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TOP MCCQE Valid Exam Duration: MCCQE Part 1 Exam - Trustable Medical Council of Canada Latest MCCQE Mock Test

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Medical Council of Canada MCCQE Part 1 Exam Sample Questions (Q163-Q168):

NEW QUESTION # 163
A 60-year-old man presents to the office with concerns regarding a pruritic rash, which he has had for several years. He reports a "crawling" sensation on his skin. He is concerned that this rash may be caused by a parasite he may have picked up while serving in the military overseas. On examination, you note multiple crusted lesions on his forearms, neck, chest, scalp, and thighs. There is a complete sparing of the skin on his back. He brought a bottle with fibrous material of different colours that he picked from his wounds. He is otherwise healthy and reports no other symptoms except some chronic fatigue and insomnia related to the itching. Which one of the following treatments is the most appropriate?

A. Butenafine
B. Doxycycline
C. Ivermectin
D. Fluconazole
E. Permethrin

Answer: C

Explanation:
This case describes classic signs of delusional parasitosis (also known as Morgellons syndrome).However, the presence of widespread crusted lesions raises suspicion for crusted scabies, particularly in older adults.
Crusted scabies may be misinterpreted as chronic dermatitis or psychocutaneous disorder. The most effective treatment is oral ivermectin.
Toronto Notes 2023 - Dermatology:
"Crusted scabies presents as widespread hyperkeratotic plaques with crusting. First-line treatment is oral ivermectin, often with topical permethrin." MCCQE1 Objectives (Medicine > Dermatology > 23-1):
"Candidates must recognize presentations of ectoparasitic infections, including scabies, and provide appropriate treatment." Permethrin (B) is for typical scabies, but crusted scabies often requires systemic ivermectin due to severity and spread.

NEW QUESTION # 164
A 64-year-old man presents with a 3-month history of gradually increasing neck pain and stiffness. The pain radiates into his upper back, and he is having difficulty driving because of limitation of neck rotation secondary to pain. Physical examination shows restricted neck motion in all directions and neck muscle spasms. There is no abnormality on neurologic examination. A radiograph shows narrowing of all of the cervical disc spaces with prominent osteophytes. Which one of the following is the most appropriate next step?

A. No further investigation.
B. Magnetic resonance imaging of the neck.
C. Lumbar puncture.
D. Electromyography of upper limbs.
E. Computed tomography of neck.

Answer: A

Explanation:
The presentation is consistent with cervical spondylosis - a degenerative condition. In the absence of neurologic findings, further imaging beyond plain radiography is not warranted. Management includes conservative measures such as physiotherapy and analgesia.
Toronto Notes 2023 - Rheumatology, Cervical Spondylosis:
"Patients with typical cervical spondylosis and no red flags (e.g., neurologic deficits) do not require MRI.
Treatment is conservative. Radiographs showing disc space narrowing and osteophytes confirm diagnosis." MCCQE1 Objectives - Internal Medicine > Musculoskeletal Disorders:
"Candidates must recognize typical degenerative spine disorders and avoid unnecessary investigations when clinical findings are straightforward." MRI (B) is useful if myelopathy or radiculopathy is suspected. CT (A), EMG (C), and LP (D) are not indicated here.

NEW QUESTION # 165
A 39-year-old woman comes to the office for a periodic health examination. She reports that her father had a recent diagnosis of breast cancer (at age 62 years) and that a paternal aunt had ovarian cancer in her early 40s.
The results of mammography are normal. Which one of the following is the most appropriate recommendation for this patient?

A. Bilateral mastectomy.
B. Annual mammography starting at age 50 years.
C. Prophylactic tamoxifen therapy.
D. Random fine-needle sampling of the breasts.
E. Genetic screening.

Answer: E

Explanation:
This patient has a family history of both male breast cancer (father) and early-onset ovarian cancer (aunt), which are red flags for BRCA1/2 mutations. Genetic counseling and BRCA testing are the appropriate next steps to stratify cancer risk and guide screening and prevention.
Toronto Notes 2023 - Oncology, "Breast Cancer Risk" Section:
"BRCA testing is recommended for individuals with a strong family history of breast or ovarian cancer, particularly if involving male relatives or early-onset cases." MCCQE1 Objectives (Population Health > 97-5: Screening and Prevention):
"Candidates must identify high-risk individuals who require genetic counseling and screening beyond population guidelines." Tamoxifen (A) and prophylactic mastectomy (E) are only considered after confirming mutation status. Annual screening starting at 50 (D) is for average-risk women. Fine-needle sampling (C) is not a screening tool.

NEW QUESTION # 166
On screening for dyslipidemia, a 45-year-old man is found to have a low high-density lipoprotein (HDL) cholesterol level. Which one of the following recommendations is the most appropriate?

A. Alcohol cessation.
B. Elimination of caffeine.
C. Garlic supplementation.
D. Vigorous exercise program.
E. Low-salt diet.

Answer: D

Explanation:
Low HDL is best managed with lifestyle changes such as increased aerobic physical activity, smoking cessation, and weight loss. Vigorous exercise has the strongest evidence for raising HDL levels.
Toronto Notes 2023 - Cardiology, Dyslipidemia:
"Increasing physical activity is among the most effective ways to raise HDL cholesterol. There is no consistent benefit to supplements such as garlic, nor does reducing salt or caffeine meaningfully raise HDL." MCCQE1 Objectives - Population Health > Cardiovascular Risk Management:
"Candidates should recommend evidence-based lifestyle interventions such as exercise to improve lipid profiles, particularly to increase HDL." Alcohol cessation (C) is generally beneficial for overall health but may actually lower HDL slightly. Garlic (D) and caffeine (E) are not evidence-based interventions for dyslipidemia.

NEW QUESTION # 167
You are conducting a virtual appointment by voice-only call with a 68-year-old man regarding back pain.
When he answers, you ask for him by name and identify yourself and the clinic from which you are calling.
Which one of the following is the best next step?

A. Ask for additional confirmation of the patient's identity.
B. Confirm the name of the patient's primary care provider.
C. Establish the reason for the virtual care visit.

Answer: A

Explanation:
Before proceeding with any virtual consultation, particularly by voice-only, it is essential to confirm the patient's identity beyond name alone - for example, by verifying date of birth or health card number. This protects privacy and ensures medical confidentiality.
Toronto Notes 2023 - ELOM, Virtual Care Section:
"Virtual care must begin by verifying patient identity using at least two identifiers (e.g., full name and date of birth) to prevent disclosure of personal health information to unintended individuals." MCCQE1 Objectives - Ethical, Legal, and Professionalism > Virtual Care:
"The candidate must confirm patient identity and consent before initiating any virtual medical encounter, especially when video is not available." Option A (reason for visit) should follow identity confirmation. Option B (confirming primary care provider) is irrelevant to identity verification.

NEW QUESTION # 168
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