Free Medical Council of Canada MCCQE Practice Test & Real Exam Questions

You are undertaking the retrospective analysis of a laboratory-confirmed influenza A virus outbreak that occurred in a long-term care facility last year. Among the 163 residents in the facility during the outbreak, 101 residents had new-onset fever, cough, myalgias, and congestion. Of these, 37 residents were transferred to acute care. Of these, 17 residents died. Which one of the following is the best estimate of the attack rate in residents at the facility?

A 34-year-old man sustained a blunt testicular trauma 2 hours ago. On physical examination, the patient has a
1.5-cm tall scrotal hematoma. You cannot palpate the testicle. Which one of the following is the best initial management?

A 15-year-old boy is brought to your office because of concerns about his breast development. He has no other symptoms. His physical examination does not reveal any other abnormality. Which one of the following is the best next step?

A 12-year-old boy is brought by his mother to your clinic with a history of attention-deficit/hyperactivity disorder. His mother reports that he has been taking immediate-release methylphenidate for 2 years. Although the medication was initially effective, it no longer seems to work. The teachers say he is disorganized and fidgety, verbally interrupts class, and does not complete his work. His mother tells you that he does listen at home. Which one of the following is the most important next step in management?

A 26-year-old woman, gravida 2, para 1, presents with a positive pregnancy test. Her previous pregnancy was associated with preeclampsia, and she delivered a 1000 g boy at 34 weeks ' gestation. Her blood pressure is
130/86 mm Hg. Which one of the following is the best recommendation for this pregnancy?

A 52-year-old man presents to the Emergency Department with a history of back, neck, and shoulder pain sustained from a workplace incident 4 years ago. He is under observation by a multidisciplinary pain clinic, and his next appointment is not for another 4 weeks. He does not report any recent change in his symptoms.
His medications are as follows:
Acetaminophen
1000 mg orally 4 times daily
Naproxen
500 mg orally twice daily
Amitriptyline
25 mg orally at bedtime
Acetaminophen 1000 mg orally four times daily
Naproxen 500 mg orally twice daily
Amitriptyline 25 mg orally at bedtime
The patient has not taken his medications for several weeks because he thinks they are not working. He requests a prescription for oxycodone because he tried some that a friend sold him, and it worked very well.
After completing an assessment and providing counseling, which one of the following is the best next step?

A 38-year-old man is brought by his wife to the Emergency Department with fatigue, dizziness, and nausea after completing a hiking tour on a hot, humid day. His wife became worried after he had collapsed. He has been sweating heavily and vomited twice on the drive in. His medical history is unremarkable, and he takes no medications. His vital signs on arrival are as follows:
Blood pressure
85/57 mm Hg
Heart rate
120/min
Respiratory rate
18/min
Temperature
40.1 °C
Oxygen saturation
95%, room air
-
On physical examination, the patient ' s skin is dry, flushed, and warm to the touch. He has a diffuse erythematous papular rash. Findings of a thorough physical examination are otherwise unremarkable. An electrocardiogram shows sinus tachycardia. Which one of the following is the best next step?

A 34-year-old woman, gravida 2, para 1, aborta 0, presents to the labor and delivery ward at 32 weeks ' gestation with a 24-hour history of worsening frontal headache, photophobia, and neck stiffness. Vitals:
BP: 121/78 mm Hg
HR: 90 bpm
Temp: 38°C
Neuro exam reveals a 2-beat ankle clonus. Tone and power are otherwise normal. No localizing signs or papilledema. Abdomen is soft, fetus is cephalic.
Which one of the following is the best next investigation?

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?