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Medical Council of Canada MCCQE Part 1 Exam Sample Questions (Q202-Q207):NEW QUESTION # 202
A 53-year-old man with a history of bipolar I disorder is brought to the office by his family. Recently, he has been sleeping for 4 to 5 hours per night, has been fidgety, and is increasinglypreoccupied with his granddaughter's safety. Five days ago, he consulted with your physician colleague and was instructed to exercise and meditate. Last night, he was found running in the street and attempted to hit a relative who was trying to calm him down. His son is dissatisfied with your physician colleague's management. Which one of the following is the most appropriate response?
- A. Acknowledge your physician colleague's mistake and apologize.
- B. Explain that you will now assess the father and that your goal is to treat him.
- C. Share that you would have prescribed a medication after the first assessment.
- D. Encourage the son to file a complaint.
- E. Point out that exercise and meditation have been proven useful in managing bipolar I disorder.
Answer: B
Explanation:
The most appropriate and professional response is to focus on the current clinical situation and reassure the family that you will take responsibility for assessment and treatment. Criticizing a colleague (A, B, E) or deflecting to generalities (D) is unprofessional and unhelpful in crisis management.
Toronto Notes 2023 - Psychiatry, Physician-Patient-Family Communication:
"In emotionally charged or crisis situations, the physician must remain focused, empathetic, and professional.
Avoid blaming colleagues; instead, offer a concrete plan of care."
MCCQE1 Objectives - Psychiatry > Ethics and Professionalism:
"Candidates must demonstrate professionalism in managing conflicts, focusing on patient care while maintaining collegial respect."
NEW QUESTION # 203
Three months ago, a physician colleague approached you in the hospital corridor for advice regarding one of his patients. You are now being named by this patient in a malpractice action. Which one of the following is the most likely reason why you may be found liable?
- A. You did not see the patient
- B. You gave advice on how to treat the patient
- C. You advised the physician to consult one of your colleagues
- D. You were given confidential patient health information
- E. You were given the patient's name
Answer: B
Explanation:
Comprehensive and Detailed Explanation:
Providing clinical advice (particularly treatment advice) without formally seeing or evaluating the patient creates a physician-patient relationship, potentially establishing a duty of care. If the advice leads to harm, you could be found liable, even if you never saw the patient directly.
Toronto Notes 2023 - Legal Medicine:
"Giving specific medical advice about diagnosis or treatment may imply a physician-patient relationship and establish duty of care." MCCQE1 Objectives (ELOM > 90-2: Legal Risk Management):
"Candidates must understand that liability can arise from informal consultations where medical advice is given." Providing advice (D) is riskier than simply hearing about a case or patient (A, C). Recommending consultation (B) does not establish duty of care. Not seeing the patient (E) does not automatically shield from liability if treatment advice was given.
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NEW QUESTION # 204
A 42-year-old woman presents to your clinic requesting an increase in her stimulant dosage for the treatment of her adult attention-deficit/hyperactivity disorder. Her medical history includes hypertension and type 1 diabetes with associated nephropathy. She has been taking methylphenidate daily for 15 years. Which one of the following would need to be addressed before the dosage can be increased?
- A. Estimated glomerular filtration rate of less than 30 mL/min/1.73 m² (#60).
- B. Average home blood pressure reading of 150/80 mm Hg.
- C. Random glucose level that is often higher than 18.0 mmol/L (4.0-11.0).
Answer: B
Explanation:
Stimulants like methylphenidate can increase heart rate and blood pressure. In patients with cardiovascular risk (e.g., hypertension, nephropathy), stimulants should not be increased without first addressing elevated blood pressure.
Toronto Notes 2023 - Psychiatry, "ADHD in Adults":
"Stimulants can exacerbate hypertension and must be used cautiously. Evaluate cardiovascular risk factors and control blood pressure before dose increases." MCCQE1 Objectives (Psychiatry > 71-1: ADHD):
"Candidates must consider the cardiovascular risks of stimulant therapy and monitor for hypertension prior to adjusting doses." While poor glycemic control (B) and renal disease (A) are important, BP control is most critical for immediate stimulant safety.
NEW QUESTION # 205
A 39-year-old woman, gravida 2, para 1, aborta 0, presents with concerns that a friend has recently suffered from postpartum psychosis. She wonders if she is likely to suffer this disorder following delivery of her 2nd child. Which one of the following is most likely to increase your patient's risk?
- A. Being a multigravida
- B. A family history of bipolar disorder
- C. Advanced maternal age
- D. A history of panic disorder
Answer: B
Explanation:
Comprehensive and Detailed Explanation:
Postpartum psychosis is strongly associated with bipolar disorder and other mood disorders. A personal or family history of bipolar disorder significantly increases the risk. It typically presents within the first 2 weeks postpartum and is a psychiatric emergency.
Toronto Notes 2023 - Psychiatry, "Postpartum Psychiatric Disorders":
"Risk factors for postpartum psychosis include personal or family history of bipolar disorder or postpartum psychosis." MCCQE1 Objectives (Psychiatry > 71-3: Mood Disorders):
"Candidates must recognize risk factors for postpartum psychiatric illness, particularly the association with bipolar spectrum disorders." Advanced maternal age (A), multiparity (B), and panic disorder (D) do not significantly increase the risk of postpartum psychosis.
NEW QUESTION # 206
An intoxicated 28-year-old man is brought to the Emergency Department after being found in the snow. His vital signs are as follows:
Temperature: 33°C
Respiratory rate: 22/min
Heart rate: 123/min
The patient is shivering and displays some dysarthria and ataxia. After his wet clothing is removed, he is provided with a warm blanket. The results of the subsequent physical examination are unremarkable, except for frostbite of the ears and fingers. Which one of the following is the best next step?
- A. Start continuous arteriovenous rewarming.
- B. Perform a peritoneal lavage.
- C. Set the room temperature to 28°C.
- D. Apply heating pads to extremities.
- E. Continuous warm bladder irrigation.
Answer: C
Explanation:
This patient is experiencing mild hypothermia (32-35°C), evidenced by shivering, ataxia, and tachycardia.
First-line management includes passive external rewarming - removing wet clothing, providing warm blankets, and ensuring a warm environment (ambient temperature ~28°C).
Toronto Notes 2023 - Emergency Medicine, Environmental Injuries:
"Mild hypothermia (32-35°C): Treatment includes passive rewarming (warm blankets, warm environment).
Avoid active rewarming methods to extremities due to risk of afterdrop." MCCQE1 Objectives - Internal Medicine > Environmental Exposure:
"Candidates must recognize appropriate levels of hypothermia and select evidence-based rewarming strategies based on severity." Options A, C, and D are used in moderate to severe hypothermia (<32°C or unconscious patients). Heating pads (B) may cause tissue damage, especially with frostbite.
NEW QUESTION # 207
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