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Medical Council of Canada MCCQE Part 1 認定 MCCQE 試験問題:

1. A 28-year-old woman presents to the office in great distress because she has no money for groceries or rent.
She is a single mother of a 7-year-old girl. She has a history of gambling disorder. She has felt unable to cope for the last 3 months and has started gambling again. Today, she is crying, and she shares that her boyfriend became violent with her yesterday. Which one of the following is the highest priority for assessment?

A) Investigate the patient ' s need for financial assistance.
B) Screen for recreational drug and alcohol use.
C) Evaluate for depression.
D) Determine the risk of violence to the patient and her child.
E) Define the extent of the patient ' s gambling disorder.

2. An 88-year-old married man is admitted following a cardiac arrest at home. He was not expected to recover, and after 2 weeks, he remains in a coma. His wife states, " I cannot let him go. That would be murder. " As the attending physician looking after her husband, which one of the following is the best next course of action?

A) Say nothing further and wait until she comes around to accepting his state
B) Emphasize that the duration of his stay in the Intensive Care Unit will be limited
C) Remove him from life support as this would not be murder
D) Seek advice from the provincial or territorial public guardian
E) Encourage her to imagine what her husband would have wanted

3. You are seeing a 78-year-old man for follow-up of metastatic cholangiocarcinoma diagnosed 8 months ago and currently being treated with thermotherapy. He has just completed his 2nd cycle and reports frequently feeling hopeless, worthless, and helpless, with no sense of a positive future. He states he is turning away invitations to socialize with family and friends. He feels like sleeping all the time and reports no appetite.
Which one of the following is the most likely diagnosis?

A) Normal grief reaction
B) Brain metastasis
C) Major depressive episode
D) Side effects of chemotherapy
E) Hepatic encephalopathy

4. A 38-year-old woman has progressive renal failure despite optimal medical treatment for her glomerulonephritis. Her ex-husband asks if he might be considered as a kidney donor. They have joint custody of their 10-year-old son. Which one of the following is the best response to the ex-husband's request?

A) He may proceed with assessment for possible organ donation.
B) Advise against a donation because of their divorce.
C) His request must be refused because of the risk of leaving their child with 2 unhealthy parents.

5. A 42-year-old man presents to your office with acute left knee pain and difficulty walking. He denies any trauma. He reports 2 painful episodes involving his right great toe in the last year. He smokes half a pack of cigarettes a day and drinks at least 3 beers daily. He has a temperature of 38.2°C and has a red, swollen and warm left knee. Which one of the following is the best next step?

A) Order blood cultures.
B) Order radiography of the knee.
C) Aspirate the knee joint.
D) Start acetaminophen.
E) Start indomethacin.

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