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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. You are following an otherwise healthy 3-month-old girl whose severe bilateral sensorineural deafness was diagnosed after early identification through a universal newborn hearing screening program. She has reached the developmental milestones for her age and has no features of an underlying syndrome. There is no family history of hearing loss. The parents request information on the speech and language prognosis for their daughter. Which one of the following is the most appropriate response?

A) Significant limitation in expressive and receptive speech should be expected.
B) The prognosis is unpredictable and not well known.
C) Most children with this condition learn to hear and speak fluently with appropriate early intervention.
D) Long-term literacy is likely to be limited to a grade 4 level.
E) Sign language and a school for the hearing impaired will be needed.

2. A mother brings her 4-week-old daughter to your office because she is concerned about the lesion shown in the attached image. Which one of the following is the most appropriate advice to give the mother?

A) The child should be referred to a dermatologist.
B) The child is at increased risk of malignant melanoma.
C) The child likely has a bleeding disorder.
D) The lesion will likely fade away with time.
E) You have a duty to report her to child protective services.

3. A 45-year-old man presents to your clinic for follow-up regarding his obsessive-compulsive disorder. He currently takes a high dosage of paroxetine, which he would like to discontinue because he feels well. His condition has been stable taking this medication since he was discharged from inpatient care 2 years ago.
Which one of the following is the most appropriate recommendation?

A) Switch paroxetine to sertraline.
B) Discontinue paroxetine and refer for supportive psychotherapy.
C) Reduce the dosage of paroxetine by 50%.
D) Maintain the current dosage of paroxetine.

4. A 69-year-old man presents with a 4-day history of a painful right knee. On history, he denies any trauma or similar previous episodes. Examination reveals effusion of the right knee that is warm to the touch. Which one of the following is the best next step?

A) Joint aspiration
B) Serum uric acid level
C) Intravenous antibiotics
D) Nonsteroidal anti-inflammatory drugs
E) Right knee radiography

5. A 42-year-old woman presents to the emergency department with a 24-hour history of severe pain in her right eye. On examination, you notice a right conjunctival injection that is worst adjacent to the iris. Direct and consensual responses to light are intact but sluggish, with severe photophobia in the right pupil is slightly smaller than the left. The patient's visual acuity is 20/20 on the left and 20/40 on the right. Visual field testing results are normal. Intraocular pressure findings are normal. Slit-lamp examination findings of the cornea are normal, and there are no cells in the anterior chamber. You are unable to visualize her fundus. Which one of the following is the most likely diagnosis?

A) Acute uveitis.
B) Viral conjunctivitis.
C) Optic neuritis.
D) Acute angle-closure glaucoma.
E) Scleritis.

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