any additional medication. Which one of the following is the best next step?

A) Explain to the patient the importance of preventing the progression of his chronic kidney disease.
B) Inform the patient that he eventually may need dialysis if he refuses the medication.
C) Provide the patient with free samples of ramipril.
D) Agree to stop the patient's amlodipine if he takes ramipril.
E) Determine why the patient is refusing to take more medication.

3. Three months ago, a physician colleague approached you in the hospital corridor for advice regarding one of his patients. You are now being named by this patient in a malpractice action. Which one of the following is the most likely reason why you may be found liable?

A) You advised the physician to consult one of your colleagues
B) You gave advice on how to treat the patient
C) You were given confidential patient health information
D) You did not see the patient
E) You were given the patient ' s name

4. A 34-year-old man with trisomy 21 is brought to the Emergency Department because of a painful, red great toe. He is accompanied by an older woman who begins giving you the history as you enter the room. The patient is sitting on the examination table with the foot exposed, but he does not speak. Which one of the following is the best next step?

A) Examine the uncovered foot immediately to provide comfort to the patient sooner.
B) Ask the woman to provide legal documentation of her responsibility for the patient.
C) Have a nurse attend with you in case the patient needs restraint.
D) Allow the woman to continue with the history to expedite the patient encounter.
E) Establish the relationship between the woman and the patient and direct questions to the patient.

5. You are caring for a 78-year-old man admitted to hospital for heart failure. On your rounds, he asks why he is not getting better. He has a history of heart failure, hypertension, and type 2 diabetes. He has an implantable cardioverter-defibrillator. This is his fourth admission in the past 6 months for acute decompensation of his heart failure. Between hospital admissions, he reports worsening shortness of breath and a progressive decline in function. Which one of the following is the next best step?

A) Advise the patient to have his defibrillator deactivated
B) Reassure the patient that his condition will improve with proper medication adherence
C) Explain the end-stage nature of the patient ' s illness

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