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[General] 100% Pass MCCQE - Trustable MCCQE Part 1 Exam Reliable Exam Answers

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【General】 100% Pass MCCQE - Trustable MCCQE Part 1 Exam Reliable Exam Answers

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Medical Council of Canada MCCQE Part 1 Exam Sample Questions (Q65-Q70):NEW QUESTION # 65
A 70-year-old man presents with severe, postprandial, mid-abdominal pain which has become more severe over the past 6 to 9 months. It is associated with nausea but has not caused him to vomit or changed his bowel habits. He has lost 14 kg over the last 6 months. Abdominal and rectal examination is normal. Upper gastrointestinal series is unremarkable. Which one of the following is the most likely diagnosis?
  • A. Mesenteric adenitis
  • B. Cholelithiasis
  • C. Mesenteric ischemia
  • D. Carcinoma of colon
  • E. Peptic ulcer disease
Answer: C
Explanation:
Chronic mesenteric ischemia (also known as "intestinal angina") presents as postprandial abdominal pain, leading to food avoidance and significant weight loss. GI exams may be normal. Imaging (e.g., angiography or CT angio) confirms the diagnosis.
Toronto Notes 2023 - Gastroenterology, "Chronic Mesenteric Ischemia":
"Classic triad: postprandial abdominal pain, weight loss, and food aversion. Physical exam and GI series may be normal." MCCQE1 Objectives (Gastroenterology > 47-1: Abdominal Pain):
"Candidates must suspect mesenteric ischemia in older adults with risk factors and postprandial pain leading to weight loss." PUD (A) usually causes epigastric pain relieved by food. Cholelithiasis (B) causes RUQ pain. Colon cancer (D) presents with altered bowel habits or bleeding. Mesenteric adenitis (C) occurs in younger patients, often with infection.

NEW QUESTION # 66
A 64-year-old man presents with a 3-month history of gradually increasing neck pain and stiffness. The pain radiates into his upper back, and he is having difficulty driving because of limitation of neck rotation secondary to pain. Physical examination shows restricted neck motion in all directions and neck muscle spasms. There is no abnormality on neurologic examination. A radiograph shows narrowing of all of the cervical disc spaces with prominent osteophytes. Which one of the following is the most appropriate next step?
  • A. Magnetic resonance imaging of the neck.
  • B. Electromyography of upper limbs.
  • C. Lumbar puncture.
  • D. No further investigation.
  • E. Computed tomography of neck.
Answer: D
Explanation:
The presentation is consistent with cervical spondylosis - a degenerative condition. In the absence of neurologic findings, further imaging beyond plain radiography is not warranted. Management includes conservative measures such as physiotherapy and analgesia.
Toronto Notes 2023 - Rheumatology, Cervical Spondylosis:
"atients with typical cervical spondylosis and no red flags (e.g., neurologic deficits) do not require MRI.
Treatment is conservative. Radiographs showing disc space narrowing and osteophytes confirm diagnosis." MCCQE1 Objectives - Internal Medicine > Musculoskeletal Disorders:
"Candidates must recognize typical degenerative spine disorders and avoid unnecessary investigations when clinical findings are straightforward." MRI (B) is useful if myelopathy or radiculopathy is suspected. CT (A), EMG (C), and LP (D) are not indicated here.

NEW QUESTION # 67
A 45-year-old man with a developmental delay and a history of disruptive behavior presents to the clinic looking for his family doctor. He is well known to the clinic. He appears drunk and has accidentally broken 2 large beer bottles in the waiting room but remains calm. The office staff requests your help to deal with this situation. Which one of the following is the most appropriate initial step?
  • A. Tell the patient that his behavior is unacceptable and ask him to leave.
  • B. Instruct the office staff to ignore him and let him calm down.
  • C. Call the social work crisis intervention team.
  • D. Assess the patient promptly.
  • E. Call the police, given the patient's presentation.
Answer: D
Explanation:
This is a known patient with intellectual disability and behavioral concerns. The presentation of alcohol intoxication in a calm patient who inadvertently broke bottles warrants prompt, nonjudgmental clinical assessment before escalating. De-escalation and safety assessment come first.
Toronto Notes 2023 - Psychiatry, "sychiatric Emergencies and Crisis Management":
"In agitated or intoxicated individuals with developmental disability, a calm approach and prompt physician assessment are essential to prevent escalation and assess for medical or psychiatric needs." MCCQE1 Objectives (Psychiatry > Crisis and Acute Presentations > 72-2):
"Candidates must assess potentially disruptive patients with dignity and caution before involving law enforcement or security. Physician engagement is often calming." Police intervention (A) is premature and may escalate matters. Ignoring (B) risks safety. Asking him to leave (C) without assessment is inappropriate. Social work (E) may help, but after medical triage.

NEW QUESTION # 68
A 72-year-old man presents to your clinic accompanied by his 70-year-old husband. The patient reports that, over the last several months, his libido has been very low. Which one of the following would be the best next step?
  • A. Order serum testosterone levels
  • B. Refer for couple's counselling
  • C. Prescribe testosterone
  • D. Assess for depression
  • E. Interview the couple together
Answer: D
Explanation:
Comprehensive and Detailed Explanation:
Decreased libido in elderly patients can be multifactorial, but depression is a common and important cause that must be ruled out before hormone therapy or other steps. A proper mental health screen should precede further interventions.
Toronto Notes 2023 - Psychiatry / Geriatrics:
"In elderly men, reduced libido may be linked to depression, medical illness, or medications. Depression screening is essential." MCCQE1 Objectives (Psychiatry > 71-1: Mood Disorders / Sexual Health):
"Candidates must consider depression as a common cause of decreased libido and assess accordingly before initiating hormone therapy." Testosterone testing (D) may follow. Prescribing (C) is premature. Couples counselling (B) may help if interpersonal issues are identified. Interviewing together (A) may inhibit disclosure.
-

NEW QUESTION # 69
A 78-year-old woman is brought to the Emergency Department by her son because she has a sodium level of
124 mmol/L (136-146). The sodium was checked as part of a blood work panel ordered by her primary health care provider to investigate symptoms of urinary frequency, fatigue, and thirst. Today, she has a blood glucose level of 44.0 mmol/L (4.0-11.0). The original blood work done by her primary health care provider did not include glucose. The patient is treated for hyperglycemia and dehydration and begins insulin. The patient and her son repeatedly express their frustration that their primary health care provider missed the diagnosis. Which one of the following is the best next step?
  • A. Report the primary health care provider to the provincial or territorial medical regulatory authority
  • B. Empathize with the patient and her son and agree that the health care provider did not meet the standard of care
  • C. Explain that routine glucose screening was not indicated
  • D. Call the primary health care provider to alert them to their oversight
  • E. Offer to find an alternate health care provider to assume the patient's primary care
Answer: D
Explanation:
In situations involving potential oversight, the appropriate next step is to contact the other physician directly.
This supports collegial communication, continuity of care, and provides an opportunity to clarify the clinical situation. It avoids premature judgment while allowing the primary provider to respond and address concerns.
Toronto Notes 2023 - ELOM, "rofessionalism and Interprofessional Communication":
"When concerns arise about another provider's care, direct communication is preferred before considering formal reporting. This maintains collaboration and fairness." MCCQE1 Objectives (ELOM > 90-2: Communication and Accountability):
"Candidates must demonstrate collegiality and appropriate methods for addressing concerns regarding another physician's care." Empathizing (D) and validating blame is unprofessional. Reporting (B) is premature. Offering another provider (C) could undermine continuity. (E) is incorrect since the glucose should have been checked based on the presenting symptoms.

NEW QUESTION # 70
......
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