MCCQE関連資格試験対応 & MCCQE受験体験

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Medical Council of Canada MCCQE Exam Syllabus Topics:

SectionObjectives
Topic 1: Dimensions of Care- Psychosocial Aspects
  • 1. Patient communication
  • 2. Mental health and behavioral sciences
  • 3. Psychosocial determinants of health
- Chronic Care
  • 1. Rehabilitation
  • 2. Long-term care
  • 3. Chronic disease management
- Acute Care
  • 1. Management of acute medical conditions
  • 2. Emergency and critical care
  • 3. Acute presentations and stabilization
- Health Promotion and Illness Prevention
  • 1. Health maintenance
  • 2. Risk factor reduction
  • 3. Patient education
  • 4. Disease prevention measures
  • 5. Screening and periodic health exams
Topic 2: Physician Activities- Assessment
  • 1. History taking
  • 2. Physical examination
  • 3. Investigations and diagnostic reasoning
- Management
  • 1. Follow-up planning
  • 2. Pharmacological and non-pharmacological treatment
  • 3. Therapeutic interventions
- Professionalism
  • 1. Leadership and scholarly habits
  • 2. Physician health for sustainable practice
  • 3. Self-awareness and reflection
  • 4. Lifelong learning
  • 5. Ethics and legal duties
- Communication
  • 1. Team communication
  • 2. Breaking bad news
  • 3. Informed consent
  • 4. Physician-patient communication

>> MCCQE関連資格試験対応 <<

MCCQE受験体験 & MCCQE資格勉強

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Medical Council of Canada MCCQE Part 1 Exam 認定 MCCQE 試験問題 (Q75-Q80):

質問 # 75
A 25-year-old woman who is at 8 weeks ' gestation plans to travel to rural Cambodia to care for her ill mother. Which one of the following treatments should be provided to her before the trip?

正解：C

解説：
Comprehensive and Detailed Explanation:
Travel to rural Cambodia poses a high risk of malaria, which can be life-threatening in pregnancy.
Antimalarial prophylaxis is strongly recommended for pregnant women traveling to endemic regions.
Chloroquine or mefloquine (depending on resistance patterns) may be used in pregnancy under specialist guidance.
Toronto Notes 2023 - Infectious Disease / Travel Medicine:
"Malaria prophylaxis is indicated in pregnant women traveling to endemic regions. The risk of severe malaria and poor fetal outcomes is high." MCCQE1 Objectives (Public Health > 65-3: Travel Medicine and Pregnancy):
"Candidates must provide preventive care to pregnant travelers including vaccination and malaria prophylaxis." Tetanus boosters (D) are given every 10 years. Hep B Ig (B) is for acute post-exposure prophylaxis.
Ciprofloxacin (C) is contraindicated in pregnancy.


質問 # 76
A 38-year-old woman presents with diffuse nodularity in the outer upper quadrant of her right breast. There is no obvious dominant mass, nipple discharge, or skin dimpling. There are no palpable lymph nodes. Which one of the following is the most likely diagnosis?

正解：C

解説：
Fibrocystic change is the most common benign breast condition in women of reproductive age. It typically presents with diffuse nodularity or "lumpy" areas, especially in the upper outer quadrant, and varies with the menstrual cycle. No dominant mass or systemic signs are expected.
Toronto Notes 2023 - Gynecology, "Benign Breast Conditions":
"Fibrocystic changes often present with bilateral or unilateral nodularity, most commonly in the upper outer quadrants, without discrete masses." MCCQE1 Objectives (Gynecology > 81-1: Breast Conditions):
"Candidates must differentiate benign breast conditions from malignant ones based on presentation and physical exam findings." Paget disease (B) presents with nipple changes. Intraductal carcinoma (C) typically shows a discrete mass or suspicious features. Phyllodes tumours are usually well-circumscribed. Mastitis (E) is inflammatory and associated with erythema, fever, and tenderness.


質問 # 77
A 65-year-old man presents to your clinic with a 2-month history of persistent erectile dysfunction. He reports having difficulties maintaining an erection. His last hemoglobin A1c level result was 6.4% (4.8-6.0). He had a negative result on his cardiac stress test 1 month ago. He has been taking stable dosages of citalopram, metformin, and ramipril for the past 2 years. His physical examination findings are normal, and his mood appears euthymic. Which one of the following investigations should be ordered before initiating treatment with sildenafil?

正解：D

解説：
Erectile dysfunction (ED) in older men is commonly vascular, medication-related, or associated with diabetes.
This patient has well-controlled diabetes (HbA1c 6.4%) and a recent negative cardiac stress test , suggesting he is at low cardiovascular risk for sexual activity. MCCQE objectives emphasize cardiovascular risk stratification prior to prescribing phosphodiesterase-5 (PDE-5) inhibitors. Patients who are stable and cleared for moderate physical exertion (e.g., recent negative stress test) do not require additional cardiac testing before initiating sildenafil.
There is no indication for routine CBC, urine culture, PSA, or echocardiography in the absence of relevant symptoms or findings. PSA screening is unrelated to ED management and should follow age-appropriate shared decision-making guidelines. Echocardiography is unnecessary without cardiac symptoms or abnormal exam.
The key contraindication to sildenafil is concurrent nitrate therapy or unstable cardiovascular disease, neither of which is present. Therefore, no additional investigations are required before initiating treatment.
Counseling should include discussion of medication interactions, side effects (e.g., headache, flushing), and avoidance with nitrates.


質問 # 78
An 85-year-old man is transferred from an acute care hospital to your long-term care (LTC) facility. He has a fever, fatigue, myalgia, and malaise. His test result is positive for influenza A virus. Two other residents and 1 LTC staff member have experienced the same symptoms. Which one of the following is the best next step to prevent further infections at the LTC facility?

正解：B


質問 # 79
A 38-year-old marathon runner presents to your office with a 6-month history of increasing right hip pain.
The pain is worse with acclivity and has prevented him from running for the last 4 months. He denies fever or chills. His wife adds that she is concerned because he is increasingly disengaged with the family and not interested in other activities he usually enjoys, including sex. Which one of the following is the best next step in management?

正解：B

解説：
In a patient presenting with physical symptoms (e.g., hip pain) and prominent psychosocial red flags - loss of interest, decreased libido, and withdrawal - the next step is to screen for depression. Somatization is common in mood disorders.
Toronto Notes 2023 - Psychiatry, Depression:
"Patients with depression may present with somatic complaints. A thorough psychosocial assessment is essential in such cases, particularly when symptoms interfere with functioning." MCCQE1 Objectives - Psychiatry > Mood Disorders:
"Candidates must consider depression in patients with non-specific physical symptoms and reduced interest or motivation, particularly with social withdrawal." Imaging or physiotherapy may be needed later, but the most urgent and informative step is psychiatric screening.


質問 # 80
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