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| Section | Objectives |
|---|---|
| Dimensions of Care | - Psychosocial Aspects
|
| Physician Activities | - Assessment
|
>> Practice MCCQE Questions <<
This is a simple and portable document of real Medical Council of Canada MCCQE Exam Questions. It contains actual Medical Council of Canada MCCQE exam questions and answers and can be helpful for quick revision or for studying on the go. It is also printable so you can easily study on a hard copy of the pdf having a break from staring.
NEW QUESTION # 262
A 45-year-old woman presents to your clinic for follow-up regarding her asthma. She is planning to attend a cultural event that includes ceremonial burning of tobacco. Which one of the following is the best next step?
Answer: B
Explanation:
The best next step is to assess whether smoke exposure is a known trigger for this patient's asthma. MCCQE objectives emphasize patient-centred, culturally safe care and risk assessment before giving directive advice.
Ceremonial tobacco burning can produce smoke exposure similar to other irritants; however, not all patients react the same way, and the clinician should first clarify the patient's history of symptom provocation with smoke (tobacco, incense, campfire) and the severity of prior reactions. This information guides individualized prevention strategies, such as ensuring optimal controller use, carrying a reliever inhaler, positioning away from dense smoke, limiting duration of exposure, and having an action plan if symptoms develop.
Updating the chart to indicate the patient smokes is inappropriate because participation in a ceremony does not equal smoking. General counselling about tobacco health effects can be relevant but is not the immediate priority and may be culturally insensitive if it ignores the context. Advising avoidance may unnecessarily disrupt culturally important participation and should come only after assessing risk and discussing mitigation options.
NEW QUESTION # 263
A 63-year-old woman presents to your office with a history of progressive abdominal discomfort over the past five months. She reports bloating and difficult digestion with constipation. She has no urinary symptoms and denies vaginal or rectal bleeding. An abdominal ultrasound shows a large complex pelvic mass with internal multiloculation and moderate ascites. The cancer antigen 125 (CA 125) is elevated at 1023 U/mL (< 35 U
/mL). Which one of the following is the most likely diagnosis?
Answer: A
Explanation:
Comprehensive and Detailed Explanation:
Postmenopausal women with abdominal distension, bloating, a complex pelvic mass, and elevated CA-125 are highly suggestive of epithelial ovarian cancer, especially serous cystadenocarcinoma-the most common type.
Toronto Notes 2023 - Gynecology / Oncology:
"Serous epithelial ovarian carcinoma presents with vague abdominal symptoms, ascites, complex pelvic mass, and elevated CA-125." MCCQE1 Objectives (Gynecology > 82-5: Ovarian Masses):
"Candidates must recognize signs and investigations of ovarian cancer, including elevated tumor markers and imaging findings." Ovarian hyperstimulation (A) occurs in fertility treatments. Colorectal cancer (C) may mimic these symptoms but typically causes rectal bleeding and has lower CA-125 levels. Uterine adenocarcinoma (D) usually causes bleeding. Hematosalpinx (E) presents with pelvic pain, not ascites.
NEW QUESTION # 264
A 57-year-old man presents with low back pain. Radiographs of the lumbar spine show a narrowed disk space at L4-L5, anterior osteophyte formation at this level, and sclerosis of the L4-L5 end plates. Which one of the following is the most likely diagnosis?
Answer: A
Explanation:
The radiographic triad of disc space narrowing, anterior osteophyte formation, and end-plate sclerosis is classic for degenerative disc disease (lumbar spondylosis). Age-related degeneration leads to disc desiccation and loss of disc height, increasing mechanical stress at vertebral end plates and facet joints. This stimulates reactive bone changes, producing osteophytes and sclerosis. These findings fit a chronic, mechanical cause of low back pain.
Osteomyelitis more often shows end-plate erosion/irregularity with disc space loss plus systemic features (fever, elevated inflammatory markers) and may progress rapidly. Prostate metastases typically cause sclerotic lesions in vertebral bodies without isolated disc space narrowing and osteophytes. Paget disease produces bony expansion, cortical thickening, and coarse trabeculation rather than focal disc degeneration changes.
Spondylolysis/spondylolisthesis is suggested by pars defects and vertebral slippage, not primarily by disc narrowing with osteophytes and end-plate sclerosis. MCCQE objectives emphasize interpreting common spine imaging patterns and distinguishing degenerative disease from infection, malignancy, and structural instability.
NEW QUESTION # 265
An infrastructure engineer in an AI factory has successfully replaced a power supply unit on an NVIDIA DGX H100. After installation, both the IN and OUT LEDs on the new power supply illuminate solid green.
Which NVSM CLI command should the engineer use to quickly verify the overall system status and ensure it is operating as expected?
Answer: B
Explanation:
Comprehensive and Detailed Explanation:
The NVIDIA System Management (NVSM) tool is the definitive CLI utility for monitoring the health of DGX platforms. While replacing a PSU (Power Supply Unit) is a common maintenance task, verifying that the new component is correctly integrated into the system's health model is mandatory. While `nvsm show power` would provide specific data regarding wattage and voltage for the PSU, the most comprehensive way to ensure the replacement hasn ' t caused secondary issues or that the system hasn ' t remained in a " Degraded
" state is to run `nvsm show health`. This command performs a global check across all subsystems: GPUs, NVLink switches, storage, fans, and power. If the PSU replacement was successful and the system is back to full redundancy, `nvsm show health` will return a " Healthy " status. In an AI factory setting, where DGX H100 nodes pull significant power, ensuring that all 6 PSUs (in an N+N or N+1 configuration) are not only physically green but logically acknowledged by the Baseboard Management Controller (BMC) is critical for preventing unexpected shutdowns during high-load training iterations.
NEW QUESTION # 266
A 62-year-old woman is referred to your clinic for evaluation of hypercalcemia. She has a history of hypertension and vitamin D deficiency. Her medications include hydrochlorothiazide and vitamin D supplements. Laboratory investigations are as follows:
* Calcium: 2.72 mmol/L (#)
* Phosphate: 0.9 mmol/L (#)
* Parathyroid hormone (PTH): 0.9 pmol/L (#)
* 25-hydroxy vitamin D: 80 nmol/L (normal)
Which one of the following is the best next step?
Answer: E
Explanation:
Comprehensive and Detailed Explanation:
This patient has hypercalcemia with suppressed PTH, ruling out primary hyperparathyroidism. The differential includes malignancy-associated hypercalcemia, vitamin D intoxication, and medications. Given the low PTH and normal vitamin D level, malignancy (e.g., multiple myeloma) is a leading concern. Serum protein electrophoresis and urine for Bence-Jones proteins (light chains) are appropriate next steps.
Toronto Notes 2023 - Endocrinology, "Hypercalcemia":
"PTH-independent hypercalcemia should prompt investigation for malignancy. Multiple myeloma is a common cause in older adults-order SPEP and UPEP." MCCQE1 Objectives (Endocrinology > 37-1: Calcium Disorders):
"Candidates must investigate non-PTH mediated hypercalcemia, including consideration of multiple myeloma." A (urine calcium) helps in familial hypocalciuric hypercalcemia, but this is unlikely given low PTH. B (calcitriol) would worsen hypercalcemia. C is inappropriate because PTH is suppressed. D (changing HCTZ) may help, but malignancy must be ruled out first.
NEW QUESTION # 267
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