Medical Council of Canada MCCQE Exam Dumps

A 34-year-old man with trisomy 21 is brought to the Emergency Department because of apainful, red great toe. He is accompanied by an older woman who begins giving you thehistory as you enter the room. The patient is sitting on the examination table with the footexposed, but he does not speak. Which one of the following is the best next step?

A 43-year-old man is referred to you for an incidental finding of elevated hemoglobin.Laboratory results are as follows:Hemoglobin185 g/L (130-170)Mean corpuscular volume92 fL (60-100)White blood cells7.8×1037.8×103 / L (4-10)Platelets250×103250×103 / L (130-400)His BMI is 23. He has type 2 diabetes for which he takes gliclazide MR 60 mg daily. Whichone of the following features on history could explain his laboratory abnormality?

A 58-year-old woman presents to your office with heavy vaginal bleeding. She has a historyof type 2 diabetes and hypertension. Some active bleeding is visible on speculumexamination. Ultrasound reveals an endometrial thickness of 12 mm. Endometrial biopsyshows complex hyperplasia with atypia. Which one of the following is the best next step?

A 53-year-old man presents to the Emergency Department with a 3-week history ofbelieving his neighbor is poisoning him by pumping gas through his home’s air vent. Heappears distracted, irritable, and is speaking very quickly. He has a family history ofdepression. Which one of the following is the most likely diagnosis?

A 38-year-old woman presents with diffuse nodularity in the outer upper quadrant of herright breast. There is no obvious dominant mass, nipple discharge, or skin dimpling. Thereare no palpable lymph nodes. Which one of the following is the most likely diagnosis?

A same-sex couple asks to join a family physician’s practice. The physician tells them thatshedoes not treat same-sex couples and will refer them to a physician with more clinicalexperience with same-sex couples. Which one of the following best describes thephysician’s obligation under the Canadian Charter of Rights and Freedoms?

A 30-year-old man comes to the office and asks you to write him a note for his employerthat recommends a stress leave. He says he feels entitled to a rest. He comes across asirritable and impulsive. He appears to show little regard for the law and admits to recentlyembezzling $5,000 from his employer. He justifies his actions and shows no remorse. Hehas a history of attention-deficit/hyperactivity disorder as a child. Which one of the followingis the most likely diagnosis?

A 37-year-old man presents with chronic back, neck, and shoulder pain following aworkplace injury 4 years ago. He has a history of alcohol misuse and PTSD related to theincident. Current medications (acetaminophen, naproxen, amitriptyline, gabapentin) provideinadequate 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 6-week-old boy is brought to your office by his parents for a follow-up following a recenturinary tract infection. His abdominal ultrasound shows dilated urinary bladder and uretersas well as bilateral hydronephrosis. Which one of the following historical findings would bemost helpful in establishing the correct diagnosis?

You are called to the Emergency Department to see a 6-month-old boy with a 3-day historyof fever. Physical examination reveals an irritable infant with a temperature of 38.1°C. Hisvital signs are:Blood pressure: 87/50 mm HgRespiratory rate: 80/minHeart rate: 140/minOxygen saturation: 92% on room airThe infant has no skin findings. On chest examination, you hear coarse crackles on theright side of the chest. Which one of the following is the best next step in the managementof this child?

A 27-year-old woman presents with an enlarged thyroid. She had not noticed it herself untilher 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 28-year-old woman presents because of spotting mid-menstrual cycle. Speculumexamination reveals an ulcerated endocervical polyp. Which one of the following is themost appropriate management?

A 37-year-old woman diagnosed with schizophrenia comes to her family physician becauseshe has been choking on her food lately. She has a history of mild spasmodic dysphonia.She was recently started on haloperidol for auditory hallucinations. Which one of thefollowing is the best short-term management?

A patient's mother comes to you with a prospective cohort study linking autism to themeasles, mumps and rubella vaccine. After reviewing the study carefully, you question theresults because of problems with the study design and execution. Which one of thefollowing sources of error would be most important in the study design or execution?

An 85-year-old man is transferred from an acute care hospital to your long-term care (LTC)facility. He has a fever, fatigue, myalgia, and malaise. His test result is positive for influenzaA virus. Two other residents and 1 LTC staff member have experienced the samesymptoms. Which one of the following is the best next step to prevent further infections atthe LTC facility?

An 18-year-old woman comes to the office because of fatigue. She tells you she isstruggling in her first year of university. She mentions that she spends much of her timerewriting her notes and filing and organizing her study materials. She is doing all the workin her group assignments because she feels others cannot do the work to a high enoughstandard. She has abandoned all enjoyable activities and seems to be constantly workingand worrying about her grades. Which one of the following is the most likely diagnosis?

A 91-year-old man comes to the Emergency Department reporting blood in his stools,which has now resolved. He is able to give a history and mentions that this also happened2 years ago. At that time, a colonoscopy was done and revealed diverticular disease as thecause. Which one of the following is the best next step?

A 69-year-old woman with long-standing hypertension presents to the emergencydepartment with a 2-hour history of persistent chest and back pain. A posteroanterior chestradiograph shows suspicious widening of the mediastinal shadow. Which one of thefollowing is most likely to yield a clinical diagnosis?

A 3-year-old boy is brought to the office because he has progressive weight gain and shortstature. He has marked truncal obesity, hypertrichosis of the upper lip, and facial swelling.Which one of the following is a physical examination most likely to reveal?

A 30-year-old woman presents to your office with a 6-week history of left lower quadrantpain and dyspareunia. A pelvic ultrasound is normal. Which one of the following is the mostimportant immediate investigation?

A 25-year-old woman, gravida 1, para 1, aborta 0, gave birth to a newborn who ishypotonic with a large protruding tongue and brachycephaly. The newborn has a singlepalmar crease bilaterally and short, broad hands with a curved fifth digit. These featuresbest support a clinical diagnosis of which one of the following?

You are on duty in the Emergency Department when 5 patients are brought in byambulance after a high-speed motor vehicle collision. Which one of the following patientsrequires the most urgent medical care?

You are counselling a couple that is concerned about the risk that their second child couldbe affected by the same X-linked recessive disorder (hemophilia A) as their last child, aboy. Neither parent has this disorder. What is the probability that their second child will beaffected?

During an office visit, your 14-year-old patient requests a prescription for oralcontraceptives. The province where you are working does not have a statutory age ofconsent. Which one of the following is the best next step?

An investigator interested in the etiology of neonatal jaundice conducted a study where heselected 150 children diagnosed with this condition and 150 children born in the same timeperiod and in the same hospital who did not have a diagnosis of neonatal jaundice. He thenreviewed the delivery records of their mothers to determine various prenatal and perinatalexposures. This is an example of which one of the following?