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Medical Council of Canada MCCQE - Medical Council of Canada Qualifying Examination Part 1 Exam

Page: 11 / 11
Total 348 questions

You performed a surgical procedure on a 32-year-old woman for a herniated disk that was causing neurologic impairment. At the 8-month follow-up visit, she has healed well; however, she requests a prescription renewal of her narcotic analgesics (hydromorphone). Her pharmacy confirms that the patient adheres to the dosage you prescribed, that she has not consulted other physicians, and that her behavior has always been respectful. You think that she no longer requires narcotic analgesics. Which one of the following approaches is most helpful to the patient?

A.

Replace short-acting hydromorphone with transdermal fentanyl.

B.

Decline the renewal of further hydromorphone and discharge the patient.

C.

Advise the provincial or territorial agency responsible for following patients who have potential substance use disorders.

D.

Counsel the patient regarding substance use disorder and arrange follow-up with her family physician.

E.

Change the patient’s prescription from short-acting hydromorphone to once-daily methadone.

A 36-year-old woman presents to the office with a 2-month history of multiple asymptomatic bumps on her vulva. She is not currently sexually active but has had 2 male sexual partners in the past, with the most recent relationship ending 1 year ago. On examination, she appears to have genital warts. She has not received the human papillomavirus (HPV) vaccine and is not interested in any treatment that is not absolutely necessary. Which of the following is the best next step?

A.

Excisional biopsy.

B.

Papanicolaou test.

C.

HPV vaccine.

D.

Cryotherapy.

E.

Contact tracing.

A 31-year-old woman, gravida 1, para 0, presents to Labour and Delivery with regular contractions at approximately 24 weeks’ gestation. As you review her prenatal records, which one of the following is the most reliable way of establishing gestational age?

A.

Serial ultrasound in 3rd trimester.

B.

Crown-rump length at 8–12 weeks.

C.

Last menstrual period.

D.

Mid 2nd trimester ultrasound.

E.

Symphysis fundal height.

A 55-year-old woman presents with a 6-month history of poor memory and impaired concentration. She has bipolar I disorder that has been treated with lithium carbonate for 4 years. She has gained a lot of weight since starting lithium. Physical examination findings are otherwise normal. She is concerned about her memory issues, but there are no other perception, mood, or cognition abnormalities. Which one of the following tests is most likely to have abnormal findings?

A.

Liver function tests

B.

Serum thyrotropin (thyroid-stimulating hormone) level

C.

Creatinine clearance

D.

Serum sodium level

E.

Parathyroid hormone