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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A previously well 4-year-old boy is brought to your office by his mother. She is concerned by his behaviour.
Shortly after falling asleep, he awakens, screams loudly and cries. He appears frightened and does not respond to his mother's efforts to calm him. During these episodes, he appears agitated and flushed. After 15-20 minutes, he settles back to sleep. Physical examination is unremarkable. Which one of the following is the most likely diagnosis?

A) Temper tantrums.
B) Non-rapid eye movement sleep arousal disorder.
C) Panic disorder.
D) Nightmare disorder.
E) Nocturnal seizures.

2. A 16-year-old girl is brought to the Emergency Department with a 12-hour history of worsening right lower quadrant abdominal pain and nausea. She is in no distress and vital signs are normal. Her abdomen is soft but locally tender in the right iliac fossa, and bowel sounds are active. White blood cell count is 7.6 × 10#/L (4-
10), C-reactive protein is 2.3 mg/L ( < 10) and serum beta human chorionic gonadotropin is undetectable.
Ultrasound reveals a small amount of fluid in the pelvis, and the appendix is not clearly apparent. Which one of the following is the best next management step?

A) Serial radiography of the abdomen.
B) Enhanced computed tomography scan of the abdomen and pelvis.
C) Intravenous ceftriaxone and metronidazole.
D) Monitoring and reassessment in 12 hours.
E) Laparoscopic appendectomy.

3. A 28-year-old nulligravid woman presents to your clinic with grey-green vaginal discharge that has a "fishy- type odour." Microscopy reveals superficial squamous cells with blurred borders caused by adherent bacteria.
The patient's symptoms abate after therapy with vaginal metronidazole. Which one of the following is the most likely cause of this clinical presentation?

A) Trichomonas vaginalis.
B) Neisseria gonorrhoeae.
C) Gardnerella vaginalis.
D) Human papillomavirus.
E) Chlamydia trachomatis.

4. A 4-year-old boy is brought by his parents to your walk-in clinic with a 3-week history of fatigue, bruising, and intermittent fever. He was previously healthy. Physical examination reveals hepatosplenomegaly and petechiae. His complete blood count shows the following:
Platelet count, blood: 15.0 × 10#/L (206.4-443.3)
White blood cell (WBC) count, blood: 1.0 × 10#/L (4.7-13.5)
Hemoglobin (Hgb), blood: 70 g/L (105-135)
Which one of the following is the most likely diagnosis?

A) Immune thrombocytopenia.
B) Acute lymphoblastic leukemia.
C) Iron deficiency anemia.
D) Bacterial sepsis.
E) Viral illness.

5. An otherwise well 18-month-old girl is brought to your family practice office for routine immunization. Her mouth is as shown in the attached image. She has no symptoms. Which one of the following is the most likely cause of this presentation?

Image description: Severe black and brown decay of multiple upper front teeth, with relatively spared lower teeth.

A) Repeated courses of antibiotics.
B) Lack of fluoride in drinking water.
C) Use of oral iron supplements.
D) Vitamin D deficiency.
E) Putting the child to bed with a bottle.

Solutions: