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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 26-year-old man presents with pain, numbness, and weakness in his right upper extremity. He works as a computer programmer, and his BMI is 32. Symptoms have worsened since he started spending more time on the keyboard. He reports that his right hand feels clumsier while he is typing. Physical examination reveals mild weakness in the intrinsic muscles of that hand, with a positive Tinel sign at the ulnar nerve. Which one of the following is the best next step?

A) Elbow extension brace for use during sleep.
B) Physiotherapy.
C) Nerve conduction studies to localize the level of the lesion.
D) Magnetic resonance imaging of the cervical spine.
E) Wrist splint to test for carpal tunnel.

2. A 37-year-old woman presents to your clinic with frequent palpitations. She has no other symptoms and is quite active. Physical examination and resting electrocardiogram findings are normal. Which one of the following is the best next step?

A) #-Blocker
B) Holter monitoring
C) Treadmill exercise test
D) Echocardiogram

3. A 9-year-old girl is brought to the Emergency Department because she has generalized urticaria, abdominal cramping, and postural dizziness 30 minutes after eating at a friend's birthday party. Which one of the following is the most appropriate route of administration for epinephrine?

A) Subcutaneous
B) Intranasal
C) Inhaled
D) Intravenous
E) Intramuscular

4. A 62-year-old woman is taken to the operating room for an elective laparoscopic cholecystectomy. Induction of anesthesia triggers a severe hypertensive crisis that ultimately resolves after administration of a 5 mg bolus of phentolamine.
Which one of the following is most consistent with this presentation?

A) High plasma cortisol
B) Elevated plasma catecholamines
C) Low urinary metanephrines
D) Increased thyrotropin (thyroid-stimulating hormone) level
E) Low renal vein renin

5. A 66-year-old woman with metastatic breast cancer presents with hard, difficult-to-pass stools. She has been experiencing this issue since starting morphine to control her pain. Which one of the following is the best next step?

A) Start docusate
B) Prescribe senna
C) Suggest increasing her physical activity
D) Add a bulk-forming fiber supplement to her diet
E) Lower her morphine dose

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