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100% Pass MCCQE - Newest MCCQE Part 1 Exam Practical Information

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Medical Council of Canada MCCQE Part 1 Exam Sample Questions (Q188-Q193):

NEW QUESTION # 188
Which one of the following bodies decides whether a physician is permitted to practise medicine in a province or territory?

A. The provincial or territorial medical licensing authority
B. The provincial or territorial Ministry of Health
C. The College of Family Physicians of Canada or the Royal College of Physicians and Surgeons of Canada
D. The board of the hospital or health region where the physician wants to practise
E. The provincial or territorial medical association

Answer: A

Explanation:
Comprehensive and Detailed Explanation:
The authority to license and regulate physicians to practise medicine is held by the medical regulatory colleges in each province or territory (e.g., CPSO in Ontario, CPSBC in BC).
MCC Objectives (ELOM > 90-1: Medical Regulation in Canada):
"Licensure to practise medicine is granted by the provincial or territorial medical regulatory authority." Toronto Notes 2023 - Ethics and Canadian Health Care System:
"Medical regulatory colleges determine physician licensure and discipline in each jurisdiction." The CFPC/RCPSC (C) certify physicians, not license them. Ministries of Health (A) oversee health policy, not licensing. Associations (E) advocate for physicians but do not regulate. Hospital boards (B) grant privileges, not licenses.

NEW QUESTION # 189
An 83-year-old woman presents to your office with a 2-day history of confusion. Her past medical history is significant for lung cancer, and she is being treated with radiation. On physical examination, she is euvolemic.
Her blood work reveals a serum sodium of 118 mmol/L (135-140) as compared with 134 mmol/L (8 days ago). Which one of the following will be most helpful in establishing the cause of her laboratory abnormality?

A. Creatinine clearance
B. Urine sodium
C. Serum osmolality
D. Parathyroid hormone-related peptide
E. Urinalysis

Answer: C

Explanation:
Comprehensive and Detailed Explanation:
Hyponatremia in a patient with lung cancer and euvolemia strongly suggests syndrome of inappropriate antidiuretic hormone secretion (SIADH), especially from small cell carcinoma. Serum osmolality is the best initial test to confirm hypotonic hyponatremia and distinguish true hyponatremia from pseudohyponatremia or other causes.
Toronto Notes 2023 - Endocrinology, "Hyponatremia":
"Serum osmolality helps classify hyponatremia as hypotonic, isotonic, or hypertonic. SIADH typically causes hypotonic hyponatremia in euvolemic patients." MCCQE1 Objectives (Endocrinology > 37-1: Electrolyte Disorders):
"Candidates must evaluate the type and cause of hyponatremia using clinical status and laboratory tests including serum osmolality." Urine sodium (B) is useful after confirming hypotonicity. PTHrP (E) is associated with hypercalcemia of malignancy, not hyponatremia. Urinalysis (A) and CrCl (D) are less directly informative.

NEW QUESTION # 190
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?

A. Cryotherapy.
B. Punch biopsy.
C. Colposcopy.
D. Polypectomy.
E. Serial cytology.

Answer: D

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 # 191
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. Suggest he donate to your medical group
B. Refer the husband to the centre's social worker
C. Accept the money as a contribution to the long-term care centre's fundraising campaign
D. Decline to accept the cheque
E. Inform him you would only be able to accept a smaller amount of money

Answer: D

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 # 192
A 22-year-old woman, gravida 1, para 0, aborta 0, comes to the office at 10 weeks' gestation for her first prenatal visit. When you ask how she is doing, she becomes tearful and says she has had severe nausea and vomiting. She is not taking her prenatal vitamins regularly and feels very guilty about it. She is worried that she is harming the fetus. Which one of the following is the most appropriate management of this patient's case?

A. Tell her she should continue to take her prenatal vitamins daily regardless of nausea
B. Suggest that she take cannabinoids 30 minutes before taking her prenatal vitamins
C. Advise her to replace her vitamin with folic acid only until her nausea improves
D. Refer her for counselling to manage her feelings of guilt
E. Prescribe ginger tablets to be taken 4 times daily

Answer: E

Explanation:
Comprehensive and Detailed Explanation:
Ginger is a first-line, evidence-based non-pharmacologic treatment for nausea and vomiting in pregnancy. It's well tolerated and effective. Addressing nausea will help her resume vitamin use and reduce distress.
Toronto Notes 2023 - Obstetrics, "Nausea and Vomiting in Pregnancy":
"Ginger 250 mg four times daily is safe and effective for mild to moderate nausea." MCCQE1 Objectives (Obstetrics > 80-1: Early Pregnancy Management):
"Candidates must treat nausea and vomiting in pregnancy using safe and effective options." Folic acid alone (A) is less effective than a full prenatal vitamin. B may help, but nausea should be addressed first. C lacks empathy for her symptoms. D (cannabinoids) is not recommended in pregnancy.

NEW QUESTION # 193
......

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