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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 42-year-old woman presents to the emergency department with a 24-hour history of severe pain in her right eye. On examination, you notice a right conjunctival injection that is worst adjacent to the iris. Direct and consensual responses to light are intact but sluggish, with severe photophobia in the right pupil is slightly smaller than the left. The patient's visual acuity is 20/20 on the left and 20/40 on the right. Visual field testing results are normal. Intraocular pressure findings are normal. Slit-lamp examination findings of the cornea are normal, and there are no cells in the anterior chamber. You are unable to visualize her fundus. Which one of the following is the most likely diagnosis?

A) Acute angle-closure glaucoma.
B) Optic neuritis.
C) Scleritis.
D) Viral conjunctivitis.
E) Acute uveitis.

2. A 45-year-old man presents to the office and reports difficulty understanding conversations that happen in a noisy environment. Ear examination findings are normal. You request audiography, from which results show bilateral high-frequency sensorineural hearing loss with a notch at 4000 Hz. Which one of the following is the most likely cause of this patient's hearing loss?

A) Attending a firing range to practise shooting before each hunting season.
B) Having had frequent ear infections during childhood.
C) Having type 2 diabetes for 10 years.
D) Working in the construction sector for the past 20 years.
E) Having a hereditary condition.

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

4. A 35-year-old man comes to your office with a history of headaches that last 1 hour and are relieved by 1000 mg of acetaminophen. These headaches, which started 6 months ago after he got his first job as a lawyer, occur regularly. The patient wants a computed tomography scan of his head to rule out a tumour. Physical examination reveals no abnormality. Review of systems does not contribute any positive findings. Which one of the following is the best management?

A) Prescribe stronger pain relief medications.
B) Refer the patient to a neurologist for further investigations.
C) Order a computed tomography of the head.
D) Refer the patient to a psychiatrist for anxiety disorder.
E) Reassure the patient.

5. A 25-year-old nulligravida woman presents after trying to conceive for 2 years without success. She is healthy, with regular menstrual periods. She denies any unusual hair growth, weight changes, or breast discharge. She gets occasional outbreaks of acne. Blood work done with her next menstrual period produces the following results:
Follicle-stimulating hormone, follicular phase: 6.2 U/L (5.0-20.0) on day 3 of menstrual cycle Luteinizing hormone, follicular phase: 6 U/L (5-22) on day 3 of menstrual cycle Estradiol: 163 pmol/L (50-200) on day 15 of menstrual cycle Thyrotropin (thyroid-stimulating hormone): 2.5 mU/L (0.4-5.0) Prolactin: 40 µg/L (4-30) Given the results of her blood work, which one of the following is the best next step?

A) Send her for a mammography.
B) Give her a prescription for bromocriptine.
C) Order magnetic resonance imaging of her brain.
D) Refer her for in vitro fertilization.

Solutions: