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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. In a research study, it is found that people who smoke tobacco cigarettes drink more coffee and have higher rates of lung cancer than people who do not smoke. However, the consumption of coffee alone is not associated with lung cancer. Which one of the following best describes the contribution of drinking coffee in the study?

A) Confounder
B) Risk factor
C) Selection bias
D) Predictor

2. You are being consulted for a 79-year-old man who is about to undergo a total hip arthroplasty. His orthopedic surgeon is aware of the diagnosis of Alzheimer disease and would like your suggestions to help avoid acute postsurgical delirium. To that end, which one of the following is the most effective strategy?

A) Refrain from prescribing opiate analgesics to treat postoperative pain
B) Avoid medications with anticholinergic potential
C) Keep family visits to a minimum to avoid postsurgical overstimulation
D) Treat postsurgical insomnia with benzodiazepines
E) Screen the patient with the Mini-Mental Status Examination prior to surgery

3. A 12-year-old boy initially presents with a 4-month history of left knee pain. He denies any obvious history of trauma, but he plays basketball frequently and notes his pain is worse after playing. On physical examination the patient has a prominent tibial tubercle, which is swollen and tender. There is full range of motion in the knee. A radiograph of the left knee reveals an ossicle anterior to the tibial tuberosity. Which one of the following is the most likely diagnosis?

A) Osteosarcoma
B) Osteomyelitis
C) Patellar tendinitis
D) Osgood-Schlatter disease
E) Chondromalacia patellae

4. A 32-year-old woman, gravida 0, comes to your office for contraception counselling, specifically about insertion of a levonorgestrel-releasing intrauterine device. She has a past history of breast cancer and is presently on tamoxifen. Which one of the following is the best advice for your patient?

A) It may increase her risk of breast cancer recurrence
B) This device will increase her risk of future infertility
C) She will require pre-procedure antibiotics
D) She has a high risk of irregular bleeding following insertion
E) After consultation with her oncologist, she may choose this option

5. A 22-year-old woman, gravida 1, para 0, aborta 0, comes to the office at 10 weeks ' gestation for her first prenatal visit. When you ask how she is doing, she becomes tearful and says she has had severe nausea and vomiting. She is not taking her prenatal vitamins regularly and feels very guilty about it. She is worried that she is harming the fetus. Which one of the following is the most appropriate management of this patient ' s case?

A) Refer her for counselling to manage her feelings of guilt
B) Suggest that she take cannabinoids 30 minutes before taking her prenatal vitamins
C) Advise her to replace her vitamin with folic acid only until her nausea improves
D) Prescribe ginger tablets to be taken 4 times daily
E) Tell her she should continue to take her prenatal vitamins daily regardless of nausea

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