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Reliable Medical Council of Canada MCCQE Dumps Ebook | Online MCCQE Version

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Medical Council of Canada MCCQE Part 1 Exam Sample Questions (Q98-Q103):

NEW QUESTION # 98
A 44-year-old woman presents to the office to discuss contraception. During the gynecologic examination, you notice an anterior cystocele to the hymenal ring. The woman denies any bulge symptoms but does report dribbling of urine, especially when she coughs or jogs.
Which one of the following is the best next step?

A. Vaginal hysterectomy
B. No impact sports
C. Urology consultation
D. Topical estrogen
E. Pelvic-floor physiotherapy

Answer: E

Explanation:
Comprehensive and Detailed Explanation:
This patient has stress urinary incontinence and an incidental cystocele. First-line management of mild pelvic organ prolapse and stress incontinence includes pelvic floor physiotherapy (e.g., Kegel exercises). Surgical options are reserved for severe or refractory cases.
Toronto Notes 2023 - Gynecology, Pelvic Floor Disorders:
"For asymptomatic prolapse or mild stress incontinence, recommend pelvic floor strengthening. Conservative management is preferred before surgical referral." MCCQE1 Objectives - Gynecology > Urogynecology:
"Candidates should initiate pelvic floor therapy in women with mild prolapse or urinary leakage prior to specialist referral." Topical estrogen (B) helps with atrophic vaginitis, not stress incontinence. Hysterectomy (A) and specialist referral (C) are premature. Avoiding impact sports (E) is not a treatment.

NEW QUESTION # 99
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. Examine the uncovered foot immediately to provide comfort to the patient sooner.
B. Ask the woman to provide legal documentation of her responsibility for the patient.
C. Have a nurse attend with you in case the patient needs restraint.
D. Establish the relationship between the woman and the patient and direct questions to the patient.
E. Allow the woman to continue with the history to expedite the patient encounter.

Answer: D

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:
"Presume 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 # 100
A 31-year-old man presents with nocturnal non-exertional chest pain. During an exercise stress test, he does not experience chest pain, and there are no significant ST segment changes on the electrocardiogram. He achieves 17 metabolic equivalent of task (MET), a blood pressure of 190/96 mm Hg (resting blood pressure of
130/80 mm Hg), and a maximum heart rate of 162/min (85% of age-predicted maximum). Which one of the following is the most appropriate next step?

A. Prescribe acetylsalicylic acid and metoprolol
B. Advise against vigorous exercise
C. Offer reassurance
D. Schedule cardiac catheterization
E. Prescribe hydrochlorothiazide

Answer: E

Explanation:
Comprehensive and Detailed Explanation:
This patient demonstrates excellent exercise tolerance (17 METs) and no ischemic changes or exertional symptoms, which makes cardiac ischemia unlikely. However, the hypertensive response to exercise (BP >190 systolic) indicates masked or latent hypertension. This should be managed proactively, typically starting with a thiazide.
Toronto Notes 2023 - Cardiology:
"An exaggerated hypertensive response during exercise is predictive of future hypertension. Treatment with antihypertensive agents such as thiazides may be warranted." MCCQE1 Objectives (Internal Medicine > 31-1: Hypertension and Risk Management):
"Candidates must identify abnormal BP responses to exercise and initiate appropriate treatment." Reassurance alone (A) ignores the hypertensive response. Catheterization (C) and beta-blockers (D) are unnecessary without ischemia. Advising against exercise (B) is counterproductive in a young, otherwise healthy patient.
-

NEW QUESTION # 101
You are working in a busy family practice. Your colleague's 48-year-old female patient presents with a 6- month history of fatigue and gastrointestinal symptoms. A recent colonoscopy was normal. Her chart indicates multiple investigations for similar symptoms over the past 2 years, all of which have been non- revealing. Your working diagnosis is somatic symptom disorder. Which one of the following is the most appropriate treatment?

A. Cognitive behavioral therapy
B. Amitriptyline 10 mg at bedtime
C. Risperidone 0.5 mg daily
D. Citalopram 20 mg daily
E. Exposure and response prevention therapy

Answer: A

Explanation:
Comprehensive and Detailed Explanation:
Cognitive behavioral therapy (CBT) is the most effective first-line treatment for somatic symptom disorder. It helps patients reframe dysfunctional thoughts and improve coping strategies for perceived physical symptoms.
Toronto Notes 2023 - Psychiatry, "Somatic Symptom and Related Disorders":
"CBT is first-line for somatic symptom disorder. Antidepressants may be considered if comorbid depression or anxiety is present." MCCQE1 Objectives (Psychiatry > 71-2: Somatic Symptom Disorders):
"Candidates must manage somatic symptom disorder with appropriate psychosocial interventions." Citalopram (B) or amitriptyline (E) may be used adjunctively if mood symptoms are prominent. Risperidone (C) and ERP (D) are not indicated.
-

NEW QUESTION # 102
An 18-month-old boy is brought to the office by his guardians for a well-child visit. His guardians are concerned that his eyes do not look the same. On examination, his eyes appear as shown in the referenced photo.
Which one of the following best represents the patient's condition?

A. Pseudostrabismus
B. Strabismus
C. Ptosis
D. Cataract

Answer: B

Explanation:
The image shows an asymmetrical light reflex (corneal light reflex not centered in both eyes), which is diagnostic of strabismus. This misalignment of the eyes must be treated early to prevent amblyopia (lazy eye).
Toronto Notes 2023 - Pediatrics, Ophthalmology:
"Strabismus presents with misaligned visual axes. The Hirschberg light reflex is off-center in the affected eye.
Prompt referral is necessary to prevent amblyopia."
MCCQE1 Objectives - Pediatrics > Vision and Developmental Disorders:
"Candidates must recognize strabismus on visual screening and refer early for correction to prevent permanent vision impairment." Pseudostrabismus (B) can be ruled out here because the light reflex is not symmetric. Ptosis (A) involves drooping of the eyelid, which is not evident. Cataracts (D) would typically present with a leukocoria (white reflex), not misalignment.

NEW QUESTION # 103
......

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