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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 56-year-old woman comes to your office because she has not been herself since her husband died in a car crash 6 weeks ago. She has no prior psychiatric history. Her son is concerned because she cries frequently, has a poor appetite, rarely leaves home and is distraught. Her sadness fluctuates and increases when she thinks of her husband. She often thinks about death, and she wishes she could join her deceased husband. Which one of the following is the best next step?

A) Admit to day hospital.
B) Offer reassurance.
C) Arrange for family systems therapy.
D) Refer to a social worker.

2. An 80-year-old woman presents to your office with weight loss and generalized weakness. Her husband calls you after the appointment and asks that his wife not be told if she is diagnosed with cancer as hearing this will likely " kill her. " Investigations subsequently show that she has metastatic lung cancer. Which one of the following is the best next step?

A) Book an immediate appointment with your patient.
B) Tell her husband she has metastatic lung cancer.
C) Tell the patient she requires a computed tomography scan of the chest.
D) Telephone her to inform her she has a bad pneumonia and prescribe antibiotics.
E) Arrange an urgent consultation with her children to confirm her wishes.

3. A 58-year-old woman presents with a 1-year history of functional decline. She reports seeing rodents and little children invading her bedroom. Her partner tells you she has a slow, unsteady gait and tends to fall. On examination, she cannot sustain her attention during cognitive testing. Which one of the following is most likely to be found on brain imaging?

A) Subdural hematoma
B) No structural abnormality
C) Medio-temporal atrophy
D) Bilateral frontal atrophy
E) Cerebellar atrophy

4. A 72-year-old woman presents with swelling of her right leg that developed overnight. She had an abdominal hysterectomy 10 days ago. On examination, there is pitting edema of the leg that extends from the foot to the groin. The calf is 3 cm larger in diameter than the calf on the left leg. Which one of the following is the most likely diagnosis?

A) Inadvertent ligation of the iliac vein.
B) Iliofemoral vein thrombosis.
C) Superficial thrombophlebitis.
D) Angioedema of the leg.
E) Phlegmasia cerulea dolens.

5. A 12-year-old boy is brought by his mother to your clinic with a history of attention-deficit/hyperactivity disorder. His mother reports that he has been taking immediate-release methylphenidate for 2 years. Although the medication was initially effective, it no longer seems to work. The teachers say he is disorganized and fidgety, verbally interrupts class, and does not complete his work. His mother tells you that he does listen at home. Which one of the following is the most important next step in management?

A) Add risperidone and see the patient in 2 weeks.
B) Complete rating scales and increase methylphenidate.
C) Switch the methylphenidate to atomoxetine and see the patient in 2 weeks.
D) Order an electroencephalogram.
E) Increase the methylphenidate and see the patient in 2 weeks.

Solutions: