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Medical Council of Canada MCCQE Part 1 Exam Sample Questions (Q211-Q216):
NEW QUESTION # 211
A 32-year-old woman, gravida 1, para 0, aborta 1, and her partner present to the office for follow-up regarding a spontaneous abortion that occurred 6 weeks ago. On history, the patient smokes tobacco cigarettes occasionally. On examination, she is healthy and has a BMI of 25. Ultrasonography findings reveal an empty uterus with a 2-cm subserosal fibroid. The couple is planning another pregnancy and would like information on how to increase her chances of carrying a pregnancy to full term. Which one of the following is the best advice?
- A. The patient should take 5 mg of folic acid daily.
- B. The patient and her partner should abstain from sexual intercourse in the first trimester.
- C. The patient should undergo excision of her fibroid.
- D. The patient should stop smoking.
- E. The patient should defer conception for 6 months.
Answer: D
Explanation:
This patient had a single spontaneous abortion and is planning another pregnancy. MCCQE objectives emphasize modifiable risk factor reduction and evidence-based preconception counseling. Smoking is a well- established risk factor for miscarriage, placental complications, fetal growth restriction, and preterm birth.
Therefore, smoking cessation is the most effective intervention among the options listed to improve the likelihood of a healthy term pregnancy.
A 2-cm subserosal fibroid does not distort the uterine cavity and is unlikely to contribute to miscarriage; surgical removal is not indicated. There is no evidence that abstaining from intercourse in the first trimester prevents miscarriage. After a single early pregnancy loss, there is no need to delay conception for 6 months; couples may attempt pregnancy once emotionally and physically ready.
While folic acid supplementation is recommended preconceptionally, the standard dose for low-risk women is
0.4-1 mg daily, not 5 mg (which is reserved for high-risk patients). Thus, smoking cessation is the most important advice.
NEW QUESTION # 212
A 32-year-old woman presents to your outpatient clinic with concerns regarding a 6-month history of both a pulsatile buzzing sound in her ears and headaches. There is no history of hearing loss, vertigo, ear pain, or discharge from the ears. There is a long-standing history of prolonged exposure to occupational noise. She has a BMI of 32. Otoscopic examination is unremarkable, and there are no neck masses present. You determine that the buzzing sound is synchronous with her radial pulse. Which of the following investigations should be ordered next?
- A. Magnetic resonance imaging of the brain
- B. Audiogram
- C. C-reactive protein
- D. Electroencephalography
Answer: A
Explanation:
Comprehensive and Detailed Explanation:
Pulsatile tinnitus synchronous with the pulse may be vascular in origin. The association with headaches and elevated BMI (a risk factor for idiopathic intracranial hypertension, IIH) warrants neuroimaging to assess for cerebral venous sinus thrombosis, vascular malformations, or raised intracranial pressure.
Toronto Notes 2023 - Neurology / ENT:
"Pulsatile tinnitus requires investigation for vascular causes including idiopathic intracranial hypertension.
MRI or MRV is the next step."
MCCQE1 Objectives (Neurology > 35-1: Headache and Tinnitus):
"Candidates must investigate pulsatile tinnitus with neuroimaging when vascular causes are suspected." Audiogram (A) is for hearing loss. EEG (C) is not useful for tinnitus. CRP (D) is irrelevant.
NEW QUESTION # 213
A system administrator needs to install a GPU/DPU in a server. The server has a free PCI-e slot, there are enough free PCI-e lanes, and there is enough room for the card. Which procedure should be followed?
- A. Ensure the server has enough power. Make sure the server is down to remove cables safely. Wear an ESD bracelet.
- B. Ensure the server has enough power. Make sure the server is up and running with attached cables. Wear an ESD bracelet.
- C. Ensure the server has enough power. Verify compatibility of cables with server ' s platform. Make sure the server is down to remove cables safely. Wear an ESD bracelet.
- D. Ensure the server has enough power. Verify compatibility of cables with server ' s platform. Make sure the server is down to remove cables safely. Do not wear an ESD bracelet.
Answer: C
Explanation:
Comprehensive and Detailed Explanation:
The physical installation of high-performance NVIDIA components, such as H100 PCIe GPUs or BlueField DPUs, requires strict adherence to data center safety and hardware preservation standards. Option D is the only " 100% verified " procedure because it covers three critical pillars: Power, Compatibility, and Safety.
First, high-end GPUs can draw up to 300W-450W individually; verifying the server ' s PDU and internal PSU capacity is essential to prevent over-current shutdowns. Second, verifying cable compatibility (such as
12VHPWR or specific PCIe power 8-pin layouts) is vital to avoid electrical damage. Third, " Cold Service " (ensuring the server is powered down and cables are removed) is the standard for non-hot-plug PCIe components to prevent short circuits. Finally, wearing an ESD (Electrostatic Discharge) bracelet is non- negotiable when handling NVIDIA hardware, as static charges can destroy the sensitive HBM (High Bandwidth Memory) or the GPU die itself. Skipping ESD protection (as suggested in Option A) or performing the install while the system is " up and running " (as suggested in Option C) are leading causes of hardware infant mortality in AI infrastructure.
NEW QUESTION # 214
A 76-year-old man is brought by his family to your clinic with new-onset urinary incontinence. They state that the patient is experiencing a slowly progressing cognitive decline marked by memory disturbance, apathy, and attentional problems. Examination reveals that the patient has a stooped, forward-leaning posture and a wide-based gait. Which one of the following is the most likely diagnosis?
- A. Parkinson disease
- B. Lewy body dementia
- C. Normal pressure hydrocephalus
- D. Alzheimer disease
- E. Frontotemporal dementia
Answer: C
Explanation:
Comprehensive and Detailed Explanation:
This patient presents with the classic triad of normal pressure hydrocephalus (NPH): gait disturbance (often wide-based and magnetic), cognitive decline, and urinary incontinence. The combination, especially with the gait being most prominent, is highly suggestive.
Toronto Notes 2023 - Geriatrics / Neurology:
"NPH presents with gait disturbance, dementia, and urinary incontinence. Gait is typically broad-based and magnetic. Imaging shows ventriculomegaly without elevated pressure." MCCQE1 Objectives (Geriatrics > 41-1: Cognitive Disorders):
"Candidates must identify NPH and distinguish it from other dementias based on clinical triad and gait features." Alzheimer's (B) primarily presents with memory loss. Parkinson's (A) has bradykinesia and rigidity. Lewy body dementia (C) includes visual hallucinations and fluctuating cognition. FTD (E) has personality and behavioral changes.
NEW QUESTION # 215
A 51-year-old man comes to your clinic for follow-up regarding his type 1 diabetes. His hemoglobin A1c is
12.5% (normal 4-6%). He has never had such high blood sugar results. He drinks 2 beers per night to help with sleep. He is not well rested because he has been sleeping on a friend's couch since losing his job last year. Which one of the following is the best next step?
- A. Send him for thyroid function testing.
- B. Ask him to create a food journal and refer him to a dietitian.
- C. Ensure that he has the finances to adequately monitor his diabetes.
- D. Prescribe an antidepressant to improve his energy and motivation.
Answer: C
Explanation:
This patient is experiencing social instability (homelessness, job loss) likely contributing to poorly controlled diabetes. Before investigating or prescribing further, it is essential to address his ability to afford and manage self-monitoring and insulin.
Toronto Notes 2023 - Endocrinology, Diabetes:
"Social determinants such as housing insecurity and financial barriers significantly affect diabetes self- management. Addressing access to glucose monitoring and insulin is critical." MCCQE1 Objectives - Internal Medicine > Chronic Disease Management:
"Candidates must assess barriers to effective disease control, including financial and psychosocial limitations." Antidepressants (B) may be helpful later if depression is suspected. Thyroid testing (C) is not the priority. A dietitian (D) may help long-term, but immediate access and adherence are more urgent.
NEW QUESTION # 216
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