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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A previously well 4-year-old boy is brought to your office by his mother. She is concerned by his behaviour.
Shortly after falling asleep, he awakens, screams loudly and cries. He appears frightened and does not respond to his mother's efforts to calm him. During these episodes, he appears agitated and flushed. After 15-20 minutes, he settles back to sleep. Physical examination is unremarkable. Which one of the following is the most likely diagnosis?

A) Non-rapid eye movement sleep arousal disorder.
B) Nightmare disorder.
C) Nocturnal seizures.
D) Temper tantrums.
E) Panic disorder.

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

3. A mother brings her previously healthy 4-month-old girl for evaluation due to fussiness for 3 weeks. The infant becomes irritable and cries with occasional body arching 1-2 hours after feeding, frequently spits up after feeds, has developed feeding aversion, and shows slowing weight gain. She has been on cow ' s milk- based formula since birth. Stools are normal, and physical examination is unremarkable. Which one of the following is the most likely diagnosis?

A) Gastroesophageal reflux disease.
B) Intermittent intussusception.
C) Celiac disease.
D) Peptic ulcer.
E) Hypertrophic pyloric stenosis.

4. An 88-year-old married man is admitted following a cardiac arrest at home. He was not expected to recover, and after 2 weeks, he remains in a coma. His wife states, " I cannot let him go. That would be murder. " As the attending physician looking after her husband, which one of the following is the best next course of action?

A) Say nothing further and wait until she comes around to accepting his state
B) Emphasize that the duration of his stay in the Intensive Care Unit will be limited
C) Encourage her to imagine what her husband would have wanted
D) Seek advice from the provincial or territorial public guardian
E) Remove him from life support as this would not be murder

5. A 67-year-old farmer presents with a 6-month history of progressive weakness in both arms. He now has difficulty in climbing but says he can still drive his tractor. Examination shows slight but definite atrophy of muscles of pectoral girdle, especially over his scapula. Fasciculations are visible. There is hyperreflexia of most tendon reflexes of arms and legs, left ankle clonus and left Babinski reflex. Which one of the following is the most likely diagnosis?

A) Astrocytoma of pons.
B) Multiple sclerosis.
C) Amyotrophic lateral sclerosis.
D) Parkinson disease.
E) Cerebellar degeneration.

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