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Medical Council of Canada MCCQE Exam Syllabus Topics:

SectionObjectives
Physician Roles (CanMEDS Framework)- Health Advocate
  • 1. Prevention and health promotion
    • 2. Population health principles
      - Medical Expert
      • 1. Clinical knowledge across core specialties (internal medicine, surgery, pediatrics, OB/GYN, psychiatry)
        • 2. Diagnostic reasoning and management planning
          - Collaborator
          • 1. Interprofessional teamwork
            • 2. Referral and consultation processes
              - Leader (Manager)
              • 1. Healthcare system navigation
                • 2. Resource stewardship
                  - Scholar
                  • 1. Evidence-based medicine
                    • 2. Continuous learning and clinical research interpretation
                      - Communicator
                      • 1. Patient-centered communication
                        • 2. Informed consent and shared decision-making
                          - Professional
                          • 1. Patient safety and legal considerations
                            • 2. Ethics and professional responsibility

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                              Medical Council of Canada MCCQE Part 1 Exam Sample Questions (Q95-Q100):

                              NEW QUESTION # 95
                              A 72-year-old woman presents with swelling of her right leg that developed overnight. She had an abdominal hysterectomy 10 days ago. On examination, there is pitting edema of the leg that extends from the foot to the groin. The calf is 3 cm larger in diameter than the calf on the left leg. Which one of the following is the most likely diagnosis?

                              Answer: B

                              Explanation:
                              This patient has classic features of proximal deep vein thrombosis (DVT) after recent major pelvic surgery:
                              acute unilateral leg swelling with pitting edema and a significant calf circumference difference ( > 3 cm). The edema extending from foot to groin strongly suggests a proximal (iliofemoral) thrombosis, which produces more extensive swelling than calf-vein DVT because venous outflow from the entire limb is impaired.
                              MCCQE objectives highlight postoperative patients as high risk for venous thromboembolism due to immobility, endothelial injury, and hypercoagulability.
                              Superficial thrombophlebitis typically causes a localized, tender, palpable cord along a superficial vein rather than diffuse whole-leg edema. Phlegmasia cerulea dolens is a severe, limb-threatening form of massive DVT characterized by marked pain, tense


                              NEW QUESTION # 96
                              A 35-year-old man comes to your office with a history of headaches that last 1 hour and are relieved by 1000 mg of acetaminophen. These headaches, which started 6 months ago after he got his first job as a lawyer, occur regularly. The patient wants a computed tomography scan of his head to rule out a tumour. Physical examination reveals no abnormality. Review of systems does not contribute any positive findings. Which one of the following is the best management?

                              Answer: A

                              Explanation:
                              This patient's headache is consistent with tension-type or stress-related headache. The symptoms are mild, responsive to over-the-counter medications, and without red flags (neurologic signs, worsening pattern, nocturnal pain). Reassurance is appropriate.
                              Toronto Notes 2023 - Neurology, "Headache" Section:
                              "In the absence of red flags (e.g., sudden onset, focal deficits, age >50, worsening pattern), reassurance is the best course. Tension headaches are often related to stress and improve with lifestyle modification and simple analgesia." MCCQE1 Objectives (Internal Medicine > 76-6: Neurologic Symptoms):
                              "Candidates should recognize benign headache patterns and avoid unnecessary investigations." CT head (B) is not indicated. Stronger analgesics (D) may cause rebound headache. Specialist or psychiatric referrals (A, E) are premature.


                              NEW QUESTION # 97
                              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?

                              Answer: E

                              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 # 98
                              A 58-year-old woman presents to your office with refractory bipolar I disorder. She is on the following medications: lithium carbonate, valproic acid, and olanzapine. She also takes acetaminophen for osteoarthritis and pantoprazole for gastroesophageal reflux. Lately, she has noticed she bruises very easily. Laboratory work displays a platelet count of 70 × 10#/L (normal 130-400). Which one of the following is most likely to induce this side effect?

                              Answer: A

                              Explanation:
                              Valproic acid is well known to cause thrombocytopenia, especially at higher serum concentrations or in patients over 60. Bruising with platelet count <100 × 10#/L is a classic manifestation.
                              Toronto Notes 2023 - Psychiatry, Mood Disorders & Pharmacology Section:
                              "Valproic acid is associated with hematologic side effects including thrombocytopenia. Platelet counts should be monitored regularly." MCCQE1 Objectives - Psychiatry > Pharmacotherapy:
                              "The candidate must recognize adverse effects of mood stabilizers including hematologic complications of valproic acid." Other listed medications (A-D) have no common or direct link with thrombocytopenia in this context.


                              NEW QUESTION # 99
                              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: E

                              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 # 100
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