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Prepare For Medical Council of Canada MCCQE Certification Exam

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Medical Council of Canada MCCQE Part 1 Exam Sample Questions (Q105-Q110):

NEW QUESTION # 105
You are taking over a practice from a retiring family physician. The practice has paper records of patients dating back many years, including records of former patients. Which one of the following organizations is the most appropriate to contact regarding medical record retention requirements?

A. The College of Family Physicians of Canada.
B. The provincial/territorial regulatory authority.
C. The Canadian Medical Association.
D. Health Canada.
E. The Medical Council of Canada.

Answer: B

Explanation:
Medical record retention is governed by laws and policies established by the provincial or territorial medical regulatory authorities (e.g., College of Physicians and Surgeons of Ontario).These bodies set requirements for how long patient records must be maintained and how to handle former patients' data.
Toronto Notes 2023 - Ethics and Health Systems:
"Retention of medical records is regulated by provincial/territorial colleges, which outline minimum retention periods and storage responsibilities." MCCQE1 Objectives (ELOM > Legal Requirements > Professional Responsibilities):
"The candidate must be able to identify the legal responsibilities of physicians regarding record-keeping, as guided by regulatory authorities." National organizations such as Health Canada, CFPC, CMA, and MCC do not set these rules for individual practice management.

NEW QUESTION # 106
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. Medio-temporal atrophy
B. Cerebellar atrophy
C. Subdural hematoma
D. No structural abnormality
E. Bilateral frontal atrophy

Answer: E

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 # 107
You are called to attend an 18-year-old woman, gravida 2, para 1, aborta 0, who is in precipitous labour. She did not realize she was pregnant and has not had any prenatal care. After the delivery, you examine the newborn boy; he is vigorous, and it appears that he was born at full term. Physical examination findings of the newborn are normal. Review of the prenatal record from the mother's last pregnancy shows the following:
* HIV: Negative
* Hepatitis B surface antibody: Positive
* Hepatitis C: Negative
* Syphilis serology: Negative
The mother's previous child was placed in foster care. The mother is withdrawn and uncommunicative after delivery. Which one of the following is the best next step?

A. Administer hepatitis B vaccine to the newborn
B. Initiate feeding with donor breast milk
C. Collect urine from the newborn for a drug screen
D. Recommend immediate skin-to-skin care

Answer: C

Explanation:
Given the lack of prenatal care, the mother's withdrawal, and prior involvement of child protection services, a newborn drug screen is warranted to assess for possible in utero exposure. This is part of the safety assessment.
Toronto Notes 2023 - Pediatrics, Newborn Assessment:
"Infants born to mothers with no prenatal care or prior social concerns should undergo a full newborn screening, including toxicology if indicated." MCCQE1 Objectives - Pediatrics > Newborn Care and Social Issues:
"Candidates must identify social risk factors and initiate appropriate newborn evaluations, including toxicology screens when substance use is suspected." The mother was previously immune to hepatitis B, so (A) is not immediately required. Skin-to-skin care (D) is beneficial but secondary to screening in this context. Donor milk (B) is not indicated unless breastfeeding is contraindicated.

NEW QUESTION # 108
A 24-year-old man presents to your clinic with a 6-month history of fatigue. On examination, he is pale. His BMI is 16, and his blood pressure is 92/58 mm Hg. Initial laboratory work shows the following:
* Creatinine: 64 µmol/L (49-93)
* Potassium: 3.0 mmol/L (3.5-5.1)
* Sodium: 138 mmol/L (136-146)
* TSH: 2.40 mIU/L (0.34-5.60)
* CBC: Normal
Which one of the following is the best next step?

A. Ask permission to discuss the patient's weight
B. Consult gastroenterology
C. Refer the patient to the emergency department
D. Advise increased caloric intake

Answer: A

Explanation:
This patient has clinical signs of an eating disorder - fatigue, low BMI, hypotension, and hypokalemia - likely secondary to nutritional deficiencies or purging. The first step is to sensitively explore the patient's perception of weight and body image. Effective management requires rapport and careful conversation.
Toronto Notes 2023 - Psychiatry, Eating Disorders:
"Approach patients with suspected eating disorders non-judgmentally. Begin with permission to discuss weight or body image. Screening tools like SCOFF can help guide further assessment." MCCQE1 Objectives - Psychiatry > Eating Disorders:
"Candidates must recognize signs of eating disorders and initiate a respectful and effective patient-centered discussion." Referring to the ED (B) is not urgent without hemodynamic instability. Advising caloric intake (C) bypasses assessment. GI referral (D) is not appropriate at this stage.

NEW QUESTION # 109
A 37-year-old man presents with chronic back, neck, and shoulder pain following a workplace injury 4 years ago. He has a history of alcohol misuse and PTSD related to the incident. Current medications (acetaminophen, naproxen, amitriptyline, gabapentin) provide inadequate pain relief. He requests oxycodone after self-trialing it with temporary benefit. After history and physical assessment, which one of the following is the best next step?

A. Ordering repeat imaging of the spine and shoulder to confirm the diagnosis.
B. Prescribing a low-dose, long-acting opioid and reassessing in 1 week for effectiveness.
C. Prescribing cannabis.
D. Prescribing a short course of a short-acting opioid to be used only as needed.
E. Referring the patient to substance use and mental health support services.

Answer: E

Explanation:
The patient has chronic non-cancer pain with comorbid PTSD and alcohol misuse - high-risk factors for opioid use disorder. Before any opioid prescribing, a comprehensive interdisciplinary approach including mental health and substance use support is essential.
Toronto Notes 2023 - Pain Management and Addiction Medicine:
"In chronic pain patients with substance use or mental health comorbidities, refer to addiction/mental health services before considering opioid therapy." MCCQE1 Objectives (ELOM > 99-4: Safe Prescribing):
"Candidates must assess for substance use risk factors and manage chronic pain using a multidisciplinary approach." Imaging (A) is unlikely to alter management. Opioids (B, C) should not be first-line in this context. Cannabis (E) is not first-line and lacks robust evidence in complex chronic pain.

NEW QUESTION # 110
......

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