Medical Council of Canada MCCQE Part 1 MCCQE

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最新的 MCCQE Part 1 MCCQE 免費考試真題:

1. A 45-year-old man with confusion is brought to the Emergency Department by ambulance. He has end-stage renal disease and has missed his last 3 dialysis appointments. He also has a past medical history of antisocial personality disorder and hepatitis C. On examination, he is in respiratory distress. His blood pressure is 170
/90 mm Hg, and his oxygen saturation is 84% on room air. His jugular venous pressure is 8 cm above the sternal angle, and he has crackles in his lungs bilaterally. A venous blood gas shows a bicarbonate of 11 mmol
/L (24-30) and potassium of 7.1 mmol/L (3.5-5.0). Which one of the following is the best next step?

A) Attempt to contact his family for consent to start dialysis.
B) Discuss with his nephrologist the reasons why he missed his dialysis appointments.
C) Start urgent dialysis.
D) Call psychiatry to evaluate his capacity to consent.
E) Prescribe morphine and furosemide.

2. A 63-year-old woman presents to your office with a history of progressive abdominal discomfort over the past five months. She reports bloating and difficult digestion with constipation. She has no urinary symptoms and denies vaginal or rectal bleeding. An abdominal ultrasound shows a large complex pelvic mass with internal multiloculation and moderate ascites. The cancer antigen 125 (CA 125) is elevated at 1023 U/mL ( < 35 U
/mL). Which one of the following is the most likely diagnosis?

A) Serous carcinoma of the ovary
B) Chronic hematosalpinx
C) Rectosigmoid adenocarcinoma
D) Metastatic uterine adenocarcinoma
E) Ovarian hyperstimulation syndrome

3. A 25-year-old nulligravida woman presents after trying to conceive for 2 years without success. She is healthy, with regular menstrual periods. She denies any unusual hair growth, weight changes, or breast discharge. She gets occasional outbreaks of acne. Blood work done with her next menstrual period produces the following results:
Follicle-stimulating hormone, follicular phase: 6.2 U/L (5.0-20.0) on day 3 of menstrual cycle Luteinizing hormone, follicular phase: 6 U/L (5-22) on day 3 of menstrual cycle Estradiol: 163 pmol/L (50-200) on day 15 of menstrual cycle Thyrotropin (thyroid-stimulating hormone): 2.5 mU/L (0.4-5.0) Prolactin: 40 µg/L (4-30) Given the results of her blood work, which one of the following is the best next step?

A) Send her for a mammography.
B) Refer her for in vitro fertilization.
C) Give her a prescription for bromocriptine.
D) Order magnetic resonance imaging of her brain.

4. A 16-year-old boy presents to the emergency department with a 12-hour history of fever and rigors. He has sickle cell anemia. On examination, his vital signs include the following:
Heart rate
110/min (60-100)
Respiratory rate
20/min (12-18)
Temperature
38.8 °C, oral (36.5-37.5)
Which one of the following places this patient at risk for sepsis?

A) Immunoglobulin deficiency
B) Chronic anemia
C) Neutrophil dysfunction
D) Functional asplenia
E) Systemic iron overload

5. A 12-year-old boy is brought to the Emergency Department with a 2-week history of a limp with malaise, fever and left leg pain. On examination, he looks sick, has a temperature of 38.5°C and is able to weight-bear.
His hip examination reveals mildly decreased range of motion. Radiographs of the hip and femur show mild sclerosis of proximal femoral metaphysis. His C-reactive protein level is 15 mg/L ( < 8). Which one of the following is the most likely diagnosis?

A) Osteomyelitis.
B) Legg-Calve-Perthes disease.
C) Undisplaced fracture of the proximal femur.
D) Transient synovitis.
E) Stable slipped capital femoral epiphysis.

問題與答案：