NEW MCCQE FRENQUENT UPDATE | HIGH PASS-RATE MEDICAL COUNCIL OF CANADA MCCQE: MCCQE PART 1 EXAM 100% PASS

New MCCQE Frenquent Update | High Pass-Rate Medical Council of Canada MCCQE: MCCQE Part 1 Exam 100% Pass

New MCCQE Frenquent Update | High Pass-Rate Medical Council of Canada MCCQE: MCCQE Part 1 Exam 100% Pass

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Medical Council of Canada MCCQE Part 1 Exam Sample Questions (Q203-Q208):

NEW QUESTION # 203
A 30-year-old woman presents to your office with a 6-week history of left lower quadrant pain and dyspareunia. A pelvic ultrasound is normal. Which one of the following is the most important immediate investigation?

  • A. Endometrial biopsy
  • B. Hysterosalpingography
  • C. Magnetic resonance imaging
  • D. Cervical swabs
  • E. Laparoscopy

Answer: D

Explanation:
This clinical presentation is highly suggestive of chronic pelvic inflammatory disease (PID), especially given the left lower quadrant pain and dyspareunia with a normal pelvic ultrasound. PID is often caused by sexually transmitted infections (STIs), such as Chlamydia trachomatis or Neisseria gonorrhoeae, which may not be evident on imaging.
Toronto Notes 2023 - Gynecology:
"Cervical swabs for N. gonorrhoeae and C. trachomatis are essential in the workup of suspected PID or cervicitis, even when imaging is normal. Dyspareunia and chronic pelvic pain with normal imaging should prompt testing for STIs." MCCQE1 Objectives (Obstetrics & Gynecology > 82-6: Pelvic Pain):
"Candidates must consider and investigate for infectious causes of pelvic pain, including PID, which requires cervical swab testing as an essential first-line investigation." Laparoscopy (A) is invasive and reserved for uncertain or refractory cases. Hysterosalpingography (C) is used in infertility workups, not acute pain. Endometrial biopsy (D) and MRI (E) are not first-line.


NEW QUESTION # 204
A 56-year-old man is admitted to hospital with pyelonephritis and started on intravenous antibiotics. On day 2 of his hospitalization, he continues to report right flank pain, but he is able to walk. His vital signs are as follows:
Temperature: 38.5°C
Blood pressure: 90/60 mm Hg
Heart rate: 105/min
The patient is mentating well but is concerned about his dog that is home alone due to his unexpected hospitalization. He requests to be released from hospital as he needs to make arrangements for his dog. Which one of the following is the best next step?

  • A. Discharge the patient, but ensure he signs an "Against Medical Advice" form.
  • B. Explain that his health is a priority and insist that he stay.
  • C. Ensure he understands the risk and accept his decision to leave for a few hours while you hold his bed.
  • D. Change him to oral antibiotics, and finish his treatment as an outpatient.
  • E. Offer to stop by his apartment on your way home, if he is agreeable to it and gives you the key.

Answer: C

Explanation:
The patient is alert and capable of making his own decisions. The most ethical and respectful approach is to ensure he understands the risks and accept his choice. Holding his bed maintains continuity of care. Forcing him to stay (C) or discharging him AMA (A) is inappropriate if he intends to return.
Toronto Notes 2023 - ELOM, Consent and Autonomy:
"Capable patients have the right to refuse or leave treatment. Physicians must ensure informed decision- making and maintain therapeutic rapport." MCCQE1 Objectives - ELOM > Capacity and Patient Autonomy:
"Candidates must respect a capable patient's right to leave care after informed discussion of risks and alternatives." Offering to enter his apartment (E) is inappropriate and unethical. Oral antibiotics (B) may not be clinically appropriate given hypotension.


NEW QUESTION # 205
A 58-year-old woman presents with a 1-year history of functional decline. She reports seeing rodents and little children invading her bedroom. Her partner tells you she has a slow, unsteady gait and tends to fall. On examination, she cannot sustain her attention during cognitive testing. Which one of the following is most likely to be found on brain imaging?

  • A. Subdural hematoma
  • B. No structural abnormality
  • C. Bilateral frontal atrophy
  • D. Medio-temporal atrophy
  • E. Cerebellar atrophy

Answer: C

Explanation:
The symptoms - visual hallucinations, attention deficits, gait instability - suggest dementia with Lewy bodies (DLB), which may show bilateral frontal or parietal atrophy on imaging.
Toronto Notes 2023 - Psychiatry, Neurocognitive Disorders:
"DLB presents with fluctuating cognition, visual hallucinations, parkinsonism, and attention deficits. Imaging may show frontal or parietal atrophy but is not always specific." MCCQE1 Objectives - Psychiatry > Neurocognitive Disorders:
"Candidates must recognize the characteristic features of DLB and support diagnosis with imaging when appropriate." Cerebellar atrophy (A) is linked to ataxia but not hallucinations. Subdural hematoma (B) causes abrupt decline. Mediotemporal atrophy (D) is typical of Alzheimer's. Option E is incorrect - imaging can support the diagnosis.


NEW QUESTION # 206
An 87-year-old man presents with a 2-week history of stiffness in both shoulders and both hips. On further questioning, he tells you that he has experienced a 2 kg unintentional weight loss over the last month. His past medical history is otherwise unremarkable and he is on no medications. On examination, he has limited range of motion due to pain in his shoulders and hips. The remainder of his examination, including muscle strength and joint exam, is normal. Which one of the following will you specifically ask about regarding his history?

  • A. Anhedonia
  • B. Recent diarrheal illness
  • C. Night sweats
  • D. Tremor
  • E. Unilateral headache

Answer: E

Explanation:
Comprehensive and Detailed Explanation:
This is a classic presentation of polymyalgia rheumatica (PMR), characterized by pain and stiffness in the shoulders and hips in older adults. PMR is closely associated with giant cell arteritis (GCA), which presents with unilateral headache, jaw claudication, visual symptoms, and scalp tenderness. Given the risk of vision loss with GCA, it's critical to screen for these symptoms in all patients with suspected PMR.
Toronto Notes 2023 - Rheumatology, PMR and GCA:
"Patients with PMR should be assessed for symptoms of GCA such as headache, visual changes, and jaw claudication. GCA can result in permanent vision loss if not promptly treated." MCCQE1 Objectives - Internal Medicine > Rheumatology:
"Candidates must identify signs of GCA in patients with PMR and understand the need for prompt diagnosis and treatment."


NEW QUESTION # 207
A 91-year-old man comes to the Emergency Department reporting blood in his stools, which has now resolved. He is able to give a history and mentions that this also happened 2 years ago. At that time, a colonoscopy was done and revealed diverticular disease as the cause. Which one of the following is the best next step?

  • A. Recommend a surgical resection of the diverticular disease.
  • B. Discuss the issue with his family before making a decision.
  • C. Perform a computed tomography colonoscopy.
  • D. Order a fecal immunochemical test (FIT).
  • E. Reassure him that a colonoscopy does not need to be repeated.

Answer: E

Explanation:
In a patient with known diverticular bleeding and no red flags (e.g., weight loss, anemia, family history), repeating colonoscopy is not required. Diverticular bleeding is typically self-limited. Colonoscopy within the past few years with clear findings suffices.
Toronto Notes 2023 - Gastroenterology, Lower GI Bleed:
"Patients with known diverticulosis and self-limited bleeding who have had prior complete colonoscopy do not require repeat endoscopy unless symptoms recur or persist." MCCQE1 Objectives - Internal Medicine > Gastroenterology:
"Candidates must recognize when no further invasive investigation is necessary in elderly patients with known benign findings and resolved symptoms." Option E is considerate but not clinically necessary for independent patients. Options A, B, and D are not indicated in resolved, low-risk cases.


NEW QUESTION # 208
......

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