100% PASS QUIZ MEDICAL COUNCIL OF CANADA MCCQE - MCCQE PART 1 EXAM UPDATED UPDATED DUMPS

100% Pass Quiz Medical Council of Canada MCCQE - MCCQE Part 1 Exam Updated Updated Dumps

100% Pass Quiz Medical Council of Canada MCCQE - MCCQE Part 1 Exam Updated Updated Dumps

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Medical Council of Canada MCCQE Part 1 Exam Sample Questions (Q143-Q148):

NEW QUESTION # 143
A 66-year-old woman suffering from a progressive neurological disease is admitted to a long-term care centre. Her husband does not wish to participate in discussions about the seriousness of his wife's disease and is convinced that she will soon come back home. During his 2nd visit to the centre, he gives you a cheque for a substantial sum made out to you, the treating physician, for your own research. Which one of the following is the best response to your patient's husband?

  • A. Inform him you would only be able to accept a smaller amount of money
  • B. Decline to accept the cheque
  • C. Refer the husband to the centre's social worker
  • D. Suggest he donate to your medical group
  • E. Accept the money as a contribution to the long-term care centre's fundraising campaign

Answer: B

Explanation:
Comprehensive and Detailed Explanation:
Physicians must avoid conflicts of interest and maintain professional boundaries with patients and their families. Accepting a personal financial gift, regardless of intent, is inappropriate and unethical.
Toronto Notes 2023 - Ethics and Professionalism:
"Personal gifts of significant value from patients or families should be declined to avoid real or perceived conflicts of interest." MCCQE1 Objectives (ELOM > 90-3: Professionalism and Boundaries):
"Candidates must maintain ethical boundaries and refuse financial incentives that could compromise or appear to compromise clinical judgment." Other options (A, B, E) still involve a conflict. D is helpful, but the ethical obligation is to decline the cheque directly.
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NEW QUESTION # 144
A 60-year-old woman presents with a 7-day history of bloody diarrhea and diffuse mild abdominal tenderness. Stool tests (culture, ova/parasites) are negative. Which one of the following is the best next step?

  • A. Recommend symptomatic observation.
  • B. Recommend a trial of loperamide.
  • C. Prescribe tapered-dose steroids.
  • D. Prescribe broad-spectrum antibiotics.
  • E. Order a diagnostic colonoscopy.

Answer: E

Explanation:
Persistent bloody diarrhea with negative stool cultures and ova/parasite testing in an older adult suggests inflammatory bowel disease (IBD) or another colitis such as ischemic or microscopic colitis. Colonoscopy is the best next diagnostic step to evaluate for ulcerative colitis, Crohn disease, ischemic colitis, or malignancy.
Toronto Notes 2023 - Gastroenterology, "Inflammatory Bowel Disease":
"Persistent bloody diarrhea with negative infectious work-up should prompt colonoscopic evaluation to rule out IBD or other forms of colitis." MCCQE1 Objectives (Internal Medicine > Gastrointestinal > 47-1):
"Candidates must assess and investigate chronic or persistent diarrhea. In the presence of red flag features such as bleeding, weight loss, or anemia, colonoscopy is indicated." Antibiotics (A) are not indicated with negative stool cultures. Observation (C) and loperamide (D) risk delaying diagnosis. Steroids (E) may be required later but only after confirmation of diagnosis.


NEW QUESTION # 145
A 72-year-old woman is brought to the Emergency Department by her daughter because of significant functional decline and progressive shortness of breath. She has widespread metastatic breast cancer and recently stopped chemotherapy due to progression and intolerance. She has been bedridden for 4 weeks. On examination:
* BP: 100/70 mm Hg with pulsus paradoxus of 20 mm Hg
* HR: 99/min
* Temp: 36.5°C
* SpO#: 94% room air
* JVP: elevated
* Heart sounds: muffled
* Chest X-ray: large globular heart
Labs:
* Hemoglobin: 90 g/L
* Sodium: 118 mmol/L
* Creatinine: 94 µmol/L
Which one of the following is the best next step?

