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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 30-year-old man comes to the office and asks you to write him a note for his employer that recommends a stress leave. He says he feels entitled to a rest. He comes across as irritable and impulsive. He appears to show little regard for the law and admits to recently embezzling $5,000 from his employer. He justifies his actions and shows no remorse. He has a history of attention-deficit/hyperactivity disorder as a child. Which one of the following is the most likely diagnosis?

A) Borderline personality disorder.
B) Narcissistic personality disorder.
C) Bipolar II disorder.
D) Antisocial personality disorder.
E) Klinefelter syndrome.

2. A 27-year-old woman presents with an enlarged thyroid. She had not noticed it herself until her mother brought it to her attention. She is asymptomatic from an endocrine perspective, and her serum thyroid- stimulating hormone (TSH) is normal.
Which one of the following is the most appropriate next step?

A) Serum calcium
B) Computed tomography of the neck
C) Fine-needle aspiration of the thyroid
D) Serum T3 and T4
E) Ultrasound of the thyroid

3. A 55-year-old man presents to the Emergency Department with intractable nausea and vomiting. He is diaphoretic, tremulous and tachycardic. In a private conversation with his spouse, you learn that for the last several weeks, he has been drinking 1.2 L of vodka daily. On questioning, he says that since he retired, he has been drinking socially and plans to continue doing so. With respect to his alcohol use, which one of the following best describes the patient's current stage of change?

A) Maintenance.
B) Precontemplation.
C) Contemplation.
D) Action.
E) Preparation.

4. A 62-year-old woman is taken to the operating room for an elective laparoscopic cholecystectomy. Induction of anesthesia triggers a severe hypertensive crisis that ultimately resolves after administration of a 5 mg bolus of phentolamine.
Which one of the following is most consistent with this presentation?

A) Increased thyrotropin (thyroid-stimulating hormone) level
B) Low urinary metanephrines
C) Low renal vein renin
D) Elevated plasma catecholamines
E) High plasma cortisol

5. A 37-year-old man comes to the office for follow-up of his opioid use disorder. He receives opioid agonist treatment, including some take-home doses. At this follow-up visit, he reports some nonprescription opioid use since his last visit. Which one of the following is the best next step?

A) Prescribe a cannabinoid
B) Slowly taper and discontinue the opioid agonist
C) Discontinue take-home doses
D) Taper the dosage of the opioid agonist
E) Increase the frequency of follow-up visits

Solutions: