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Medical Council of Canada MCCQE Part 1 Sample Questions:

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

2. A 37-year-old man presents with chronic back, neck, and shoulder pain following a workplace injury 4 years ago. He has a history of alcohol misuse and PTSD related to the incident. Current medications (acetaminophen, naproxen, amitriptyline, gabapentin) provide inadequate pain relief. He requests oxycodone after self-trialing it with temporary benefit. After history and physical assessment, which one of the following is the best next step?

A) Ordering repeat imaging of the spine and shoulder to confirm the diagnosis.
B) Prescribing a short course of a short-acting opioid to be used only as needed.
C) Referring the patient to substance use and mental health support services.
D) Prescribing a low-dose, long-acting opioid and reassessing in 1 week for effectiveness.
E) Prescribing cannabis.

3. A 25-year-old man presents to the Emergency Department with diffuse abdominal pain and anorexia. He was tackled in a football game yesterday. He reports a 3-week history of sore throat and fatigue. Vital signs are as follows:
Blood pressure: 95/45 mm Hg
Heart rate: 96/min
Temperature: 37.6°C
Which one of the following is the most likely diagnosis?

A) Ruptured spleen
B) Pyelonephritis
C) Ruptured duodenum
D) Appendicitis
E) Pneumonia

4. A 32-year-old man presents to the clinic for assessment of a dog bite sustained 3 days ago while traveling in another country. He recalls having seen the dog eat where he was staying, and the animal did not appear well.
On examination, the patient has 2 distinct deep puncture wounds on his left leg. There is an erythematous border but no exudate. He is unsure of his immunization status. Which one of the following is the most appropriate management?

A) Irrigate the wounds with hydrogen peroxide
B) Arrange for wound debridement
C) Give rabies immunoglobulin and vaccine
D) Start antibiotic treatment with ciprofloxacin
E) Order serum creatine kinase

5. A 1-week-old boy born at full term is brought by his parents to the office with a 2-day history of eye swelling and watery discharge. This morning, the discharge became thick and yellow. On physical exam, he is afebrile and fussy with bilateral eyelid edema, purulent discharge, and erythematous conjunctivae. After taking appropriate cultures of the eyes, which one of the following is the best next step?

A) Admit the patient and start antibiotic therapy
B) Reassure the parents and prescribe a topical antibiotic
C) Recommend lacrimal sac massage
D) Advise warm compresses every 2 to 3 hours until discharge is cleared
E) Prescribe an oral antibiotic and reassess in 48 hours

Solutions: