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| Section | Weight | Objectives |
|---|---|---|
| Physician Activities | 50% | - Communication - Professional Behaviours - Management - Psychosocial Aspects |
| Dimensions of Care | 50% | - Assessment and Diagnosis - Acute Care - Chronic Care - Health Promotion and Illness Prevention |
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Medical Council of Canada MCCQE Exam Questions just focus on what is important and help you achieve your goal. With high-quality MCCQE guide materials and flexible choices of learning mode, they would bring about the convenience and easiness for you. Every page is carefully arranged by our experts with clear layout and helpful knowledge to remember.
NEW QUESTION # 95
A 6-year-old boy is brought to the Emergency Department with a 2-day history of a limp. On examination, he looks well, has a temperature of 38 °C and is able to weight-bear. His hip examination reveals mild decreased range of motion. Radiographs of his hip and pelvis show no abnormality. His C-reactive protein level is 8 mg
/L (< 6). Which one of the following is the most likely diagnosis?
Answer: C
Explanation:
Comprehensive and Detailed Explanation:
Transient synovitis is the most common cause of hip pain and limp in children aged 3-10 years. It is often preceded by a viral infection. Patients appear well, can often bear weight, and have only mild to moderate elevation in inflammatory markers. Radiographs are normal.
Toronto Notes 2023 - Pediatrics, "Limping Child":
"Transient synovitis is benign and self-limiting. Presentation includes mild limp, low-grade fever, normal or slightly elevated CRP/ESR, and ability to bear weight." MCCQE1 Objectives (Pediatrics > 78-2: Musculoskeletal Disorders):
"Candidates must distinguish between transient synovitis and more serious causes of limping, such as septic arthritis." Septic arthritis (A) usually causes inability to bear weight and more significant fever and CRP elevation.
Osteomyelitis (B) typically presents with localized tenderness and systemic signs. Bursitis (D) is rare in young children. JIA (E) is chronic.
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NEW QUESTION # 96
A 56-year-old woman presents to your office with a 9-month history of intolerable sweating, palpitations, and periodic anxiety. Her last period was 12 months ago. She continues to have regular Papanicolaou testing with no worrisome pathology. She is otherwise healthy. Which one of the following is the most effective treatment for these symptoms?
Answer: C
Explanation:
In postmenopausal women with severe vasomotor symptoms, hormone therapy (estrogen with progesterone in women with an intact uterus) is the most effective treatment. It improves hot flashes, sleep, and mood symptoms.
Toronto Notes 2023 - Gynecology, Menopause Management:
"Combination hormone therapy is first-line for moderate to severe menopausal symptoms. Non-hormonal agents may be considered if contraindications exist." MCCQE1 Objectives - Gynecology > Menopause:
"Candidates must recognize the indication and benefits of hormone therapy for vasomotor symptoms in appropriate patients." Lifestyle changes (A) are supportive but insufficient. Primrose oil (C) lacks robust evidence. SSRIs (D) and clonidine (E) are second-line.
NEW QUESTION # 97
A 62-year-old woman with type 2 diabetes comes in for follow-up. She has noticed that her vision has been getting blurry over the past year and that she now needs a bright light to look at photos of her grandchildren.
Upon fundoscopic examination, you note yellow deposits in the central retina. Which one of the following is the most likely diagnosis?
Answer: A
Explanation:
Yellow deposits in the central retina (macula) are most consistent with drusen, the hallmark finding of age- related macular degeneration (AMD). MCCQE objectives emphasize correlating key funduscopic findings with patterns of vision loss. AMD typically causes gradual, progressive central vision blurring (difficulty reading, recognizing faces, and seeing fine detail), while peripheral vision is relatively preserved. The history of needing brighter light for near tasks aligns with impaired macular function and reduced contrast sensitivity seen in AMD.
Diabetic retinopathy more commonly shows microaneurysms, dot-blot hemorrhages, hard exudates scattered in the retina, venous beading, and/or neovascularization rather than discrete drusen in the macula as the defining feature. Retinal vein occlusion usually presents more abruptly with extensive hemorrhages and
"blood and thunder" appearance. Cataracts cause lens opacity with impaired red reflex and generalized haze on fundoscopy rather than macular deposits. Open-angle glaucoma causes optic disc cupping and peripheral field loss, not central drusen. Recognizing AMD prompts appropriate counseling (smoking cessation, risk factor control), vision monitoring, and ophthalmology referral to assess for dry vs wet AMD.
NEW QUESTION # 98
A 40-year-old woman presents to your clinic for follow-up regarding her major depressive disorder, which is being treated with the starting dosage of escitalopram. Most of her symptoms have now improved. However, she has noted anorgasmia since taking this medication. This has significantly affected her relationship with her wife. Which one of the following is the best next step?
Answer: B
Explanation:
Comprehensive and Detailed Explanation:
Sexual dysfunction, including anorgasmia, is a common side effect of SSRIs like escitalopram. Bupropion, a norepinephrine-dopamine reuptake inhibitor, has minimal sexual side effects and can be safely added to mitigate this issue while preserving the antidepressant effect.
Toronto Notes 2023 - Psychiatry / Pharmacology:
"SSRI-induced sexual dysfunction can be managed by dose reduction, switching agents, or adding bupropion." MCCQE1 Objectives (Psychiatry > 71-1: Depressive Disorders):
"Candidates should be able to address side effects of antidepressants, including sexual dysfunction, and adjust therapy appropriately." Increasing the dose (A) may worsen sexual dysfunction. Venlafaxine (B), an SNRI, also has sexual side effects. D (no change) does not address the patient's concern.
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NEW QUESTION # 99
A 56-year-old woman comes to your office because she has not been herself since her husband died in a car crash 6 weeks ago. She has no prior psychiatric history. Her son is concerned because she cries frequently, has a poor appetite, rarely leaves home and is distraught. Her sadness fluctuates and increases when she thinks of her husband. She often thinks about death, and she wishes she could join her deceased husband. Which one of the following is the best next step?
Answer: C
Explanation:
Her presentation at 6 weeks after a spouse's death is most consistent with acute/normal grief : intense sadness, crying, social withdrawal, reduced appetite, and waves of distress triggered by reminders of the deceased.
MCCQE objectives stress distinguishing grief from major depressive disorder by the fluctuating nature of symptoms , grief "pangs," and the link to thoughts of the deceased. Although she expresses wishing to "join" her husband, this can occur in normal bereavement; the key clinical duty is to assess safety (suicidal intent, plan, means, past attempts, protective factors). In the absence of imminent risk or psychosis, inpatient/day- hospital admission is not the default. "Reassurance" alone is insufficient because she is significantly impaired and needs structured support. The best next step is referral for bereavement-focused support (often via social work), which can provide grief counseling, coping strategies, mobilization of supports, and monitoring, and can facilitate escalation if complicated grief or major depression emerges. Family systems therapy may help later, but immediate practical and grief-specific support plus safety assessment is the priority.
NEW QUESTION # 100
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