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[General] Free PDF MCCQE - MCCQE Part 1 Exam Latest Exam Dumps

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【General】 Free PDF MCCQE - MCCQE Part 1 Exam Latest Exam Dumps

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Medical Council of Canada MCCQE Part 1 Exam Sample Questions (Q194-Q199):NEW QUESTION # 194
A 34-year-old man with trisomy 21 is brought to the Emergency Department because of a painful, red great toe. He is accompanied by an older woman who begins giving you the history as you enter the room. The patient is sitting on the examination table with the foot exposed, but he does not speak. Which one of the following is the best next step?
  • A. Ask the woman to provide legal documentation of her responsibility for the patient.
  • B. Have a nurse attend with you in case the patient needs restraint.
  • C. Establish the relationship between the woman and the patient and direct questions to the patient.
  • D. Examine the uncovered foot immediately to provide comfort to the patient sooner.
  • E. Allow the woman to continue with the history to expedite the patient encounter.
Answer: C
Explanation:
Patients with developmental disabilities must still be engaged directly unless clearly incapable. It is vital to first establish the companion's relationship to the patient and give the patient the opportunity to communicate.
Toronto Notes 2023 - ELOM, Consent and Capacity:
"resume capacity in adults with developmental disabilities unless proven otherwise. Direct communication with the patient is essential, and the identity of accompanying individuals should be clarified." MCCQE1 Objectives - ELOM > Patient Autonomy and Consent:
"Candidates must respect patient autonomy and include developmentally delayed individuals in medical discussions unless incapacity is determined." Options A and C delay establishing capacity and relationship. Option D is premature. Option E bypasses consent and interaction with the patient.

NEW QUESTION # 195
You performed a surgical procedure on a 32-year-old woman for a herniated disk that was causing neurologic impairment. At the 8-month follow-up visit, she has healed well; however, she requests a prescription renewal of her narcotic analgesics (hydromorphone). Her pharmacy confirms that the patient adheres to the dosage you prescribed, that she has not consulted other physicians, and that her behavior has always been respectful.
You think that she no longer requires narcotic analgesics. Which one of the following approaches is most helpful to the patient?
  • A. Counsel the patient regarding substance use disorder and arrange follow-up with her family physician.
  • B. Decline the renewal of further hydromorphone and discharge the patient.
  • C. Replace short-acting hydromorphone with transdermal fentanyl.
  • D. Change the patient's prescription from short-acting hydromorphone to once-daily methadone.
  • E. Advise the provincial or territorial agency responsible for following patients who have potential substance use disorders.
Answer: A
Explanation:
The patient's pain is no longer medically justified for opioids, but there is no evidence of misuse. The most appropriate and supportive action is to explain concerns, provide education about opioid tapering or dependency, and transition care to her family physician for ongoing management.
Toronto Notes 2023 - ELOM, "Safe Prescribing and Opioid Stewardship" Section:
"When opioids are no longer indicated, engage the patient in a conversation about tapering and arrange appropriate follow-up. Coordinate care with primary providers when long-term management is needed." MCCQE1 Objectives (ELOM > 99-1: Professionalism and Substance Use):
"Candidates must address the risk of dependency, counsel the patient, and ensure a safe transition to appropriate care without abrupt termination." Methadone (E) and fentanyl (A) are for opioid use disorder or chronic pain, not for tapering in low-risk patients. Discharging the patient (B) or reporting (C) is punitive and unnecessary.

NEW QUESTION # 196
A 70-year-old woman consults you for progressive vision problems. She describes seeing haloes at night around street lights and having double vision. Her near vision has improved. Which one of the following is an ophthalmologic examination most likely to uncover?
  • A. Arcus senilis.
  • B. Retinal exudates.
  • C. Kayser-Fleischer ring.
  • D. Altered red reflex.
  • E. Increased intra-ocular pressure.
Answer: D
Explanation:
The symptoms described - haloes at night, monocular diplopia, and improved near vision (second sight) - are classic signs of nuclear sclerosis-type cataracts. On exam, the most consistent finding would be an altered red reflex due to lens opacification.
Toronto Notes 2023 - Ophthalmology, Cataracts:
"Cataracts can cause glare, monocular diplopia, and improved near vision. A diminished or irregular red reflex is commonly seen on direct ophthalmoscopy." MCCQE1 Objectives - Internal Medicine > Ophthalmologic Disorders:
"The candidate must recognize symptoms and physical findings of cataracts, including changes in red reflex and visual acuity." Options A and B are associated with lipid deposition and Wilson's disease, respectively. Retinal exudates (D) suggest diabetic or hypertensive retinopathy. Increased intraocular pressure (E) suggests glaucoma but is not supported by this clinical picture.

NEW QUESTION # 197
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. Required workplace accommodations
  • C. Diagnosis
  • D. Treatment options
  • E. Medical imaging results
Answer: B
Explanation:
Comprehensive and Detailed Explanation:
In a workplace medical note, physicians are responsible for commenting on the patient's functional capacity and any required accommodations-not providing detailed medical diagnoses or test results unless consented to. The goal is to support a safe return to work with appropriate modifications.
Toronto Notes 2023 - ELOM, "Documentation and Work Notes":
"hysicians should focus on functional abilities and restrictions, rather than detailed diagnoses or treatments, in employer communications." MCCQE1 Objectives (ELOM > 90-2: Confidentiality and Occupational Fitness):
"Candidates must maintain patient confidentiality and document work-related limitations and accommodations in employer letters." Diagnosis (B), imaging (E), and treatment plans (A) are confidential medical details. C (physiotherapist's evaluation) is not the physician's documentation.
-

NEW QUESTION # 198
A 26-year-old woman, gravida 2, para 1, presents with a positive pregnancy test. Her previous pregnancy was associated with preeclampsia, and she delivered a 1000 g boy at 34 weeks' gestation. Her blood pressure is 130
/86 mm Hg. Which one of the following is the best recommendation for this pregnancy?
  • A. Accurate dating by ultrasound.
  • B. Amniocentesis for karyotyping.
  • C. Prophylactic labetalol.
  • D. Complete bed rest starting at 20 weeks' gestation.
  • E. Genetic assessment and counseling.
Answer: A
Explanation:
Accurate dating is critical in pregnancies at high risk for preeclampsia and intrauterine growthrestriction. First- trimester ultrasound is used to establish gestational age, which guides monitoring and interventions.
Toronto Notes 2023 - Obstetrics, High-Risk Pregnancy:
"In women with a history of preeclampsia, early and accurate dating allows for appropriate fetal surveillance and timely delivery." MCCQE1 Objectives - Obstetrics > Prenatal Care:
"Candidates should recognize the importance of accurate pregnancy dating in high-risk pregnancies." Prophylactic labetalol (E) is not indicated in normotensive patients. Genetic testing (A, B) is not appropriate unless additional risk factors are present. Bed rest (D) is not evidence-based for preeclampsia prevention.

NEW QUESTION # 199
......
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