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Medical Council of Canada MCCQE Part 1 Exam Sample Questions (Q139-Q144):

NEW QUESTION # 139
A 25-year-old woman who is at 8 weeks' gestation plans to travel to rural Cambodia to care for her ill mother.
Which one of the following treatments should be provided to her before the trip?

A. Antimalarial chemoprophylaxis
B. Ciprofloxacin for travellers' diarrhea
C. Hepatitis B immunoglobulin
D. Tetanus and diphtheria booster if last received more than 5 years ago

Answer: A

Explanation:
Comprehensive and Detailed Explanation:
Travel to rural Cambodia poses a high risk of malaria, which can be life-threatening in pregnancy.
Antimalarial prophylaxis is strongly recommended for pregnant women traveling to endemic regions.
Chloroquine or mefloquine (depending on resistance patterns) may be used in pregnancy under specialist guidance.
Toronto Notes 2023 - Infectious Disease / Travel Medicine:
"Malaria prophylaxis is indicated in pregnant women traveling to endemic regions. The risk of severe malaria and poor fetal outcomes is high." MCCQE1 Objectives (Public Health > 65-3: Travel Medicine and Pregnancy):
"Candidates must provide preventive care to pregnant travelers including vaccination and malaria prophylaxis." Tetanus boosters (D) are given every 10 years. Hep B Ig (B) is for acute post-exposure prophylaxis.
Ciprofloxacin (C) is contraindicated in pregnancy.

NEW QUESTION # 140
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 Medical Council of Canada.
C. Health Canada.
D. The provincial/territorial regulatory authority.
E. The Canadian Medical Association.

Answer: D

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 # 141
Your colleague's receptionist asks you to assess her 4-year-old daughter who has had 2 episodesof acute otitis media in the last month. The mother wants you to arrange a consultation with an ear, nose and throat (ENT) specialist to get a tympanostomy before her daughter starts school. You do not believe there is a surgical indication at this time. Which one of the following is the best next step?

A. Explain that there is no indication for the surgery but refer her daughter for consultation.
B. Call the ENT consultant on call to discuss your dilemma.
C. Suggest that the next time they go to the Emergency Department for quicker access to the ENT consultant.
D. Decline to send her daughter for consultation and explain your decision.
E. Ask another family physician to see the daughter due to a conflict of interest.

Answer: D

Explanation:
Referrals should be medically indicated. Physicians are not obligated to refer simply because a patient (or colleague) requests it, especially when it may lead to unnecessary care. The ethical and appropriate action is to explain your medical reasoning and decline an unwarranted referral.
Toronto Notes 2023 - ELOM, "Professionalism and Resource Stewardship" Section:
"Physicians have a responsibility to act as gatekeepers to specialist services and should not refer patients when criteria are not met. Explaining the reasoning and declining the request respectfully is appropriate." MCCQE1 Objectives (ELOM > 99-1: Professionalism and Clinical Judgment):
"Candidates must demonstrate ethical reasoning in managing requests for unwarranted interventions." Involving the emergency department (B) or another physician (C) is not appropriate unless there's a true conflict of interest. Calling a consultant (E) may be unnecessary if no medical reason exists.

NEW QUESTION # 142
A 26-year-old man presents with pain, numbness, and weakness in his right upper extremity. He works as a computer programmer, and his BMI is 32. Symptoms have worsened since he started spending more time on the keyboard. He reports that his right hand feels clumsier while he is typing. Physical examination reveals mild weakness in the intrinsic muscles of that hand, with a positive Tinel sign at the ulnar nerve. Which one of the following is the best next step?

A. Wrist splint to test for carpal tunnel.
B. Physiotherapy.
C. Nerve conduction studies to localize the level of the lesion.
D. Elbow extension brace for use during sleep.
E. Magnetic resonance imaging of the cervical spine.

Answer: C

Explanation:
This patient presents with symptoms and signs of ulnar neuropathy-most likely at the elbow (cubital tunnel).
Weakness in the intrinsic hand muscles and positive Tinel sign at the ulnar nerve are suggestive. Nerve conduction studies are the gold standard to confirm and localize the lesion.
Toronto Notes 2023 - Neurology, "Peripheral Nerve Disorders":
"In cases of suspected mononeuropathy such as ulnar nerve compression, nerve conduction studies confirm the diagnosis and localize the lesion." MCCQE1 Objectives (Medicine > Neurology > 35-2):
"Candidates should identify and investigate focal mononeuropathies using nerve conduction studies to confirm the diagnosis and location." Splinting (A, C) may help after diagnosis. Physiotherapy (B) is adjunctive. MRI (D) is not the first-line investigation.

NEW QUESTION # 143
A 76-year-old man is brought to the emergency department in an unresponsive state. He has a history of chronic kidney disease with a baseline serum creatinine level of 300 µmol/L (49-93) and a history of dilated cardiomyopathy with an ejection fraction of 30%. On assessment, he has no pulse or blood pressure. Cardiac monitor demonstrates a wide complex tachycardia. Which one of the following recently started medications is the most likely cause of this arrhythmia?

A. Clopidogrel
B. Diltiazem
C. Hydrochlorothiazide
D. Spironolactone
E. Metoprolol

Answer: D

Explanation:
Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia, especially in patients with impaired renal function. Hyperkalemia can lead to life-threatening arrhythmias, particularly wide complex tachycardia or ventricular fibrillation.
Toronto Notes 2023 - Cardiology and Nephrology, "Hyperkalemia" Section:
"Patients with CKD are at increased risk for hyperkalemia, particularly when taking potassium-sparing medications such as spironolactone. Severe hyperkalemia may cause bradycardia or wide-complex tachyarrhythmias." MCCQE1 Objectives (Internal Medicine > 76-2: Electrolyte Abnormalities):
"Candidates must recognize drug-induced hyperkalemia as a cause of cardiac arrhythmias, especially in patients with renal dysfunction." Hydrochlorothiazide (B) can cause hypokalemia. Metoprolol (C) and diltiazem (E) are rate-controlling agents but do not typically cause wide complex tachycardia. Clopidogrel (D) has no effect on cardiac conduction.

NEW QUESTION # 144
......

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Medical Council of Canada MCCQE Part 1 Exam Sample Questions (Q139-Q144):

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