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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 24-year-old man is brought to the Emergency Department by ambulance with a severe pelvic fracture from a motor vehicle collision. After resuscitation and stabilization, he is noted to have a bloody penile discharge.
Which one of the following is the best next step?

A) Sonography of penis.
B) Foley catheter and continuous bladder irrigation.
C) Transrectal ultrasound.
D) Voiding cystography.
E) Retrograde urethrography.

2. A 66-year-old woman with metastatic breast cancer presents with hard, difficult-to-pass stools. She has been experiencing this issue since starting morphine to control her pain. Which one of the following is the best next step?

A) Start docusate
B) Lower her morphine dose
C) Suggest increasing her physical activity
D) Prescribe senna
E) Add a bulk-forming fiber supplement to her diet

3. A 26-year-old woman, gravida 2, para 2, aborta 0, has just delivered a full-term newborn via spontaneous vaginal delivery after 4 hours of labor. Following oxytocin administration and placental expulsion, there continues to be a steady trickle of bright red blood from her vagina. On examination, the placenta is intact and the fundus feels firm. Her vital signs are within normal range.
Which one of the following is the most likely diagnosis?

A) Vaginal or cervical tear
B) Retained products of conception
C) Disseminated intravascular coagulopathy
D) Uterine rupture
E) Uterine atony

4. A 72-year-old man reports that his wife says he has hearing trouble. Examination reveals that air conduction on the right side is less than on the left side and greater than bone conduction bilaterally. He hears a tuning fork placed on the top of his head better with his left ear. Which one of the following is the most appropriate next step in management?

A) Hearing aid.
B) Wax removal from the ears by irrigation.
C) Audiometry.
D) Computed tomography scan of the head.
E) Magnetic resonance imaging of the posterior fossa.

5. A 56-year-old woman is admitted to hospital with gastrointestinal bleeding. Her hemoglobin level is low and the physician who saw her in the Emergency Department has recommended a blood transfusion. You attend her on the unit and tell her that a blood transfusion will help her feel better. Which one of the following is the best next step?

A) Give the patient a blood transfusion before her condition becomes unstable.
B) Withhold the transfusion to avoid any risk for liability.
C) Discuss with the patient the potential risks and benefits of having a transfusion.
D) Review the patient's chart to see if she consented to transfusions in the past.
E) Ask a colleague to see the patient and make the same recommendation.

Solutions: