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Medical Council of Canada MCCQE Part 1 Sample Questions:

1. A 53-year-old man presents to the Emergency Department with a 3-week history of believing his neighbor is poisoning him by pumping gas through his home's air vent. He appears distracted, irritable, and is speaking very quickly. He has a family history of depression. Which one of the following is the most likely diagnosis?

A) Delirium
B) Psychotic disorder secondary to traumatic brain injury
C) Brief psychotic disorder
D) Malingering
E) Bipolar I disorder

2. A 42-year-old woman presents to your clinic requesting an increase in her stimulant dosage for the treatment of her adult attention-deficit/hyperactivity disorder. Her medical history includes hypertension and type 1 diabetes with associated nephropathy. She has been taking methylphenidate daily for 15 years. Which one of the following would need to be addressed before the dosage can be increased?

A) Average home blood pressure reading of 150/80 mm Hg.
B) Random glucose level that is often higher than 18.0 mmol/L (4.0-11.0).
C) Estimated glomerular filtration rate of less than 30 mL/min/1.73 m² (#60).

3. A 24-year-old woman with chronic anorexia nervosa presents to the Emergency Department with diarrhea, chest pain and palpitations. She is noted to have a BMI of 13, a heart rate of 48/min, significant orthostatic hypotension and a temperature of 35.9 °C. Her electrocardiogram shows frequent premature ventricular contractions. Her blood work indicates elevated liver transaminases and evidence of acute kidney injury from dehydration. She agrees to admission for medical stabilization only if she does not receive fluids either orally or intravenously, as they will cause her to gain weight and to feel bloated. Which one of the following is the best next step?

A) Assess her capacity to consent for medical treatment
B) Obtain a psychiatric consultation
C) Ask her if she has a substitute decision-maker
D) Refuse to admit her unless she agrees to full treatment
E) Start intravenous fluids and physically restrain if necessary

4. A 39-year-old man presents to your clinic 4 months after a motor vehicle collision. He is trying to return to work but is having a difficult time because his job requires him to drive. He used to love his job, but he is worried about going back because every time he gets into a car, he is filled with dread, gets dizzy, and feels faint. He has regular nightmares about the incident. Which one of the following is the most likely diagnosis?

A) Malingering.
B) Generalized anxiety disorder.
C) Posttraumatic stress disorder.
D) Panic disorder.

5. A 45-year-old man presents to your family practice for follow-up because he has had repeated transient ischemic attacks and had been advised not to drive. During the interview, you find out that he is still driving.
He explains that he only drives to the grocery store and his wife, who also has a driver ' s license, is always a passenger with him. He insists he can drive. You think that he should no longer be driving a car. Which one of the following is the best next step?

A) Consult a neurologist to assess whether the patient is fit to drive.
B) Communicate your concerns to the motor vehicle licensing authority.
C) Discuss this further with him.
D) Refuse to treat him further unless he stops driving.
E) Physically take away his license.

Solutions: