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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 39-year-old woman, gravida 2, para 1, aborta 0, presents with concerns that a friend has recently suffered from postpartum psychosis. She wonders if she is likely to suffer this disorder following delivery of her 2nd child. Which one of the following is most likely to increase your patient ' s risk?

A) A history of panic disorder
B) A family history of bipolar disorder
C) Advanced maternal age
D) Being a multigravida

2. A 29-year-old woman presents with vaginal spotting after 6 weeks of amenorrhea. She is asymptomatic otherwise. Serum #-hCG is 2150 IU/L, and pelvic ultrasound shows an empty uterus. She has been trying to conceive for 7 months. Which one of the following is the best next step?

A) Perform dilatation and curettage for chorionic villi.
B) Arrange exploratory laparoscopy.
C) Administer intramuscular methotrexate.
D) Repeat pelvic ultrasonography in 10 days.
E) Repeat serum #-hCG test in 48 hours.

3. You are being consulted for a 79-year-old man who is about to undergo a total hip arthroplasty. His orthopedic surgeon is aware of the diagnosis of Alzheimer disease and would like your suggestions to help avoid acute postsurgical delirium. To that end, which one of the following is the most effective strategy?

A) Keep family visits to a minimum to avoid postsurgical overstimulation
B) Refrain from prescribing opiate analgesics to treat postoperative pain
C) Treat postsurgical insomnia with benzodiazepines
D) Screen the patient with the Mini-Mental Status Examination prior to surgery
E) Avoid medications with anticholinergic potential

4. A 22-year-old woman is brought to the Emergency Department by her boyfriend, who says that she is experiencing a fentanyl overdose. She is unresponsive and cyanotic. She regains consciousness after naloxone is injected intravenously and demonstrates no further respiratory depression during 8 hours of observation.
She states that she is 22 weeks ' pregnant and wants to stop using opioids. Which one of the following is the best next step?

A) Refer the patient for opioid use disorder counselling
B) Refer the patient for initiation of methadone
C) Prescribe medications for symptom control so that the patient can detoxify at home
D) Admit the patient for medically supervised detoxification

5. A 34-year-old woman, gravida 2, para 1, aborta 0, presents to the labor and delivery ward at 32 weeks ' gestation with a 24-hour history of worsening frontal headache, photophobia, and neck stiffness. Vitals:
BP: 121/78 mm Hg
HR: 90 bpm
Temp: 38°C
Neuro exam reveals a 2-beat ankle clonus. Tone and power are otherwise normal. No localizing signs or papilledema. Abdomen is soft, fetus is cephalic.
Which one of the following is the best next investigation?

A) Amniocentesis with culture
B) Computed tomography of the head
C) Fetal ultrasonography
D) Urine protein to creatinine ratio
E) Lumbar puncture

Solutions: