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Medical Council of Canada MCCQE Part 1 Exam Sample Questions (Q98-Q103):

NEW QUESTION # 98
A 30-year-old woman presents to the office with her partner and reports that they are planning for her to conceive soon. They visited Mexico recently and are concerned about exposure to the Zika virus. Which one of the following is the best next step?

A. Explain that condoms are ineffective in preventing sexual transmission of Zika virus
B. Prescribe a prophylactic antiviral medication
C. Request serologic testing
D. Recommend ceasing conception until 3 months after the couple's return to Canada
E. Refer the couple to an infectious disease specialist

Answer: D

Explanation:
Comprehensive and Detailed Explanation:
The Zika virus can be sexually transmitted and poses a serious risk of congenital Zika syndrome if infection occurs during pregnancy. The CDC and WHO recommend that couples delay conception for at least 3 months after potential male exposure due to the virus's persistence in semen.
Toronto Notes 2023 - Infectious Diseases / Travel Medicine:
"Zika virus may persist in semen for weeks. Couples should delay conception for 3 months after male exposure, even if asymptomatic." MCCQE1 Objectives (Public Health > 65-3: Travel Medicine and Reproductive Health):
"Candidates must counsel appropriately regarding risks of Zika in conception and apply current public health recommendations." Testing (B) is not reliable for asymptomatic individuals. Antivirals (E) are ineffective. Condoms (D) do reduce risk. Specialist referral (A) is not needed in most cases with no complications.
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NEW QUESTION # 99
You have been asked to develop a program in your hospital for people who are at the highest risk of death by suicide. The hospital administrator asks you to describe the types of patients they should expect in the program. Which one of the following groups is the most likely prominent demographic?

A. Men aged 50 to 70 years who have limited social supports and alcohol use disorder
B. Women aged 14 to 20 years who have histories of being abused and who are experiencing financial hardships
C. Women aged 20 to 40 years who have cluster B personality disorders and experience relationship losses
D. Patients of both sexes who have psychotic disorders
E. Men aged 11 to 20 years who have histories of juvenile delinquency and narcotic use

Answer: A

Explanation:
Comprehensive and Detailed Explanation:
Middle-aged to older men with social isolation and substance use disorders (especially alcohol) are among the highest-risk groups for completed suicide. They are less likely to seek help and often use more lethal methods.
Toronto Notes 2023 - Psychiatry, "Suicide Risk Assessment":
"High-risk demographics include older men, social isolation, comorbid alcohol use, and chronic illness. These patients have the highest rates of completed suicide." MCCQE1 Objectives (Psychiatry > 71-1: Suicide Risk):
"Candidates must recognize epidemiologic risk factors for completed suicide, including demographics and comorbidities." Although women and youth have higher rates of suicidal ideation and attempts, men over 50 have the highest completion rates.

NEW QUESTION # 100
A 20-year-old nulligravid woman presents with severe pain during menstruation. She is unable to take nonsteroidal anti-inflammatory drugs (NSAIDs) and is adamant about not taking any hormonal therapy. She has questions about non-medicinal therapeutic options. Which one of the following recommendations is the most appropriate?

A. Massage therapy
B. Progesterone-releasing intrauterine device
C. High-frequency transcutaneous electrical nerve stimulation (TENS)
D. Laparoscopic uterine nerve ablation (LUNA)
E. Spinal manipulation

Answer: C

Explanation:
TENS has been shown to be effective for managing primary dysmenorrhea when pharmacological options are contraindicated or refused. It works by interfering with pain signal transmission and increasing endorphin levels.
Toronto Notes 2023 - Gynecology, Dysmenorrhea:
"High-frequency TENS is effective in managing primary dysmenorrhea and can be considered when NSAIDs or hormonal therapies are not acceptable to the patient." MCCQE1 Objectives - Gynecology > Menstrual Disorders:
"Candidates must be aware of non-pharmacological interventions for dysmenorrhea, including TENS and heat therapy." Options D and E involve hormonal or surgical intervention. Spinal manipulation and massage (B and C) lack consistent evidence for dysmenorrhea relief.

NEW QUESTION # 101
A 24-year-old woman has had several episodes of left lower lobe pneumonia. She has a chronic productive cough with occasional blood-streaked sputum. Physical examination is normal except for rales at the left base.
Chest radiograph shows a linear infiltrate in this area. Which one of the following is the most likely diagnosis?

A. Pulmonary tuberculosis
B. Pulmonary infarction
C. Mitral stenosis
D. Chronic bronchitis
E. Bronchiectasis

Answer: E

Explanation:
Comprehensive and Detailed Explanation:
Bronchiectasis is characterized by recurrent localized pneumonia, chronic productive cough, and hemoptysis.
A linear infiltrate that persists in the same area suggests localized airway damage-typical of bronchiectasis.
Toronto Notes 2023 - Respirology:
"Bronchiectasis presents with recurrent infections in the same location, productive cough, and hemoptysis.
Chest X-ray may show linear opacities; high-resolution CT is diagnostic." MCCQE1 Objectives (Respiratory > 45-1: Chronic Respiratory Symptoms):
"Candidates must investigate recurrent pneumonias and consider bronchiectasis, especially if localized." Chronic bronchitis (A) presents bilaterally. Mitral stenosis (B) may cause hemoptysis but not localized infiltrates. TB (E) usually affects upper lobes. Infarction (C) is acute and not recurrent.

NEW QUESTION # 102
A 43-year-old man is referred to you for an incidental finding of elevated hemoglobin. Laboratory results are as follows:
Hemoglobin
185 g/L (130-170)
Mean corpuscular volume
92 fL (60-100)
White blood cells
7.8×1037.8×103 / L (4-10)
Platelets
250×103250×103 / L (130-400)
His BMI is 23. He has type 2 diabetes for which he takes gliclazide MR 60 mg daily. Which one of the following features on history could explain his laboratory abnormality?

A. Central sleep apnea
B. Alcohol abuse
C. Hypertension
D. Hypothyroidism
E. Cirrhosis

Answer: A

Explanation:
Elevated hemoglobin in the absence of polycythemia vera can be due to secondary causes such as chronic hypoxia. Central sleep apnea, often associated with diabetes or neurologic conditions, leads to intermittent hypoxia and compensatory erythropoiesis.
Toronto Notes 2023 - Hematology and Respiratory Medicine, "Polycythemia" Section:
"Secondary erythrocytosis may result from hypoxic conditions including sleep apnea, COPD, or high altitude.
Assess for sleep-disordered breathing in patients with elevated hemoglobin and no myeloproliferative features." MCCQE1 Objectives (Internal Medicine > 76-7: Hematologic Abnormalities):
"Candidates must investigate secondary causes of elevated hemoglobin, including hypoxia-related conditions." Hypertension (A), hypothyroidism (C), and cirrhosis (D) do not cause polycythemia. Alcohol (B) typically causes macrocytosis and anemia.

NEW QUESTION # 103
......

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