MCCQE Practice Questions

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 24-year-old man presents to your clinic with a 6-month history of fatigue. On examination, he is pale. His BMI is 16, and his blood pressure is 92/58 mm Hg. Initial laboratory work shows the following:

Creatinine: 64 µmol/L (49–93)

Potassium: 3.0 mmol/L (3.5–5.1)

Sodium: 138 mmol/L (136–146)

TSH: 2.40 mIU/L (0.34–5.60)

CBC: Normal

Which one of the following is the best next step?

You are called to attend an 18-year-old woman, gravida 2, para 1, aborta 0, who is in precipitous labour. She did not realize she was pregnant and has not had any prenatal care. After the delivery, you examine the newborn boy; he is vigorous, and it appears that he was born at full term. Physical examination findings of the newborn are normal. Review of the prenatal record from the mother ' s last pregnancy shows the following:

HIV: Negative

Hepatitis B surface antibody: Positive

Hepatitis C: Negative

Syphilis serology: Negative

The mother ' s previous child was placed in foster care. The mother is withdrawn and uncommunicative after delivery. Which one of the following is the best next step?

A 55-year-old man presents with vague abdominal pain and general weakness. His mother had colon cancer and died at age 60 years. His physical examination findings and complete blood count results are normal. Which one of the following tests should be ordered first?

Following a potluck supper organized by the residency director of your training program, many of your fellow residents and other guests fall ill with gastroenteritis. Which one of the following is the best way to identify the source of this food-borne outbreak?

A previously healthy 7-year-old boy presents to the Emergency Department with a generalized tonic-clonic seizure, which subsided spontaneously after 10 minutes. There is no history of trauma. Physical examination reveals normal vital signs and a normal neurologic examination. Which one of the following diagnostic studies is urgently indicated?

Three months ago, a physician colleague approached you in the hospital corridor for advice regarding one of his patients. You are now being named by this patient in a malpractice action. Which one of the following is the most likely reason why you may be found liable?

A 6-week-old boy is brought to your office by his parents for a follow-up following a recent urinary tract infection. His abdominal ultrasound shows dilated urinary bladder and ureters as well as bilateral hydronephrosis. Which one of the following historical findings would be most helpful in establishing the correct diagnosis?

A prepubertal 9-year-old girl with severe developmental disability is brought to your office by her parents. They are seeing you to discuss some difficulties that might occur with puberty. They are afraid that menses will complicate hygiene care and they have heard of significant mood/behavioural changes in this population when menses occur. Which one of the following recommendations is the most appropriate?

You are asked to assess an 85-year-old man who was admitted to the hospital for management of a bowel obstruction. The patient is in bed and has a faint pulse with no detectable blood pressure. There is vomitus on his bed and clothing. He has central cyanosis, and oxygen saturation is 75% on supplemental oxygen. Which one of the following is the best next step?