Free PDF Quiz Medical Council of Canada - MCCQE Study Reference
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Medical Council of Canada MCCQE Part 1 Exam Sample Questions (Q36-Q41):
NEW QUESTION # 36
A 37-year-old woman presents to your clinic with frequent palpitations. She has no other symptoms and is quite active. Physical examination and resting electrocardiogram findings are normal. Which one of the following is the best next step?
Answer: B
Explanation:
Comprehensive and Detailed Explanation:
The most appropriate next step for a patient with intermittent palpitations and a normal ECG is Holter monitoring (or event monitoring). This can capture and correlate symptoms with cardiac rhythm.
Toronto Notes 2023 - Cardiology, "Palpitations":
"Holter or event monitoring is indicated when the initial ECG is normal but the patient has episodic symptoms such as palpitations." MCCQE1 Objectives (Cardiology > 34-2: Arrhythmia):
"Candidates must use ambulatory ECG monitoring to investigate intermittent palpitations when resting ECG is unremarkable." Echocardiogram (A) assesses structural issues but not rhythm. #-blockers (B) should not be started without diagnosis. Stress testing (D) is for ischemia.
NEW QUESTION # 37
In a research study, it is found that people who smoke tobacco cigarettes drink more coffee and have higher rates of lung cancer than people who do not smoke. However, the consumption of coffee alone is not associated with lung cancer. Which one of the following best describes the contribution of drinking coffee in the study?
Answer: B
Explanation:
A confounder is a variable associated with both the exposure and the outcome but not in the causal pathway.
In this study, coffee drinking is associated with smoking (the actual risk factor for lung cancer), but not independently associated with lung cancer.
Toronto Notes 2023 - Epidemiology Chapter:
"A confounder is a third variable that distorts the observed association between an exposure and an outcome.
It must be associated with both the exposure and the outcome, but not a result of the exposure." MCCQE1 Objectives (Population Health > 97-3: Study Design and Bias):
"Recognize and control for confounding in the interpretation of observational study data." Coffee is not a risk factor (B) since it's not independently associated with lung cancer, and it's not selection bias (C), which involves how participants are enrolled in a study.
NEW QUESTION # 38
Following a potluck supper organized by the residency director of your training program, many of your fellow residents and other guests fall ill with gastroenteritis. Which one of the following is the best way to identify the source of this food-borne outbreak?
Answer: B
Explanation:
Calculating food-specific attack rates (i.e., number of people who became ill after eating aparticular food divided by the total number who ate that food) is the most effective method to identify the probable source of infection in a known cohort outbreak.
Toronto Notes 2023 - Public Health, Outbreak Investigations:
"Foodborne outbreaks are best analyzed using food-specific attack rates to determine associations between individual foods and illness." MCCQE1 Objectives - Preventive Medicine > Epidemiologic Principles:
"Candidates must use epidemiologic tools, such as attack rates, to identify probable sources during outbreak investigations." Cohort study (C) is also acceptable but more time-intensive. Stool and food cultures (B, D) confirm the pathogen but not the source. HACCP (E) is a preventive method, not a tool for outbreak investigation.
NEW QUESTION # 39
A 28-year-old woman presents because of spotting mid-menstrual cycle. Speculum examination reveals an ulcerated endocervical polyp. Which one of the following is the most appropriate management?
Answer: C
Explanation:
Endocervical polyps are common and often benign. An ulcerated polyp may bleed but is not itself suspicious unless it shows atypical features. The appropriate management is to remove the polyp (polypectomy) and send it for histopathology to exclude malignancy.
Toronto Notes 2023 - Gynecology, Cervical Pathology:
"Endocervical polyps are removed by polypectomy and sent for histological analysis. Most are benign.
Atypical or ulcerated appearance may raise concern, but biopsy is unnecessary if the entire lesion is excised." MCCQE1 Objectives - Gynecology > Abnormal Bleeding and Cervical Lesions:
"Candidates should recognize that cervical polyps causing intermenstrual bleeding should be removed and assessed histologically." Colposcopy (B) is reserved for abnormal cytology or high-risk lesions. Cryotherapy (A) is for cervical dysplasia. Punch biopsy (E) is used for lesions that are not amenable to polypectomy.
NEW QUESTION # 40
A 2-year-old boy is brought by his parents to your clinic because of sudden onset of high fever, refusal to drink, and drooling. Examination reveals cervical lymphadenopathy as well as multiple ulcers on the inner lips, tongue, and gums. Which one of the following is the most likely diagnosis?
Answer: B
Explanation:
Primary herpetic gingivostomatitis caused by HSV-1 is common in toddlers. It presents with high fever, irritability, drooling, refusal to eat, and painful oral ulcers on the lips, gums, and tongue. Cervical lymphadenopathy is common.
Toronto Notes 2023 - Pediatrics, "Infectious Conditions in Children":
"Primary HSV-1 infection in children presents with high fever, cervical lymphadenopathy, and painful oral ulcers (gingivostomatitis)." MCCQE1 Objectives (Pediatrics > 75-2: Infectious Diseases):
"Candidates must recognize viral exanthems and enanthems, including herpetic gingivostomatitis, based on clinical findings." Kawasaki (A) includes conjunctivitis, strawberry tongue, and extremity changes. Epiglottitis (B) presents with drooling but without oral ulcers. Mono (C) lacks the ulcerative pattern. Hand-foot-mouth (D) affects palms and soles, not inner lips and gums predominantly.
NEW QUESTION # 41
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