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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. You are examining a full-term baby girl in the nursery. You notice that her left forefoot is adducted and supinated relative to the contralateral foot, which makes her left foot appear C-shaped. Which one of the following findings is most instrumental in deciding on the management of this issue?

A) Cephalohematoma
B) Internal tibial torsion
C) Syndactyly of 2nd and 3rd toes
D) Flexibility of the deformity
E) Significant hallux valgus

2. 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) Arthrography.
B) Ultrasonography.
C) Arthroscopy.
D) Computed tomography.

3. A 45-year-old man is brought to the Emergency Department with chest pain. He has no significant medical history. He is anxious and agitated, and he reports severe central chest pain that began about 90 minutes ago.
His vital signs are as follows: blood pressure 200/110 mm Hg, heart rate 140/min, respiratory rate 30/min, oxygen saturation 98% on supplemental oxygen. Physical examination reveals a restless and slightly tremulous man. Pupils are 7 mm reactive. There are no focal neurologic signs. Cardiopulmonary examination is normal. The 12-lead electrocardiogram reveals sinus tachycardia; findings are otherwise normal. Which one of the following is the most likely cause of this clinical presentation?

A) Heroin.
B) Alcohol.
C) Oxycodone.
D) Cannabis.
E) Cocaine.

4. A 63-year-old man is brought to the Emergency Department by ambulance after he injured his abdomen.
While working on a house, he fell 1 m from a scaffold and landed on a metal pipe. He is clinically stable but reports localized abdominal pain. On examination, he has a 17-cm laceration to his abdomen in the left hypochondrium. The laceration is 4 cm deep, but there is no fascial laceration. Which one of the following is the best next step?

A) Antibiotic irrigation of the wound.
B) Surgical debridement and delayed closure.
C) Exploratory laparotomy.
D) Abdominal computed tomography.
E) Primary repair of the laceration.

5. An otherwise healthy 21-year-old college student is brought to the Emergency Department after falling from the rooftop terrace of a night club. A grade III splenic laceration measuring 3 cm is identified on computed tomography scan. You elect to manage the patient non-operatively with close monitoring, repeat examinations and hemoglobin levels. A repeat computed tomography at 48 hours shows no deterioration. Diet is resumed and over the next few days, the patient resumes ambulation. Which one of the following do you discuss with your patient prior to discharge?

A) Vaccinate against encapsulated organisms.
B) Organize an angiography with possible embolization.
C) Recommend avoidance of vigorous activity for 3 months.
D) Arrange weekly outpatient follow-up with repeat hemoglobin measurement.
E) Plan an interval laparoscopic splenectomy within the next 6 weeks.

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