Medical Council of Canada MCCQE Part 1 - MCCQE

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Medical Council of Canada MCCQE Part 1 認定 MCCQE 試験問題:

1. A 45-year-old man is brought to the Emergency Department with chest pain. He has no significant medical history. He is anxious and agitated, and he reports severe central chest pain that began about 90 minutes ago.
His vital signs are as follows: blood pressure 200/110 mm Hg, heart rate 140/min, respiratory rate 30/min, oxygen saturation 98% on supplemental oxygen. Physical examination reveals a restless and slightly tremulous man. Pupils are 7 mm reactive. There are no focal neurologic signs. Cardiopulmonary examination is normal. The 12-lead electrocardiogram reveals sinus tachycardia; findings are otherwise normal. Which one of the following is the most likely cause of this clinical presentation?

A) Cocaine.
B) Oxycodone.
C) Heroin.
D) Cannabis.
E) Alcohol.

2. A 69-year-old woman with long-standing hypertension presents to the emergency department with a 2-hour history of persistent chest and back pain. A posteroanterior chest radiograph shows suspicious widening of the mediastinal shadow. Which one of the following is most likely to yield a clinical diagnosis?

A) Ventilation-perfusion lung scan
B) Transthoracic echocardiography
C) Pulmonary angiography
D) Computed tomography of the chest
E) Electrocardiography

3. A 77-year-old woman is brought to the Emergency Department by ambulance because she has severe heel ulcers and dehydration. Her husband reports that she has been sick for the past 6 to 8 weeks with a cough and congestion. He shares that he has tried to bring her to medical attention on several occasions, but she refused.
The paramedics reported that her bed at home was soiled and that they could hardly reach her room due to clutter. On questioning, her answers seem reasonable. Which one of the following is the most critical next step?

A) Assess the risk of financial abuse by her husband
B) Determine whether the patient has alcohol or substance use disorder
C) Obtain pictures to confirm the state of their house
D) Assess the patient's decision-making ability
E) Find out whether the husband has a criminal record

4. During an office visit, your 14-year-old patient requests a prescription for oral contraceptives. The province where you are working does not have a statutory age of consent. Which one of the following is the best next step?

A) Refuse to prescribe the pills because she is less than 18 years of age.
B) Advise her to return with her parents so that legal consent can be obtained.
C) Give her the prescription and book a follow-up appointment.
D) Notify child protective services because of the possibility of sexual abuse.
E) Determine her understanding of the medical issues before prescribing the pills.

5. A 55-year-old woman presents with a 6-month history of poor memory and impaired concentration. She has bipolar I disorder that has been treated with lithium carbonate for 4 years. She has gained a lot of weight since starting lithium. Physical examination findings are otherwise normal. She is concerned about her memory issues, but there are no other perception, mood, or cognition abnormalities. Which one of the following tests is most likely to have abnormal findings?

A) Liver function tests
B) Parathyroid hormone
C) Serum sodium level
D) Serum thyrotropin (thyroid-stimulating hormone) level
E) Creatinine clearance

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