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[Hardware] 優秀的MCCQE考試大綱和認證考試的領導者材料與有實踐的MCCQE資訊

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【Hardware】 優秀的MCCQE考試大綱和認證考試的領導者材料與有實踐的MCCQE資訊

Posted at yesterday 03:22      View：24 | Replies：0        Print      Only Author   [Copy Link] 1#
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最新的 MCCQE Part 1 MCCQE 免費考試真題 (Q37-Q42):問題 #37
A 35-year-old woman presents to your clinic with double vision and a gritty sensation in her eyes for the past several weeks. On examination, you notice her eyes are bulging. There is inflammation of her conjunctivae and swelling around her eyes. Which one of the following is the most likely diagnosis?
  • A. Graves ophthalmopathy
  • B. Orbital pseudotumor
  • C. Allergic conjunctivitis
  • D. Myasthenia gravis
  • E. Periorbital cellulitis
答案：A
解題說明：
The findings of exophthalmos (bulging eyes), conjunctival inflammation, and periorbital swelling are hallmark features of Graves ophthalmopathy, a manifestation of autoimmune hyperthyroidism.
Toronto Notes 2023 - Endocrinology, "Thyroid Disorders":
"Graves ophthalmopathy: proptosis, periorbital edema, conjunctivitis, and diplopia due to extraocular muscle involvement. Often independent of thyroid levels." MCCQE1 Objectives (Internal Medicine > 36-1: Thyroid Disease):
"Candidates must recognize and manage Graves disease and its ocular manifestations." Myasthenia gravis may cause diplopia but not proptosis or swelling. Pseudotumor and cellulitis are painful and acute. Allergic conjunctivitis is itchy but lacks proptosis.

問題 #38
A 32-year-old woman presents to the office with questions related to the mRNA vaccines that are approved for COVID-19. She is a health care worker. She gave birth to a healthy child 2 months ago. Before being immunized, which one of the following is the most important detail to elicit from the patient's history?
  • A. Previous anaphylactic reaction to vaccine components.
  • B. Work in a medical unit caring for patients with COVID-19.
  • C. Presently breastfeeding.
  • D. Current immunosuppression.
答案：A
解題說明：
The most important pre-vaccination history to elicit is any previous anaphylaxis to vaccine components.
mRNA COVID-19 vaccines (e.g., Pfizer-BioNTech and Moderna) may contain polyethylene glycol (PEG), a potential allergen. This is a contraindication to administration.
Toronto Notes 2023 - Infectious Disease & Immunization Chapter:
"Absolute contraindications to mRNA COVID-19 vaccination include a documented anaphylactic reaction to a component of the vaccine such as polyethylene glycol (PEG)." MCCQE1 Objectives - Population Health > Preventive Medicine > Immunizations:
"The candidate must be able to assess for contraindications prior to immunization, including anaphylaxis to previous vaccines or components." Breastfeeding and occupational exposure (Options B and D) do not preclude vaccination. Current immunosuppression (Option C) may affect vaccine efficacy but is not a contraindication unless specifically advised.

問題 #39
A 73-year-old woman is seen in the office 2 weeks after a coronary bypass surgical procedure. The site of saphenous vein removal in the left thigh shows an area of tenderness and a 3 × 5 cm palpable mass. The skin is intact. Her temperature is 37.7 °C, hemoglobin is 110 g/L (125-167), and white blood cell count is 8 × 10#
/L (4-10). Which one of the following is the most likely diagnosis?
  • A. Wound abscess
  • B. Femoral artery aneurysm
  • C. Acute venous bleeding
  • D. Wound hematoma
  • E. Thrombophlebitis
答案：D
解題說明：
Comprehensive and Detailed Explanation:
A localized mass with tenderness at a recent surgical site, intact skin, low-grade temperature, and normal white count is most consistent with a wound hematoma. This is a common complication at saphenous vein graft harvest sites post-CABG.
Toronto Notes 2023 - Surgery / Cardiac:
"Wound hematoma presents as localized swelling and tenderness near recent surgical sites. Abscess is suggested by erythema, warmth, and systemic signs." MCCQE1 Objectives (Surgery > 50-2: Postoperative Complications):
"Candidates must identify and differentiate wound complications, including hematoma, seroma, and abscess." Abscess (E) would show redness, fluctuance, and fever. Aneurysm (B) is rare and pulsatile. Bleeding (A) would not form a stable mass 2 weeks post-op. Thrombophlebitis (C) usually involves superficial veins and erythema.
-

問題 #40
A 44-year-old woman presents to the office to discuss contraception. During the gynecologic examination, you notice an anterior cystocele to the hymenal ring. The woman denies any bulge symptoms but does report dribbling of urine, especially when she coughs or jogs.
Which one of the following is the best next step?
  • A. Topical estrogen
  • B. Vaginal hysterectomy
  • C. Urology consultation
  • D. Pelvic-floor physiotherapy
  • E. No impact sports
答案：D
解題說明：
Comprehensive and Detailed Explanation:
This patient has stress urinary incontinence and an incidental cystocele. First-line management of mild pelvic organ prolapse and stress incontinence includes pelvic floor physiotherapy (e.g., Kegel exercises). Surgical options are reserved for severe or refractory cases.
Toronto Notes 2023 - Gynecology, Pelvic Floor Disorders:
"For asymptomatic prolapse or mild stress incontinence, recommend pelvic floor strengthening. Conservative management is preferred before surgical referral." MCCQE1 Objectives - Gynecology > Urogynecology:
"Candidates should initiate pelvic floor therapy in women with mild prolapse or urinary leakage prior to specialist referral." Topical estrogen (B) helps with atrophic vaginitis, not stress incontinence. Hysterectomy (A) and specialist referral (C) are premature. Avoiding impact sports (E) is not a treatment.

問題 #41
A 55-year-old man with alcohol use disorder presents with a 2-day history of confusion. Onexamination, you note a sixth nerve palsy and a horizontal nystagmus. Which one of the following is the most likely diagnosis?
  • A. Wernicke encephalopathy
  • B. Subdural hematoma
  • C. Hepatic encephalopathy
  • D. Cerebellar hemorrhage
  • E. Cerebellar degeneration
答案：A
解題說明：
Wernicke encephalopathy is a medical emergency caused by thiamine (vitamin B1) deficiency, most often seen in chronic alcohol use. The classic triad is:
* Confusion
* Oculomotor dysfunction (e.g., nystagmus, cranial nerve palsies)
* Ataxia
Toronto Notes 2023 - Neurology and Psychiatry, "Wernicke Encephalopathy" Section:
"Wernicke encephalopathy is diagnosed clinically. Symptoms include ophthalmoplegia (e.g., CN VI palsy), horizontal nystagmus, ataxia, and confusion. Immediate parenteral thiamine is indicated before glucose administration." MCCQE1 Objectives (Neurology > 75-1: Neurologic Emergencies):
"Candidates must recognize Wernicke encephalopathy in at-risk individuals and initiate urgent thiamine replacement." Other choices like cerebellar degeneration (A) and hepatic encephalopathy (D) are more chronic and lack the characteristic eye findings. Subdural hematoma (B) and hemorrhage (E) may mimic confusion but are less likely with these neurologic signs and history.

問題 #42
......
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