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[Hardware] MCCQE Reliable Exam Review - Exam MCCQE Simulator Fee

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【Hardware】 MCCQE Reliable Exam Review - Exam MCCQE Simulator Fee

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Medical Council of Canada MCCQE Part 1 Exam Sample Questions (Q47-Q52):NEW QUESTION # 47
A 51-year-old man comes to your clinic for follow-up regarding his type 1 diabetes. His hemoglobin A1c is
12.5% (normal 4-6%). He has never had such high blood sugar results. He drinks 2 beers per night to help with sleep. He is not well rested because he has been sleeping on a friend's couch since losing his job last year. Which one of the following is the best next step?
  • A. Ensure that he has the finances to adequately monitor his diabetes.
  • B. Prescribe an antidepressant to improve his energy and motivation.
  • C. Ask him to create a food journal and refer him to a dietitian.
  • D. Send him for thyroid function testing.
Answer: A
Explanation:
This patient is experiencing social instability (homelessness, job loss) likely contributing to poorly controlled diabetes. Before investigating or prescribing further, it is essential to address his ability to afford and manage self-monitoring and insulin.
Toronto Notes 2023 - Endocrinology, Diabetes:
"Social determinants such as housing insecurity and financial barriers significantly affect diabetes self- management. Addressing access to glucose monitoring and insulin is critical." MCCQE1 Objectives - Internal Medicine > Chronic Disease Management:
"Candidates must assess barriers to effective disease control, including financial and psychosocial limitations." Antidepressants (B) may be helpful later if depression is suspected. Thyroid testing (C) is not the priority. A dietitian (D) may help long-term, but immediate access and adherence are more urgent.

NEW QUESTION # 48
A 35-year-old woman, gravida 3, para 0, aborta 3, presents with her male partner because she has been unable to conceive despite trying for more than 1 year. Her menstrual cycles have been absent for 9 months, and she has occasional mild cyclic pain. She has a medical history of 3 suction curettages. Her BMI is 24.
Investigation results are as follows:
Hysterosalpingogram: Obliterated uterine cavity, no tubal dye spill
Progesterone (midluteal): 48.0 nmol/L (16.4-59.0)
Partner's semen: All parameters normal
Which one of the following is the most likely diagnosis?
  • A. Polycystic ovary syndrome
  • B. Perimenopause
  • C. Fibroids
  • D. Intrauterine synechiae
  • E. Hypothalamic insufficiency
Answer: D
Explanation:
This patient has secondary amenorrhea, infertility, and a history of multiple uterine curettages, which strongly points toward Asherman syndrome (intrauterine adhesions or synechiae). The hysterosalpingogram shows an obliterated uterine cavity and no tubal dye spill-classic for intrauterine synechiae. Her midluteal progesterone level is normal, indicating ovulation.
Toronto Notes 2023 - Gynecology, "Infertility" section:
"Asherman syndrome results from intrauterine adhesions due to curettage, leading to amenorrhea and infertility. HSG shows an obliterated or irregular uterine cavity." MCCQE1 Objectives (Gynecology > 82-1: Infertility):
"Candidates should evaluate secondary amenorrhea and interpret imaging such as hysterosalpingogram in the diagnosis of intrauterine abnormalities." Other options are ruled out by the presence of normal ovulation (rules out hypothalamic and PCOS) and by imaging (not suggestive of fibroids or perimenopause).

NEW QUESTION # 49
A 42-year-old man presents with a history of fatigue and weight loss. He looks unwell, has a darker than usual complexion and his liver is enlarged. He is also found to have marked glycosuria. Which one of the following is the most useful diagnostic test?
  • A. Serum amylase
  • B. Serum alpha-1 antitrypsin
  • C. Serum cortisol
  • D. Serum ferritin
  • E. Hemoglobin A1c
Answer: D
Explanation:
This presentation suggests hereditary hemochromatosis. Common features include hyperpigmentation ("bronze diabetes"), hepatomegaly, diabetes, fatigue, and elevated liver enzymes. Serum ferritin is a screening test for iron overload, and elevated levels support the diagnosis.
Toronto Notes 2023 - Endocrinology / Gastroenterology:
"Hemochromatosis presents with skin hyperpigmentation, hepatomegaly, diabetes, fatigue. Diagnosis begins with serum ferritin and transferrin saturation." MCCQE1 Objectives (Internal Medicine > Metabolic and Endocrine > 37-1):
"Candidates must investigate iron overload syndromes using ferritin and transferrin saturation." Cortisol (B) is for adrenal insufficiency. A1AT (C) is a liver disease cause but not typical here. Amylase (E) is for pancreatitis. A1c (A) would confirm diabetes but not the underlying cause.

NEW QUESTION # 50
A 78-year-old man presents to the Emergency Department with chest pain. His electrocardiogram and blood work confirm an acute myocardial infarction. He is admitted to the Intensive Care Unit. Three days later, he develops right-sided abdominal pain. An ultrasonogram reveals an inflamed gallbladder with no evidence of stones. He does not improve after 48 hours of antibiotics. Which one of the following is the best next step?
  • A. Arrange for percutaneous cholecystostomy
  • B. Arrange for endoscopic retrograde cholangiopancreatography
  • C. Send for laparoscopic cholecystectomy
  • D. Send for hepatobiliary iminodiacetic acid (HIDA) scan
  • E. Broaden antibiotic therapy
Answer: A
Explanation:
This presentation is consistent with acute acalculous cholecystitis, often seen in critically ill or post-MI patients. If unresponsive to antibiotics, percutaneous cholecystostomy is the preferred next step in those who are poor surgical candidates.
Toronto Notes 2023 - General Surgery, "Hepatobiliary Disorders" Section:
"Acalculous cholecystitis occurs in critically ill patients and is often managed with percutaneous cholecystostomy if the patient is not a candidate for surgery." MCCQE1 Objectives (Surgery > 84-3: Biliary Disease):
"Candidates must be able to diagnose and manage acalculous cholecystitis. Management includes antibiotics and drainage via percutaneous cholecystostomy in unstable patients." Laparoscopic cholecystectomy (C) is standard but not suitable in acutely ill ICU patients. Broadening antibiotics (A) alone is insufficient after failure of initial therapy. ERCP (B) is for biliary obstruction or cholangitis. HIDA scan (E) is diagnostic, not therapeutic.

NEW QUESTION # 51
A 17-year-old boy presents to your clinic with a 6-month history of recurrent headaches. The headaches are excruciating, and he describes them as a stabbing pain, usually around his right eye. They occur several times daily for 2 to 3 weeks and recur every few months. The headaches are associated with tearing from his right eye and tend to get worse when he is overtired. Which one of the following is the most likely diagnosis?
  • A. Brain tumour
  • B. Sinusitis
  • C. Migraine
  • D. Cluster headache
  • E. Post-concussive headache
Answer: D
Explanation:
The classic description of brief, severe unilateral periorbital pain with autonomic symptoms (tearing), occurring in clusters (same time daily for weeks), is diagnostic of cluster headache.
Toronto Notes 2023 - Neurology, "Headaches":
"Cluster headaches: severe unilateral periorbital pain, often with lacrimation, nasal congestion, occurring in clusters over weeks. More common in young males." MCCQE1 Objectives (Internal Medicine > 35-2: Headache Disorders):
"Candidates must distinguish among headache types based on duration, pattern, and associated symptoms." Migraine tends to last hours and has nausea or photophobia. Sinusitis causes dull, pressure-like pain. Tumour- related headache is progressive and worse with Valsalva. Post-concussive headache would have trauma history.

NEW QUESTION # 52
......
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