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Medical Council of Canada MCCQE Part 1 Exam Sample Questions (Q208-Q213):

NEW QUESTION # 208
An 18-month-old boy is brought to the office by his guardians for a well-child visit. His guardians are concerned that his eyes do not look the same. On examination, his eyes appear as shown in the referenced photo.
Which one of the following best represents the patient ' s condition?

Answer: C

Explanation:
The image shows an asymmetrical light reflex (corneal light reflex not centered in both eyes), which is diagnostic of strabismus. This misalignment of the eyes must be treated early to prevent amblyopia (lazy eye).
Toronto Notes 2023 - Pediatrics, Ophthalmology:
"Strabismus presents with misaligned visual axes. The Hirschberg light reflex is off-center in the affected eye.
Prompt referral is necessary to prevent amblyopia."
MCCQE1 Objectives - Pediatrics > Vision and Developmental Disorders:
"Candidates must recognize strabismus on visual screening and refer early for correction to prevent permanent vision impairment." Pseudostrabismus (B) can be ruled out here because the light reflex is not symmetric. Ptosis (A) involves drooping of the eyelid, which is not evident. Cataracts (D) would typically present with a leukocoria (white reflex), not misalignment.


NEW QUESTION # 209
A 14-year-old girl, accompanied by her mother, presents to your office with a 3-month history of feeling
"dizzy." After you take an initial history, which one of the following is the most appropriate next step?

Answer: A

Explanation:
In adolescents presenting with vague or potentially sensitive symptoms, it is critical to speak with them alone to obtain a complete and honest history, including mental health, sexual activity, substance use, and abuse screening.
Toronto Notes 2023 - Pediatrics, Adolescent Medicine:
"Private interviews are essential to obtain accurate histories in adolescents, especially when symptoms may have underlying psychosocial or reproductive causes." MCCQE1 Objectives - Pediatrics > Adolescent Health:
"Candidates must demonstrate adolescent-appropriate interviewing techniques, including private questioning to identify sensitive or risk-related concerns." Physical examination and pregnancy testing (A, B, D) may follow based on the private history. Vital signs (E) are standard but do not replace psychosocial assessment.


NEW QUESTION # 210
A 56-year-old woman comes to your office because she has not been herself since her husband died in a car crash 6 weeks ago. She has no prior psychiatric history. Her son is concerned because she cries frequently, has a poor appetite, rarely leaves home and is distraught. Her sadness fluctuates and increases when she thinks of her husband. She often thinks about death, and she wishes she could join her deceased husband. Which one of the following is the best next step?

Answer: C

Explanation:
Her presentation at 6 weeks after a spouse's death is most consistent with acute/normal grief : intense sadness, crying, social withdrawal, reduced appetite, and waves of distress triggered by reminders of the deceased.
MCCQE objectives stress distinguishing grief from major depressive disorder by the fluctuating nature of symptoms , grief "pangs," and the link to thoughts of the deceased. Although she expresses wishing to "join" her husband, this can occur in normal bereavement; the key clinical duty is to assess safety (suicidal intent, plan, means, past attempts, protective factors). In the absence of imminent risk or psychosis, inpatient/day- hospital admission is not the default. "Reassurance" alone is insufficient because she is significantly impaired and needs structured support. The best next step is referral for bereavement-focused support (often via social work), which can provide grief counseling, coping strategies, mobilization of supports, and monitoring, and can facilitate escalation if complicated grief or major depression emerges. Family systems therapy may help later, but immediate practical and grief-specific support plus safety assessment is the priority.


NEW QUESTION # 211
A same-sex couple asks to join a family physician's practice. The physician tells them that shedoes not treat same-sex couples and will refer them to a physician with more clinical experience with same-sex couples.
Which one of the following best describes the physician's obligation under the Canadian Charter of Rights and Freedoms?

Answer: C

Explanation:
Refusing care based on sexual orientation constitutes discrimination under the Canadian Charter of Rights and Freedoms and violates professional standards. Physicians must not deny care based on personal bias or prejudice.
Toronto Notes 2023 - ELOM, Equity in Care and Professionalism:
"Denying care based on sexual orientation violates both human rights legislation and professional obligations.
Physicians must ensure equitable access for all patients."
MCCQE1 Objectives - ELOM > Professionalism and Patient Rights:
"Candidates must act in accordance with patients' rights to equitable, non-discriminatory access to care regardless of race, gender, or sexual orientation." Referral (Option B) does not excuse discriminatory refusal. Personal discomfort or inexperience (Options D and E) do not justify discrimination.


NEW QUESTION # 212
A 58-year-old woman presents to your office with heavy vaginal bleeding. She has a history of type 2 diabetes and hypertension. Some active bleeding is visible on speculum examination. Ultrasound reveals an endometrial thickness of 12 mm. Endometrial biopsy shows complex hyperplasia with atypia. Which one of the following is the best next step?

Answer: D

Explanation:
Comprehensive and Detailed Explanation:
Complex endometrial hyperplasia with atypia carries a high risk of progression to or concurrent endometrial carcinoma. Definitive management in postmenopausal women is total hysterectomy with bilateral salpingo- oophorectomy.
Toronto Notes 2023 - Gynecology, Abnormal Uterine Bleeding:
"Endometrial hyperplasia with atypia in postmenopausal women is best managed surgically due to the risk of malignancy." MCCQE1 Objectives - Gynecology > Postmenopausal Bleeding:
"Candidates should identify endometrial hyperplasia with atypia as an indication for hysterectomy in appropriate patients." Ablation (A) is contraindicated. Progesterone (B) is used for non-atypical hyperplasia. D&C (C) and hysteroscopy (D) are diagnostic but not definitive.


NEW QUESTION # 213
......

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