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Medical Council of Canada MCCQE Part 1 Exam Sample Questions (Q112-Q117):

NEW QUESTION # 112
On screening for dyslipidemia, a 45-year-old man is found to have a low high-density lipoprotein (HDL) cholesterol level. Which one of the following recommendations is the most appropriate?

Answer: D

Explanation:
Low HDL is best managed with lifestyle changes such as increased aerobic physical activity, smoking cessation, and weight loss. Vigorous exercise has the strongest evidence for raising HDL levels.
Toronto Notes 2023 - Cardiology, Dyslipidemia:
"Increasing physical activity is among the most effective ways to raise HDL cholesterol. There is no consistent benefit to supplements such as garlic, nor does reducing salt or caffeine meaningfully raise HDL." MCCQE1 Objectives - Population Health > Cardiovascular Risk Management:
"Candidates should recommend evidence-based lifestyle interventions such as exercise to improve lipid profiles, particularly to increase HDL." Alcohol cessation (C) is generally beneficial for overall health but may actually lower HDL slightly. Garlic (D) and caffeine (E) are not evidence-based interventions for dyslipidemia.


NEW QUESTION # 113
A 10-year-old boy and his mother present to your office with a concern about handwashing. The mother explains that her son has been at a new school for the past month and that teachers have noticed that he is washing his hands all day. He has also hidden hand sanitizer in his desk. The hand-cleaning is a response to a constant anxiety that his hands are dirty, and that he might pass an infection to someone. Which one of the following is the most appropriate initial management?

Answer: A

Explanation:
This child demonstrates classic features of obsessive-compulsive disorder (OCD): intrusive contamination fears (obsession) and repetitive handwashing behaviors (compulsion) performed to reduce anxiety. The symptoms are excessive, impairing school function, and persist beyond normal developmental concerns.
According to MCCQE objectives, first-line treatment for mild to moderate pediatric OCD is cognitive- behavioral therapy (CBT) with exposure and response prevention (ERP). ERP involves gradual exposure to feared contaminants while preventing the compulsive handwashing response, thereby reducing anxiety through habituation and cognitive restructuring. Pharmacologic treatment with selective serotonin reuptake inhibitors (e.g., fluoxetine) is indicated for moderate to severe cases or when CBT alone is insufficient, but it is not the preferred initial intervention when psychotherapy is accessible. Risperidone is not first-line and may be considered only as augmentation in refractory cases. Changing schools or providing a teaching assistant does not address the underlying anxiety disorder. Early evidence-based intervention improves prognosis and functional outcomes in pediatric OCD.


NEW QUESTION # 114
A 42-year-old woman is admitted to the Intensive Care Unit with a massive pulmonary embolism. Her condition is stabilized with intubation, hydration, inotropic support, and intravenous administration of heparin. Her partner provides you with a list of her medications. A combination oral contraceptive pill was recently prescribed. She smokes tobacco cigarettes, and her BMI is 36. Which one of the following is the best next step?

Answer: D

Explanation:
Oral contraceptives increase the risk of thromboembolic events, particularly in patients with risk factors such as smoking and obesity. However, informing the patient's partner of potential contributing factors in a factual, non-judgmental manner is appropriate and does not imply fault.
Toronto Notes 2023 - ELOM, "Informed Consent and Risk Communication":
"Patients and families should be informed of all relevant information, including potential drug-related adverse events. Blame must not be assigned without full investigation." MCCQE1 Objectives (ELOM > 90-2: Physician-Patient Communication):
"Candidates must be able to communicate adverse outcomes factually, while respecting confidentiality and without prematurely assigning fault." Discussing the case with the ethics committee or reporting the prescribing doctor without context is premature and inappropriate (A, D). Telling the partner the physician was at fault (C) is speculative and unethical.


NEW QUESTION # 115
A 34-year-old woman, gravida 3, para 2, aborta 0, presents at 38 weeks' gestation. She is in early labor with ruptured membranes. Her previous pregnancy was complicated by fever during labor. Which one of the following would increase the risk of fever recurrence?

Answer: D

Explanation:
Comprehensive and Detailed Explanation:
Epidural analgesia is associated with increased maternal intrapartum fever due to non-infectious(neurogenic) thermoregulation impairment. This is a well-known phenomenon in laboring women.
Toronto Notes 2023 - Obstetrics / Anesthesia:
"Epidural analgesia increases risk of intrapartum fever by up to 20% via non-infectious mechanisms." MCCQE1 Objectives (Obstetrics > 80-5: Intrapartum Care):
"Candidates must recognize risk factors for intrapartum complications, including effects of epidural use." Multiparity (A), precipitous labor (B), and maternal age (C) are not established risk factors for intrapartum fever.


NEW QUESTION # 116
An 18-month-old girl is brought in with a 3-day history of frequently passing loose stools. The stools are not bloody, but when she passes the stools, she is in obvious pain. She started vomiting earlier today, but she is still wetting diapers. On examination, she is mildly dehydrated but active and alert. Physical examination findings are otherwise normal. Which one of the following is the best management of this patient's case?

Answer: E

Explanation:
This child has acute viral gastroenteritis with mild dehydration. She remains alert, active, and continues to produce urine, indicating mild volume depletion. According to MCCQE objectives and pediatric guidelines, the first-line management of mild to moderate dehydration due to gastroenteritis is oral rehydration therapy (ORT) using a commercially prepared oral rehydration solution (ORS). ORS contains the appropriate balance of glucose and electrolytes to promote sodium and water absorption via the sodium-glucose cotransporter in the intestine. Antidiarrheal agents such as loperamide are contraindicated in young children due to risk of adverse effects and limited benefit. Withholding food until diarrhea resolves is unnecessary; early refeeding with an age-appropriate diet is recommended once rehydration begins. Apple juice and chicken broth do not provide the correct electrolyte composition and may worsen diarrhea due to high osmolarity. Routine lactose restriction is not indicated unless persistent symptoms suggest secondary lactose intolerance. Early ORT reduces the need for intravenous fluids and hospital admission.


NEW QUESTION # 117
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