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Test MCCQE Dumps Demo - MCCQE Real Exam

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Medical Council of Canada MCCQE Part 1 Exam Sample Questions (Q185-Q190):

NEW QUESTION # 185
A 9-year-old girl is brought to the Emergency Department because she has generalized urticaria, abdominal cramping, and postural dizziness 30 minutes after eating at a friend's birthday party. Which one of the following is the most appropriate route of administration for epinephrine?

A. Intranasal
B. Intravenous
C. Intramuscular
D. Subcutaneous
E. Inhaled

Answer: C

Explanation:
Anaphylaxis requires immediate administration of epinephrine via the intramuscular (IM) route, typically in the lateral thigh. This route provides the fastest and most reliable absorption for emergency treatment.
Toronto Notes 2023 - Pediatrics, Anaphylaxis:
"Epinephrine 0.01 mg/kg IM is the first-line treatment for anaphylaxis. The intramuscular route provides the most rapid and safe absorption in emergencies." MCCQE1 Objectives - Pediatrics > Allergy and Immunology:
"Candidates must know the emergency management of anaphylaxis, including proper dosage and intramuscular administration of epinephrine." IV administration (A) is reserved for critical care settings. Subcutaneous (C) and intranasal/inhaled routes (D, E) are ineffective in anaphylaxis.

NEW QUESTION # 186
A 14-month-old boy is brought to see you for a well-baby check-up and is noted to have onlyone testis.
Ultrasound confirms an undescended testis. Which one of the following is the best next step?

A. Surgical removal of the undescended testis
B. Observation for a year
C. Hormonal therapy with testosterone
D. Surgical orchiopexy
E. Hormonal therapy with gonadotropins

Answer: D

Explanation:
Orchiopexy is the treatment of choice for cryptorchidism and should be performed between 6-18 months of age. Early surgery improves fertility outcomes and reduces malignancy risk.
Toronto Notes 2023 - Pediatrics, Urology:
"Undescended testes should be referred for orchiopexy ideally before 18 months of age. Observation beyond
6 months is not recommended."
MCCQE1 Objectives - Pediatrics > Genitourinary Disorders:
"Candidates must recognize and refer for cryptorchidism early to optimize testicular function and reduce cancer risk." Hormonal therapies (C, D) are not recommended due to limited efficacy. Observation (A) is too late beyond

NEW QUESTION # 187
A health authority implements the first-ever colon cancer screening program in its territory. Which one of the following colon cancer indices will likely increase?

A. Treatment rate
B. Case fatality rate
C. Positive biopsy rate
D. Positive predictive value of the screening test
E. Incidence rate

Answer: E

Explanation:
When a screening program is introduced, the incidence rate appears to rise because more cases (including subclinical ones) are identified earlier. This is known as "lead-time bias" or "ascertainment bias." Toronto Notes 2023 - Public Health, Screening and Epidemiology:
"Screening increases the apparent incidence of disease as more early or latent cases are detected." MCCQE1 Objectives - Preventive Medicine > Screening:
"Candidates should understand how implementation of screening programs affects disease incidence and epidemiologic metrics." Case fatality rate (A) may decrease. PPV (B) depends on prevalence. Positive biopsy rate (C) may remain stable. Treatment rate (E) could increase, but incidence is the most directly and consistently affected.

NEW QUESTION # 188
A 29-year-old woman presents with vaginal spotting after 6 weeks of amenorrhea. She is asymptomatic otherwise. Serum #-hCG is 2150 IU/L, and pelvic ultrasound shows an empty uterus. She has been trying to conceive for 7 months. Which one of the following is the best next step?

A. Administer intramuscular methotrexate.
B. Arrange exploratory laparoscopy.
C. Repeat serum #-hCG test in 48 hours.
D. Perform dilatation and curettage for chorionic villi.
E. Repeat pelvic ultrasonography in 10 days.

Answer: C

Explanation:
An empty uterus with #-hCG >1500-2000 IU/L raises concern for a pregnancy of unknown location (PUL), including the possibility of ectopic pregnancy. However, the patient is hemodynamically stable and asymptomatic. In such cases, the best initial step is to repeat serum #-hCG in 48 hours to assess the rise or fall of hCG levels.
Toronto Notes 2023 - Obstetrics, "First Trimester Bleeding":
"If #-hCG >1500 IU/L and no intrauterine pregnancy is visualized on ultrasound, repeat #-hCG in 48 hours to determine rise or decline. A suboptimal rise (less than 66%) suggests ectopic pregnancy." MCCQE1 Objectives (Obstetrics > 79-1: Early Pregnancy Complications):
"In a patient with early pregnancy bleeding, the candidate must interpret quantitative #-hCG trends to distinguish ectopic pregnancy, miscarriage, or viable intrauterine pregnancy." Immediate administration of methotrexate or invasive procedures such as D&C or laparoscopy are not appropriate until further diagnostic clarification is obtained.

NEW QUESTION # 189
You are being consulted for a 79-year-old man who is about to undergo a total hip arthroplasty. His orthopedic surgeon is aware of the diagnosis of Alzheimer disease and would like your suggestions to help avoid acute postsurgical delirium. To that end, which one of the following is the most effective strategy?

A. Avoid medications with anticholinergic potential
B. Treat postsurgical insomnia with benzodiazepines
C. Refrain from prescribing opiate analgesics to treat postoperative pain
D. Screen the patient with the Mini-Mental Status Examination prior to surgery
E. Keep family visits to a minimum to avoid postsurgical overstimulation

Answer: A

Explanation:
One of the strongest modifiable risk factors for postoperative delirium in older adults is exposure to anticholinergic medications (e.g., diphenhydramine, certain antidepressants). Avoiding these can reduce delirium risk.
Toronto Notes 2023 - Geriatrics, "Delirium Prevention":
"Avoid high-risk medications including anticholinergics, benzodiazepines, and narcotics if possible. Maintain orientation cues and adequate pain control." MCCQE1 Objectives (Medicine > Geriatrics > 41-1: Cognitive Impairment):
"Candidates must recognize predisposing factors for delirium and apply prevention strategies, including medication review." Opiates (B) should be used judiciously; untreated pain can also cause delirium. Cognitive screening (C) is helpful for baseline but does not prevent delirium. Benzodiazepines (D) increase delirium risk. Family involvement is actually helpful (E).

NEW QUESTION # 190
......

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