Medical Council of Canada MCCQE Exam Dumps

You perform a literature search of journal articles on the effectiveness of a newantihypertensive for first-line treatment of people aged 35 to 50. You find reports of 4 goodquality studies. Three of them show that statistically, the new drug is significantly moreeffective than the standard treatment, and one shows no difference. Before you concludethat the new antihypertensive is more effective in this group of patients, which one of thefollowing concepts must be given consideration?

The parents of a 12-year-old boy present to your clinic to discuss their son’s submersioninjury. The patient was seen in hospital for 6 months after being pulled unresponsive from alake at his friend’s house; he had been submerged for an estimated 20 minutes. Afterextended resuscitation and a 2-month stay in the intensive care unit, he remains in apersistent vegetative state but needs no respiratory or cardiac support. When evaluatingthe discharge from hospital, which one of the following is most appropriate?

A 51-year-old man comes to your clinic for follow-up regarding his type 1 diabetes. Hishemoglobin A1c is 12.5% (normal 4–6%). He has never had such high blood sugar results.He drinks 2 beers per night to help with sleep. He is not well rested because he has beensleeping on a friend’s couch since losing his job last year. Which one of the following is thebest next step?

A 42-year-old man presents with a history of fatigue and weight loss. He looks unwell, hasa darker than usual complexion and his liver is enlarged. He is also found to have markedglycosuria. Which one of the following is the most useful diagnostic test?

A couple is diagnosed with primary infertility secondary to azoospermia. They are not  interested in in vitro fertilization techniques, so you recommend insemination with a sperm onor. The male partner is hesitant. He thinks he might have difficulty accepting raising achild who is not biologically his. Which one of the following is the best next step?

A 40-year-old man presents to the emergency department with a 24-hour history of severeabdominal pain and recurrent vomiting. He has a long-term history of alcohol use disorder.His blood pressure is 90/60 mm Hg, and his heart rate is 120/min. The pain is locatedmostly in the epigastrium but radiates to the right upper quadrant and to his back.Radiographs of the abdomen and chest reveal some distended small bowel loops in hisupper abdomen. Laboratory work results are pending. After fluid resuscitation, which one ofthe following is the best next step?

A 43-year-old man comes to your office for the first time. He has not seen a doctor in over5 years and has no known past medical history. On examination, his blood pressure is120/70 mm Hg, and the remainder of his examination is normal. As part of the initial visit,you order some screening blood work that reveals a fasting blood glucose of 6.3 mmol/L(3.3–5.8) and a hemoglobin A1c of 6.1% (4–6). Which one of the following is the best nextstep?

A 9-year-old girl is brought to the Emergency Department because she has generalizedurticaria, abdominal cramping, and postural dizziness 30 minutes after eating at a friend’sbirthday party. Which one of the following is the most appropriate route of administration forepinephrine?

A 25-year-old woman presents to the Emergency Department with a 2-hour history ofpelvic pain associated with no other symptoms. The first day of her last menstrual periodwas 14 days ago. On examination, her vital signs are as follows:Blood pressure108/72 mm HgHeart rate110/minTemperature37 °CAbdominal examination reveals rebound tenderness and guarding. Pelvic examinationreveals exquisite left adnexal tenderness. Which one of the following is the most likelydiagnosis?

A 60-year-old woman presents with a 7-day history of bloody diarrhea and diffuse mildabdominal tenderness. Stool tests (culture, ova/parasites) are negative. Which one of thefollowing is the best next step?

You are covering for your colleague who is on vacation this week. You receive the resultsfrom an ultrasonography that had been ordered for a 32-year-old woman, gravida 2, para 1,aborta 0. The ultrasonography-estimated fetal weight is below the fifth percentile for 30weeks' gestation; gestational age was confirmed by an earlier ultrasonogram. The amnioticfluid volume is within normal range. Her first child's birth weight was 2800 g at full term.Which one of the following is the best next step?

A 34-year-old man sustained a blunt testicular trauma 2 hours ago. On physicalexamination, the patient has a 1.5-cm tall scrotal hematoma. You cannot palpate thetesticle. Which one of the following is the best initial management? 

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

A 55-year-old woman presents with a 6-month history of poor memory and impairedconcentration. She has bipolar I disorder that has been treated with lithium carbonate for 4years. She has gained a lot of weight since starting lithium. Physical examination findingsare otherwise normal. She is concerned about her memory issues, but there are no otherperception, mood, or cognition abnormalities. Which one of the following tests is most likelyto have abnormal findings?

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

A 44-year-old woman presents to the office to discuss contraception. During thegynecologic examination, you notice an anterior cystocele to the hymenal ring. The womandenies any bulge symptoms but does report dribbling of urine, especially when she coughsor jogs.Which one of the following is the best next step?

A 30-year-old woman presents to the office with her partner and reports that they areplanning for her to conceive soon. They visited Mexico recently and are concerned aboutexposure to the Zika virus. Which one of the following is the best next step?

A 34-year-old woman, gravida 3, para 2, aborta 0, presents at 38 weeks' gestation. She isin early labor with ruptured membranes. Her previous pregnancy was complicated by feverduring labor. Which one of the following would increase the risk of fever recurrence?

A 58-year-old woman presents with a 1-year history of functional decline. She reportsseeing rodents and little children invading her bedroom. Her partner tells you she has aslow, unsteady gait and tends to fall. On examination, she cannot sustain her attentionduring cognitive testing. Which one of the following is most likely to be found on brainimaging?

You are counselling the wife of a 75-year-old man admitted under your care after a fall. Thepatient is confused, disoriented, barely sleeps at night and has complex visualhallucinations of animals running through his room. Given his state, which one of thefollowing is the best advice for the wife?

An 84-year-old woman is brought by ambulance to the emergency department after shewas found by a neighbour. She had fallen, sustained a hip fracture, and was unable tomove for the past 2 days. After starting rehydration, she reports hip pain and numbnessand tingling in both her legs. Physical examination reveals faint pulses in both legs andseverely swollen lower legs that are painful to palpation. The urine in the Foley catheterbag seems to be darker than normal. Which one of the following is the best next step?

You are a physician working at a university campus health centre. Staff at the centre arethinking about initiating a campus-wide education campaign on stimulant medication useand misuse. From a physician's perspective, which one of the following is the key messageto include in this campaign?

A 55-year-old woman presents to the office with a 2-month history of right shoulder painand limited function that started after she began an upper body weight training program.Examination shows tenderness inferior to the acromion. She has full passive range ofmotion of the shoulder but significant pain with abduction from 30° to 120° of arc. Whichone of the following is the best next step?

A 53-year-old man with a history of bipolar I disorder is brought to the office by his family.Recently, he has been sleeping for 4 to 5 hours per night, has been fidgety, and isincreasinglypreoccupied with his granddaughter's safety. Five days ago, he consulted withyour physician colleague and was instructed to exercise and meditate. Last night, he wasfound running in the street and attempted to hit a relative who was trying to calm him down.His son is dissatisfied with your physician colleague's management. Which one of thefollowing is the most appropriate response?

A 24-year-old woman presents with rapidly increasing lower leg pain. Less than 24 hoursago, she fell off her bicycle and had some minor abrasions. On examination, she is insevere pain and appears anxious. Local examination of her leg reveals mild discolorationwith marked tenderness but no swelling in her calf. Which one of the following is the mostlikely diagnosis?