Free MCCQE Part I: Medical Council of Canada Qualifying Examination Exam Questions and Answers

In a well-designed randomized controlled trial of a drug to treat chronic hepatitis, the case fatality rate was lower for patients who were given the drug. This result was followed by the notation “(P = .05)." Which one of the following statements best applies?

• AA. Treated patients were 20 times less likely to die than untreated patients.
• BB. The probability is 1 in 20 that the observed differences could have happened by chance alone.
• CC. The chance is 1 in 20 that a difference would be found again if the trial were repeated.
• DD. An improved chance of survival was noted for 19 of 20 patients treated.
• EE. The mortality rate for patients was less than 1 in 20.

A 25-year-old man presents to your clinic with a 2-month history of swelling, pain, and inflammation in his knee. He has been experiencing low back pain and morning stiffness for 2 years. Which one of the following is most likely to confirm the diagnosis?

• AA. Uric acid level
• BB. Antinuclear antibodies test
• CC. Radiography of the sacroiliac joints
• DD. Rheumatoid factor level
• EE. Synovial fluid analysis

A 78-year-old woman presents to your clinic after she is found to have a 2-cm hypoechoic thyroid nodule on ultrasonogram. She feels well and does not report hoarseness, dysphagia, or hyperthyroid symptoms. Her medical history includes type 2 diabetes and hypertension. She has never had head or neck radiation, and there is no family history of thyroid cancer. Her thyrotropin (thyroid-stimulating hormone) level is 0.10 mIU/L (0.34–5.60). Which one of the following is the best next step?

• AA. Computed tomography of the neck.
• BB. Thyroid antibody levels.
• CC. Fine-needle aspiration of the thyroid.
• DD. Repeat thyroid ultrasonography in 6 months.
• EE. Thyroid uptake and scan.

A 77-year-old man presents to your clinic because of urinary incontinence for the past 2 months. He says that his bladder always feels full, and he frequently loses bladder control during the day and night. For the past year, he has had to urinate every 2 to 3 hours and has had nocturia. Which one of the following is the most likely diagnosis?

• AA. Interstitial cystitis
• BB. Prostate cancer
• CC. Neurogenic bladder
• DD. Chronic cystitis
• EE. Overflow incontinence

An 8-year-old boy is brought by his mother to your clinic because of a 6-month history of a persistent cough. He has single bark-like coughs about 20 times daily. He does not cough through the night. His mother mentions that he has been shaking his head and blinking more frequently throughout the day. Which one of the following in the patient's history would be most important to consider?

• AA. Frequent vomiting
• BB. Family history of epilepsy
• CC. Academic performance
• DD. Exposure to allergens

A 42-year-old woman presents to your clinic and shares that her husband is physically abusing her. A few days later, you receive a call from a police officer who says she is investigating a complaint made by your patient against her husband. The police officer explains that she needs medical information from you for the investigation. Which one of the following is the best next step?

• AA. Call the police officer after you review the patient's file.
• BB. Contact the patient to discuss the request.
• CC. Send the police officer a medicolegal report.
• DD. Refuse to speak with the police officer.

A 36-year-old woman, gravida 2, para 1, aborta 0, presents to your clinic for her first prenatal visit. Her pregnancy is at 14 weeks' gestation. She is 155 cm tall and weighs 140 kg (BMI 58). Her prepregnancy weight was 138 kg (BMI 57). Which one of the following is the best advice to give the patient about weight gain during pregnancy?

• AA. She should gain 12 kg to 18 kg.
• BB. Her weight gain should be based on her prepregnancy BMI.
• CC. Her risk of having a macrosomic neonate is lower if she gains 11 kg to 16 kg.
• DD. She should gain 400 g each week during the second trimester.
• EE. She should begin a calorie-restricted diet.

A 26-year-old man presents to your clinic with anejaculation, which he has had since he started taking paroxetine. He has major depressive disorder. He would like to switch to a different antidepressant. Which one of the following medications is the most indicated?

• AA. Fluoxetine
• BB. Venlafaxine
• CC. Bupropion
• DD. Clomipramine
• EE. Phenelzine

A 24-year-old man presents to your clinic for the first time and reports having had suicidal thoughts for most of his life. He says that he and his girlfriend recently broke up, and he is feeling alone and abandoned. He also notes that he often feels empty and his mood is very unstable. He says "People think I'm a little bit crazy. They never know what I'm going to do." These symptoms are indicative of which one of the following personality disorders?

• AA. Antisocial
• BB. Narcissistic
• CC. Schizotypal
• DD. Borderline
• EE. Histrionic

A 42-year-old man presents to your clinic for follow-up. He has been experiencing paranoid ideation that began 8 months ago. After a few weeks of treatment, he was able to return to work as a teacher. His delusions were limited to the belief that coworkers were sending messages about him to each other through various hand signals. He has had no auditory hallucinations and has retained a good range of affect. Which one of the following is the most likely diagnosis?

• AA. Schizophrenia
• BB. Schizoaffective disorder
• CC. Body dysmorphic disorder
• DD. Delusional disorder
• EE. Major depressive disorder with psychotic features