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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 1-month-old breastfed baby is brought to your office by his parents for his well-baby check-up. He was born at 32 weeks' gestation. Growth parameters at birth revealed head circumference, weight and length at the
50th percentile. Today, his weight is at the 10th percentile. Which one of the following is the most appropriate plan of action?

A) Obtain serology for celiac disease.
B) Observe the infant while feeding.
C) Order a sweat chloride test.
D) Supplement with formula feeding.
E) Reassure the parents.

2. An 83-year-old woman presents to your office with a 2-day history of confusion. Her past medical history is significant for lung cancer, and she is being treated with radiation. On physical examination, she is euvolemic.
Her blood work reveals a serum sodium of 118 mmol/L (135-140) as compared with 134 mmol/L (8 days ago). Which one of the following will be most helpful in establishing the cause of her laboratory abnormality?

A) Urinalysis
B) Serum osmolality
C) Parathyroid hormone-related peptide
D) Creatinine clearance
E) Urine sodium

3. A 62-year-old woman is referred to your clinic for evaluation of hypercalcemia. She has a history of hypertension and vitamin D deficiency. Her medications include hydrochlorothiazide and vitamin D supplements. Laboratory investigations are as follows:
Calcium: 2.72 mmol/L (#)
Phosphate: 0.9 mmol/L (#)
Parathyroid hormone (PTH): 0.9 pmol/L (#)
25-hydroxy vitamin D: 80 nmol/L (normal)
Which one of the following is the best next step?

A) Order 24-hour urine calcium
B) Start calcitriol
C) Order serum protein electrophoresis and urine for light chains
D) Refer for consideration of parathyroidectomy
E) Switch to a different antihypertensive medication

4. A 32-year-old woman presents to the office and reports that she feels unwell and tired. She is worried about long-standing episodic diarrhea and vague abdominal discomfort. Laboratory investigations reveal a hemoglobin of 90 g/L (123-157), mean corpuscular volume of 75 fL (80-100), and serum ferritin level of 4 µg
/L (11-307). Which one of the following tests is most likely to produce a diagnosis?

A) Stool for culture and sensitivity.
B) Helicobacter pylori serology.
C) Fecal fat determination.
D) Total iron-binding capacity.
E) Immunoglobulin A tissue transglutaminase.

5. A 31-year-old woman, gravida 4, para 3, aborta 0, presents at 8 weeks' gestation with scant vaginal bleeding and no abdominal pain. Her heart rate is 90/min and blood pressure is 100/70 mm Hg. A speculum examination reveals a closed cervix. The beta-human chorionic gonadotropin level is 300,000 IU/L. Which one of the following is the most likely diagnosis?

A) Incomplete abortion.
B) Tubal pregnancy.
C) Implantation bleeding.
D) Molar pregnancy.
E) Threatened abortion.

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