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Medical Council of Canada MCCQE Part 1 Exam Sample Questions (Q190-Q195):

NEW QUESTION # 190
A 62-year-old man, who has not seen a physician in 20 years, presents to your clinic with a burning sensation in his feet. The symptoms have been progressing slowly over the last 6 months. There is no associated motor weakness or skin changes. He reports no significant past medical history and takes no medications. His alcohol intake is minimal. On examination, he has reduced pinprick/vibration sensation and proprioception in the ankles with absent ankle reflexes. Which one of the following blood tests would you expect to be abnormal?

A. Hemoglobin A1c
B. Folate
C. Ferritin
D. Anti-acetylcholine receptor antibodies
E. Uric acid

Answer: A

Explanation:
This is a classic presentation of diabetic peripheral neuropathy: bilateral distal sensory symptoms with preserved motor function and no other systemic findings. The most useful test to confirm this in a previously undiagnosed patient is HbA1c.
Toronto Notes 2023 - Endocrinology, Diabetes Complications:
"Peripheral neuropathy is a common complication of undiagnosed or poorly controlled diabetes. Confirm with HbA1c if diagnosis is not yet established." MCCQE1 Objectives - Internal Medicine > Endocrinology:
"Candidates should evaluate for diabetes in patients with peripheral neuropathy and screen appropriately with HbA1c." Folate (B) and B12 deficiency may also cause neuropathy but are less likely in the absence of nutritional risk factors. Other choices (A, D, E) are unrelated to this pattern.

NEW QUESTION # 191
You are a physician working at a university campus health centre. Staff at the centre are thinking about initiating a campus-wide education campaign on stimulant medication use and misuse. From a physician's perspective, which one of the following is the key message to include in this campaign?

A. Ethical perspectives regarding nonprescription stimulant medication use.
B. Legal perspectives regarding nonprescription stimulant medication use.
C. Adverse effects and health risks associated with stimulant medication use.
D. Improvement of study habits through educational initiatives.
E. Prevalence of stimulant medication use by students on university campuses.

Answer: C

Explanation:
The key public health message from a physician's perspective is the evidence-based health risks and adverse effects associated with nonprescribed stimulant use (e.g., insomnia, anxiety, cardiovascular events, and dependency). This is central to a harm-reduction approach.
Toronto Notes 2023 - Public Health & Psychiatry, Substance Use:
"Misuse of prescription stimulants is common among university students. Education campaigns should emphasize medical risks including cardiovascular complications, addiction potential, and psychiatric disturbances." MCCQE1 Objectives - Preventive Medicine > Health Promotion:
"Candidates should identify core messages in public education campaigns, prioritizing evidence-based risks and harm reduction." Legal and ethical issues (B, C) are important but secondary to the health implications. Prevalence data (D) informs the campaign design, but is not the message itself. Study habits (A) are relevant for academic counseling, not medical messaging.

NEW QUESTION # 192
You are seeing a 5-month-old infant who has had intermittent stridor since age 2 months. He is otherwise healthy. He has been drinking well and has been reaching all the age-specific developmental milestones.
Which one of the following is the most likely diagnosis?

A. Laryngomalacia.
B. Aspiration of a foreign body.
C. Subglottic hemangioma.
D. Tracheoesophageal fistula.
E. Vascular ring.

Answer: A

Explanation:
Laryngomalacia is the most common cause of chronic stridor in infants. It presents with inspiratory stridor that worsens with feeding, supine positioning, or agitation. The child remains otherwise well and meets developmental milestones.
Toronto Notes 2023 - Pediatrics, Airway Disorders:
"Laryngomalacia presents with intermittent inspiratory stridor, typically beginning in the first few months of life. Diagnosis is clinical and prognosis is usually good." MCCQE1 Objectives - Pediatrics > Respiratory Disorders:
"Candidates must recognize the typical presentation of laryngomalacia and differentiate it from other causes of pediatric stridor." Vascular ring (A) or subglottic hemangioma (C) often present with more severe or progressive symptoms.
Foreign body aspiration (D) presents acutely. TE fistula (E) usually causes feeding difficulties from birth.

NEW QUESTION # 193
A 4-year-old girl is brought to the family practice by her father. The child has a 2-week history of low-grade fever, fatigue, and sore throat. She has also developed several small, round, mildly tender lumps bilaterally in her neck. She was previously well. Which one of the following is most likely to be found on abdominal examination?

A. Generalized tenderness
B. Shifting dullness
C. Palpable spleen
D. Renal mass
E. Abdominal bruit

Answer: C

Explanation:
This child likely has infectious mononucleosis caused by Epstein-Barr virus (EBV), characterized by fever, sore throat, cervical lymphadenopathy, fatigue, and splenomegaly. A palpable spleen is a hallmark of EBV in children.
Toronto Notes 2023 - Pediatrics, "Infectious Mononucleosis":
"Key features include fever, pharyngitis, lymphadenopathy, and splenomegaly. Children may have milder symptoms but often exhibit palpable spleen." MCCQE1 Objectives (Pediatrics > 75-2: Infectious Disease):
"Candidates should recognize common viral syndromes such as EBV and identify complications including splenomegaly." Other options (renal mass, ascites, etc.) are inconsistent with this viral presentation.

NEW QUESTION # 194
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?

A. Short course of anti-inflammatory medications.
B. Further inquiry into depressive symptoms.
C. Blood work including inflammatory markers.
D. Physiotherapy for hip strengthening.
E. Magnetic resonance imaging of the pelvis and right hip.

Answer: B

Explanation:
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.

NEW QUESTION # 195
......

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MCCQE Exam Guide - MCCQE Reliable Test Tips

Medical Council of Canada MCCQE Reliable Test Tips & MCCQE Exam Sims

Medical Council of Canada MCCQE Part 1 Exam Sample Questions (Q190-Q195):

2025 MCCQE: MCCQE Part 1 Exam Realistic Exam Guide 100% Pass Quiz

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