  • A. Normal saline infusion
  • B. Discussion on goals of care
  • C. Pericardiocentesis
  • D. Consult with the Intensive Care Unit
  • E. Blood transfusion

Answer: B

Explanation:
This patient has classic signs of cardiac tamponade (Beck's triad: hypotension, muffled heartsounds, elevated JVP, plus pulsus paradoxus). However, she also has advanced metastatic cancer, functional decline, and has stopped active treatment. In this context, a goals-of-care discussion is the most appropriate next step to determine her wishes regarding interventions like pericardiocentesis.
Toronto Notes 2023 - Palliative Care:
"End-of-life care should prioritize quality of life and patient preferences. In patients with terminal illness and life-threatening conditions (e.g., tamponade), initiate a conversation about goals before aggressive intervention." MCCQE1 Objectives - Internal Medicine > Palliative and End-of-Life Care:
"Candidates must assess prognosis, patient values, and initiate appropriate end-of-life discussions before invasive treatment." Although pericardiocentesis (A) may relieve symptoms, it should follow consent based on the patient's goals.
ICU (E), fluids (B), or transfusion (D) are not appropriate without this discussion.


NEW QUESTION # 146
A 60-year-old man presents to the office with concerns regarding a pruritic rash, which he has had for several years. He reports a "crawling" sensation on his skin. He is concerned that this rash may be caused by a parasite he may have picked up while serving in the military overseas. On examination, you note multiple crusted lesions on his forearms, neck, chest, scalp, and thighs. There is a complete sparing of the skin on his back. He brought a bottle with fibrous material of different colours that he picked from his wounds. He is otherwise healthy and reports no other symptoms except some chronic fatigue and insomnia related to the itching. Which one of the following treatments is the most appropriate?

  • A. Ivermectin
  • B. Doxycycline
  • C. Permethrin
  • D. Fluconazole
  • E. Butenafine

Answer: A

Explanation:
This case describes classic signs of delusional parasitosis (also known as Morgellons syndrome).However, the presence of widespread crusted lesions raises suspicion for crusted scabies, particularly in older adults.
Crusted scabies may be misinterpreted as chronic dermatitis or psychocutaneous disorder. The most effective treatment is oral ivermectin.
Toronto Notes 2023 - Dermatology:
"Crusted scabies presents as widespread hyperkeratotic plaques with crusting. First-line treatment is oral ivermectin, often with topical permethrin." MCCQE1 Objectives (Medicine > Dermatology > 23-1):
"Candidates must recognize presentations of ectoparasitic infections, including scabies, and provide appropriate treatment." Permethrin (B) is for typical scabies, but crusted scabies often requires systemic ivermectin due to severity and spread.


NEW QUESTION # 147
You are conducting a virtual appointment by voice-only call with a 68-year-old man regarding back pain.
When he answers, you ask for him by name and identify yourself and the clinic from which you are calling.
Which one of the following is the best next step?

  • A. Establish the reason for the virtual care visit.
  • B. Ask for additional confirmation of the patient's identity.
  • C. Confirm the name of the patient's primary care provider.

Answer: B

Explanation:
Before proceeding with any virtual consultation, particularly by voice-only, it is essential to confirm the patient's identity beyond name alone - for example, by verifying date of birth or health card number. This protects privacy and ensures medical confidentiality.
Toronto Notes 2023 - ELOM, Virtual Care Section:
"Virtual care must begin by verifying patient identity using at least two identifiers (e.g., full name and date of birth) to prevent disclosure of personal health information to unintended individuals." MCCQE1 Objectives - Ethical, Legal, and Professionalism > Virtual Care:
"The candidate must confirm patient identity and consent before initiating any virtual medical encounter, especially when video is not available." Option A (reason for visit) should follow identity confirmation. Option B (confirming primary care provider) is irrelevant to identity verification.


NEW QUESTION # 148
......

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