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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 40-year-old woman presents with a 3-month history of discharge from her right nipple. The discharge was initially milky white, but over the last 2 weeks, the patient has noted blood stains on her bra. There is mild discomfort in the same breast around the time of menses periods. On physical examination, the upper outer quadrant of the breast is tender, but there are no palpable lumps. You are able to express fluid from the nipple which is in fact blood-tinged. Which one of the following is the most likely diagnosis?

A) Paget disease.
B) Ductal carcinoma in situ.
C) Mammary duct ectasia.
D) Staphylococcal infection.
E) Intraductal papilloma.

2. A 22-year-old woman presents to the office for episodic mood changes that her boyfriend has noticed. During such episodes, she cries suddenly, is irritable and sad, and withdraws from socializing. Which one of the following would be most useful in establishing a diagnosis?

A) Urine drug screen.
B) Mood journal.
C) Personality testing.
D) Interviewing the boyfriend alone.
E) Trial of lorazepam.

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

A) Vaccine company sponsorship of study
B) Parental recall of vaccine administration
C) Recruitment of study families at an autism seminar
D) Not accounting for all potential confounders during recruitment
E) Reporting standard error with point estimates of difference

4. A 30-year-old woman presents to your office for a follow-up assessment of a sports-related musculoskeletal injury to her right leg. She requests a letter for her employer regarding her return to work. You feel she should be able to manage some aspects of her factory work. Which one of the following is most appropriate to include in your medical note to this patient ' s employer?

A) Physiotherapist ' s evaluation
B) Treatment options
C) Required workplace accommodations
D) Diagnosis
E) Medical imaging results

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

A) Recommend a trial of loperamide.
B) Recommend symptomatic observation.
C) Prescribe tapered-dose steroids.
D) Order a diagnostic colonoscopy.
E) Prescribe broad-spectrum antibiotics.

Solutions: