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[General] Reliable MCCQE Exam Answers | Test MCCQE Sample Questions

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【General】 Reliable MCCQE Exam Answers | Test MCCQE Sample Questions

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Medical Council of Canada MCCQE Part 1 Exam Sample Questions (Q103-Q108):NEW QUESTION # 103
A mother brings her 13-year-old daughter to the office. The girl has had intermittent lower abdominal pain, constipation, and difficulty voiding for 3 months. She says that she is not sexually active. She looks well. She has reached age-specific developmental milestones, and her vital signs are within normal range. On abdominal examination, she is found to have a palpable suprapubic mass that persists after voiding. The girl says that her older sister started having menstrual periods at this age. The patient is surprised that hers have not started. Which one of the following is the best next step?
  • A. Pelvic ultrasonography.
  • B. Abdominal radiography.
  • C. Examination of external genitalia.
  • D. Urinalysis.
  • E. Measurement of serum human chorionic gonadotropin.
Answer: C
Explanation:
The clinical picture suggests an obstructive anomaly of the female reproductive tract, such as imperforate hymen or vaginal outflow tract obstruction, leading to hematocolpos. The first essential step is physical examination of the external genitalia.
Toronto Notes 2023 - Pediatrics and Gynecology, "Amenorrhea" Section:
"In girls with primary amenorrhea and cyclic abdominal pain, perform an external genital exam to rule out obstructive anomalies (e.g., imperforate hymen or transverse vaginal septum). Examination should always precede imaging." MCCQE1 Objectives (Pediatrics > 78-3: Puberty and Menstrual Disorders):
"Candidates must evaluate delayed menarche with physical exam, including inspection of the genitalia to rule out anatomic obstruction." Pelvic ultrasound (D) is helpful but should follow physical exam. Radiography (B), hCG (C), and urinalysis (E) are not primary steps in evaluating amenorrhea with a mass.

NEW QUESTION # 104
An 88-year-old married man is admitted following a cardiac arrest at home. He was not expected to recover, and after 2 weeks, he remains in a coma. His wife states, "I cannot let him go. That would be murder." As the attending physician looking after her husband, which one of the following is the best next course of action?
  • A. Remove him from life support as this would not be murder
  • B. Say nothing further and wait until she comes around to accepting his state
  • C. Encourage her to imagine what her husband would have wanted
  • D. Emphasize that the duration of his stay in the Intensive Care Unit will be limited
  • E. Seek advice from the provincial or territorial public guardian
Answer: C
Explanation:
In discussions about end-of-life care, it is critical to shift the focus from the substitute decision-maker's own feelings to what the patient would have wanted. This approach promotes ethically sound and patient-centered decisions. It is respectful, supportive, and maintains trust.
Toronto Notes 2023 - ELOM, "Advance Care Planning and End-of-Life Decisions":
"When a patient cannot express wishes, decisions must be based on known prior wishes or substituted judgment-what the patient would have wanted." MCCQE1 Objectives (ELOM > 90-2: Capacity, Consent, and End-of-Life Care):
"Candidates must guide surrogate decision-makers toward reflecting on the patient's values and previously expressed wishes." Options A and B are inappropriate-waiting without engagement or unilateral withdrawal is unethical. C does not address the wife's emotional or ethical concerns. E is premature unless the wife is clearly unable or unfit to act as decision-maker.

NEW QUESTION # 105
An 84-year-old woman is brought by ambulance to the emergency department after she was found by a neighbour. She had fallen, sustained a hip fracture, and was unable to move for the past 2 days. After starting rehydration, she reports hip pain and numbness and tingling in both her legs. Physical examination reveals faint pulses in both legs and severely swollen lower legs that are painful to palpation. The urine in the Foley catheter bag seems to be darker than normal. Which one of the following is the best next step?
  • A. Surgical fixation of the patient's hip fracture.
  • B. Compartment pressure measurements of the lower legs.
  • C. Bilateral Doppler ultrasonography of the legs.
  • D. Myoglobin urine test.
  • E. Bilateral angiography of the lower legs.
Answer: B
Explanation:
This patient presents with signs of acute compartment syndrome (pain out of proportion, paresthesia, pallor, swelling, decreased pulses, and dark urine indicating rhabdomyolysis). Measuring compartment pressures is the diagnostic test of choice to confirm the diagnosis and guide urgent surgical fasciotomy.
Toronto Notes 2023 - Orthopedics:
"Acute compartment syndrome should be suspected in any patient with severe extremity pain, swelling, sensory deficits, and tense compartments. Confirm with compartment pressure measurements. Fasciotomy is indicated if pressure is >30 mmHg or within 30 mmHg of diastolic pressure." MCCQE1 Objectives (Surgery > 51-2: Limb Trauma):
"Candidates must diagnose acute compartment syndrome and initiate appropriate surgical referral after confirming with pressure measurements." Angiography and Doppler studies assess vascular compromise but are not the first step in suspected compartment syndrome. Fixing the hip (C) and testing myoglobin (E) are not diagnostic steps.

NEW QUESTION # 106
One of your patients presents to your clinic for a consultation regarding their recurrent hemoptysis. On review of their chart, you realize that although you had ordered chest radiography 2 months ago, the result cannot be found in the chart. You call the radiology department and are relieved to find that the chest radiography was done and that it did not reveal any pathology. After informing the patient of this lapse in reporting, which one of the following is the best next step?
  • A. Send a letter of complaint to the radiology department for not sending a report.
  • B. Remind the patient that they are responsible for calling for outstanding test results.
  • C. Review your clinic's filing procedures and make any needed improvements.
  • D. Reassure the patient that this is a rare occurrence in your clinic.
Answer: C
Explanation:
When an error in the system is identified (e.g., test result not properly followed up), the most responsible approach is to analyze and improve internal clinic processes. Patient safety depends on reliable result tracking systems.
Toronto Notes 2023 - ELOM, "Medical Errors and Quality Improvement" Section:
"When an error or near miss is identified, root cause analysis and system-level interventions are required to prevent recurrence. Blaming the patient or others without review of internal processes is inappropriate." MCCQE1 Objectives (ELOM > 99-1: Medical Error and Disclosure):
"Candidates must recognize the importance of continuous quality improvement in health care. System-level changes should be implemented when safety lapses occur." Option A shifts responsibility improperly onto the patient. Option C deflects blame without assessing one's own clinic. Option D minimizes the error and does not lead to improvement.

NEW QUESTION # 107
A 67-year-old man underwent his first endoscopy. He has long-term reflux and heartburn, treatedintermittently with antacids. Biopsies of the distal esophagus reveal Barrett epithelium. Which one of the following is most important in determining the frequency of surveillance endoscopy?
  • A. Depth of intestinal metaplasia
  • B. Family history of gastrointestinal malignancy
  • C. Length of Barrett segment
  • D. Grade of dysplasia
  • E. Stricture formation
Answer: D
Explanation:
The most important factor in determining the surveillance interval in Barrett esophagus is the presence and grade of dysplasia (e.g., none, low-grade, high-grade). High-grade dysplasia requires more frequent monitoring or intervention due to the risk of progression to esophageal adenocarcinoma.
Toronto Notes 2023 - Gastroenterology, Barrett Esophagus:
"Surveillance intervals depend on histologic findings. No dysplasia: q3-5 years; low-grade: q6-12 months; high-grade: consider endoscopic resection or ablation." MCCQE1 Objectives - Internal Medicine > Gastroenterology:
"Candidates must identify the risk of progression in Barrett esophagus and apply appropriate surveillance strategies based on dysplasia." Length of the segment (A) may influence risk but not surveillance frequency alone. Other options (B, C, E) are less determinative.

NEW QUESTION # 108
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