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Medical Council of Canada MCCQE Part 1 Exam Sample Questions (Q56-Q61):

NEW QUESTION # 56
You are examining a newborn in the delivery room. He was born at full term by spontaneous vaginal delivery.
On examination, he is active, and his vital signs are within normal range. His head circumference is at the third percentile, with height and weight at the 10th percentile. Auscultation of his chest is clear with normal cardiovascular examination findings. The abdomen is protuberant with a liver edge palpable at 4 cm below the costal margin and mild splenomegaly. Which one of the following is the most likely diagnosis?

A. Congenital viral infection
B. Cephalic molding
C. Cystic fibrosis
D. Trisomy 21
E. Lipid storage disease

Answer: A

Explanation:
Microcephaly, intrauterine growth restriction, hepatosplenomegaly, and normal vital signs in a term newborn strongly suggest congenital viral infection (e.g., CMV, toxoplasmosis, rubella).
Toronto Notes 2023 - Pediatrics, Congenital Infections:
"Signs of congenital TORCH infections include microcephaly, hepatosplenomegaly, and growth restriction.
Early identification is key."
MCCQE1 Objectives - Pediatrics > Infectious Disease:
"Candidates must recognize signs suggestive of congenital infections and distinguish from genetic or structural abnormalities." Cephalic molding (A) is benign and resolves spontaneously. Lipid storage diseases (B) are not present at birth. Cystic fibrosis (C) does not cause microcephaly or hepatosplenomegaly at birth. Trisomy 21 (D) has distinct dysmorphic features not described here.

NEW QUESTION # 57
A mother brings her 13-year-old daughter to the office. The girl has had intermittent lower abdominal pain, constipation, and difficulty voiding for 3 months. She says that she is not sexually active. She looks well. She has reached age-specific developmental milestones, and her vital signs are within normal range. On abdominal examination, she is found to have a palpable suprapubic mass that persists after voiding. The girl says that her older sister started having menstrual periods at this age. The patient is surprised that hers have not started. Which one of the following is the best next step?

A. Measurement of serum human chorionic gonadotropin.
B. Abdominal radiography.
C. Pelvic ultrasonography.
D. Urinalysis.
E. Examination of external genitalia.

Answer: E

Explanation:
The clinical picture suggests an obstructive anomaly of the female reproductive tract, such as imperforate hymen or vaginal outflow tract obstruction, leading to hematocolpos. The first essential step is physical examination of the external genitalia.
Toronto Notes 2023 - Pediatrics and Gynecology, "Amenorrhea" Section:
"In girls with primary amenorrhea and cyclic abdominal pain, perform an external genital exam to rule out obstructive anomalies (e.g., imperforate hymen or transverse vaginal septum). Examination should always precede imaging." MCCQE1 Objectives (Pediatrics > 78-3: Puberty and Menstrual Disorders):
"Candidates must evaluate delayed menarche with physical exam, including inspection of the genitalia to rule out anatomic obstruction." Pelvic ultrasound (D) is helpful but should follow physical exam. Radiography (B), hCG (C), and urinalysis (E) are not primary steps in evaluating amenorrhea with a mass.

NEW QUESTION # 58
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?

A. Strabismus
B. Ptosis
C. Pseudostrabismus
D. Cataract

Answer: A

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 # 59
A 72-year-old woman is brought to the Emergency Department by her daughter because of significant functional decline and progressive shortness of breath. She has widespread metastatic breast cancer and recently stopped chemotherapy due to progression and intolerance. She has been bedridden for 4 weeks. On examination:
* BP: 100/70 mm Hg with pulsus paradoxus of 20 mm Hg
* HR: 99/min
* Temp: 36.5°C
* SpO#: 94% room air
* JVP: elevated
* Heart sounds: muffled
* Chest X-ray: large globular heart
Labs:
* Hemoglobin: 90 g/L
* Sodium: 118 mmol/L
* Creatinine: 94 µmol/L
Which one of the following is the best next step?

A. Pericardiocentesis
B. Discussion on goals of care
C. Blood transfusion
D. Normal saline infusion
E. Consult with the Intensive Care Unit

Answer: B

Explanation:
This patient has classic signs of cardiac tamponade (Beck's triad: hypotension, muffled heartsounds, elevated JVP, plus pulsus paradoxus). However, she also has advanced metastatic cancer, functional decline, and has stopped active treatment. In this context, a goals-of-care discussion is the most appropriate next step to determine her wishes regarding interventions like pericardiocentesis.
Toronto Notes 2023 - Palliative Care:
"End-of-life care should prioritize quality of life and patient preferences. In patients with terminal illness and life-threatening conditions (e.g., tamponade), initiate a conversation about goals before aggressive intervention." MCCQE1 Objectives - Internal Medicine > Palliative and End-of-Life Care:
"Candidates must assess prognosis, patient values, and initiate appropriate end-of-life discussions before invasive treatment." Although pericardiocentesis (A) may relieve symptoms, it should follow consent based on the patient's goals.
ICU (E), fluids (B), or transfusion (D) are not appropriate without this discussion.

NEW QUESTION # 60
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. Random fine-needle sampling of the breasts.
B. Annual mammography starting at age 50 years.
C. Bilateral mastectomy.
D. Prophylactic tamoxifen therapy.
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 # 61
......

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Medical Council of Canada MCCQE Exam | Pdf Demo MCCQE Download - Trustable Planform Supplying Reliable New MCCQE Exam Topics

New Medical Council of Canada MCCQE Exam Topics & Valid Dumps MCCQE Pdf

Medical Council of Canada MCCQE Part 1 Exam Sample Questions (Q56-Q61):

Free PDF Quiz 2025 Medical Council of Canada MCCQE Updated Pdf Demo Download