Medical Council of Canada MCCQE Part 1 - MCCQE Exam Practice Test

A 59-year-old woman is referred to you because of a 2-month history of left nipple discharge. She is otherwise healthy and is not on any medication. There are no palpable lesions on breast examination. She is able to express a small amount of blood-tinged liquid from her breast. Which one of the following would be the best next step?

A 67-year-old woman presents with headaches, muscle weakness, pain in her shoulders and hips, weight loss, and depression. While also arranging appropriate investigations to confirm a diagnosis, which one of the following is the most important objective of treatment?

You are treating a 78-year-old man for recent onset of diarrhea, tenesmus, and minor bleeding when he wipes.
He has a history of prostate cancer that was treated by radiotherapy. Rectal examination findings are normal.
Colonoscopy reveals a pale rectum with ulcerations and areas of mucosal hemorrhage. Which one of the following is the most likely explanation for this clinical presentation?

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

A 55-year-old woman presents to the office with a 2-month history of right shoulder pain and 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 of motion of the shoulder but significant pain with abduction from
30° to 120° of arc. Which one of the following is the best next step?

A 56-year-old woman comes to your office because she has not been herself since her husband died in a car crash 6 weeks ago. She has no prior psychiatric history. Her son is concerned because she cries frequently, has a poor appetite, rarely leaves home and is distraught. Her sadness fluctuates and increases when she thinks of her husband. She often thinks about death, and she wishes she could join her deceased husband. Which one of the following is the best next step?

A 45-year-old woman presents to your clinic for follow-up regarding her asthma. She is planning to attend a cultural event that includes ceremonial burning of tobacco. Which one of the following is the best next step?

A 42-year-old man comes to your family practice. He has started seeing a reflexologist to help manage his chronic back pain. He presents to you a letter from the reflexologist outlining the weekly necessary treatments, each costing $300, and a list of blood tests for the patient to have done. The patient asks you to order the laboratory testing and send the results to his "other doctor." Which one of the following is the best next step?

A 20-year-old woman from a remote northern community presents to the office with a 2-week history of malaise and a 2-day history of disabling pain in her left elbow. She had a sore throat 4 weeks ago. She also notes that she has had 2 weeks of pain and swelling in her right knee, followed by pain and swelling in her left elbow. On examination, you note 0.5-cm to 1-cm nodules just above both her elbows. You find no active joint swelling. An electrocardiogram shows a prolonged PR interval. Which one of the following is the most appropriate investigation?

A 69-year-old man presents with a 4-day history of a painful right knee. On history, he denies any trauma or similar previous episodes. Examination reveals effusion of the right knee that is warm to the touch. Which one of the following is the best next step?

A mother brings her 1-month-old infant for routine health examination. The infant was born at term with no complications. He is exclusively breastfed every 3-4 hours and growth parameters are normal. His mother tells you that feedings are difficult (the baby cries any time she tries to put him down) and that she is exhausted. Her husband has been on a military mission since the infant was 2-weeks-old. Which one of the following is the most appropriate next step in management?

A 62-year-old woman with type 2 diabetes comes in for follow-up. She has noticed that her vision has been getting blurry over the past year and that she now needs a bright light to look at photos of her grandchildren.
Upon fundoscopic examination, you note yellow deposits in the central retina. Which one of the following is the most likely diagnosis?

You are 1 of 3 physicians on an interdisciplinary brain injury team at a hospital. The team ' s physiotherapist has concerns regarding a patient ' s medication. Which one of the following is the most appropriate course of action for communicating with the physiotherapist?

A 15-year-old boy is brought to the Emergency Department by his parents because he fainted at home earlier in the day. They are recent immigrants, and there is a language barrier. Which one of the following is the best option for facilitating a thorough history-taking?