Free Medical Council of Canada Qualifying Examination Practice Questions

Sample Practice Questions

Try these 10 sample questions from the Medical Council of Canada Qualifying Examination practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1A patient arrives at a clinic with heavy vaginal bleeding. Which assessment should the physician prioritize initially?

   1. A.Assess the patient's circulatory stabilityCorrect answer: A
   2. B.Assess the patient's pregnancy status
   3. C.Assess the patient's hemoglobin level
   4. D.Assess the patient's uterine tenderness

   Explanation: The MCC objectives emphasize "first and foremost, the patient’s hemodynamic stability". Pregnancy status, blood count and pelvic assessment are important, but circulatory stability is the initial priority.

   Reference: MCC Medical Expert Examination Objectives — Vaginal bleeding, excessive/irregular/abnormal, Enabling Objectives, page 338

2. 2A child with diabetic ketoacidosis has received one hour of intravenous fluids. The serum potassium is 2.7 mmol/L. Which electrolyte should be replaced before starting insulin infusion?

   1. A.PotassiumCorrect answer: A
   2. B.Magnesium
   3. C.Phosphate
   4. D.Calcium

   Explanation: The CPS states, "Replace potassium before starting insulin if potassium levels are less than or equal to 3.0 mmol/L." This child's potassium of 2.7 mmol/L meets that condition.

   Reference: Current recommendations for management of paediatric diabetic ketoacidosis — Management recommendations, Insulin

3. 3A physician has explained a new anticoagulant and its bleeding risks to a patient. The patient nods but seems uncertain. Which next question most directly checks the patient's understanding of what to do?

   1. A.How would you explain your medication plan in your own words?Correct answer: A
   2. B.Would you like me to give you a written medication plan?
   3. C.Do you feel that you understood the medication plan?
   4. D.Would you like a family member to hear the medication plan?

   Explanation: The CMPA describes teach-back as "asking the patient to re-phrase what they have just been told and inviting them to ask questions." The other steps may support communication, but they do not directly establish what the patient understood.

   Reference: CMPA Good practices: Informed consent — Capacity to consent

4. 4In Ontario, a 15-year-old understands a proposed treatment and appreciates its foreseeable consequences. A parent accompanies the patient and wants to decide. From whom should the physician obtain consent for this treatment?

   1. A.The capable adolescentCorrect answer: A
   2. B.The accompanying parent
   3. C.The adolescent's legal guardian
   4. D.The adolescent's substitute decision-maker

   Explanation: The CPSO states, "If a minor is capable with respect to a treatment, the physician must obtain consent from the minor directly, even if the minor is accompanied by their parent or guardian." In Ontario, capacity is assessed for the treatment and is not determined by age alone.

   Reference: CPSO Guide to the Health Care Consent Act — Capacity, Incapacity, and Minors; Minors and Capacity

5. 5An adult with persistent cough, night sweats and hemoptysis is being evaluated for possible pulmonary tuberculosis. According to Canadian tuberculosis standards, what is the minimum number of sputum specimens to collect for microscopy and culture?

   1. A.One specimen
   2. B.Two specimens
   3. C.Three specimensCorrect answer: C
   4. D.Four specimens

   Explanation: The Canadian Tuberculosis Standards recommend "at least three (either spontaneous or induced) sputum specimens" for microscopy and culture when pulmonary tuberculosis is suspected. Three is the minimum; one or two fall below it, while four is more than the requested minimum.

   Reference: Canadian Tuberculosis Standards: Diagnosis of tuberculosis disease and drug-resistant tuberculosis — Chapter 3, section 3.1 Clinical samples, Recommendations

6. 6A patient develops anaphylaxis shortly after vaccination. Epinephrine for intramuscular injection is immediately available. Which injection site is recommended?

   1. A.Mid-anterolateral thighCorrect answer: A
   2. B.Deltoid region of the arm
   3. C.Ventrogluteal region of the hip
   4. D.Dorsogluteal region of the buttock

   Explanation: The Canadian Immunization Guide specifies the "mid-anterolateral aspect of the thigh (vastus lateralis muscle)" for intramuscular epinephrine. The deltoid is less effective for absorption; the other listed sites are not the recommended site for this emergency.

   Reference: Canadian Immunization Guide: Anaphylaxis and other acute reactions following vaccination — EPINEPHrine treatment - additional information

7. 7A patient with limited English is discussing a sensitive diagnosis. A trained medical interpreter is available, and the patient's adult son offers to translate. Which person is the best initial choice to support an accurate and confidential discussion?

   1. A.The patient's adult son
   2. B.A trained medical interpreterCorrect answer: B
   3. C.A bilingual family friend
   4. D.An untrained community volunteer

   Explanation: The CMPA explains that "it may be appropriate to use a trusted interpreter to assist with language impediments." It cautions that family members may filter sensitive information; they may assist with the patient’s permission when a translator is unavailable.

   Reference: CMPA Good practices: Patient-centred communication — Challenges to communicating – language factors

8. 8An Ontario patient is now incapable of a treatment decision. While capable, the patient expressed one wish about this treatment at age 15 and a different applicable wish at age 17. No later wish is known. What should guide the substitute decision-maker?

   1. A.The patient's applicable wish expressed at age 17Correct answer: A
   2. B.The substitute's own preferred treatment choice
   3. C.The treating physician's personal treatment preference
   4. D.The patient's earlier wish expressed at age 15

   Explanation: The CPSO states that the substitute must decide "in accordance with the most recent and known wish expressed by the patient while they were capable and at least 16 years old." Here the known applicable wish meets those conditions.

   Reference: CPSO Guide to the Health Care Consent Act — Once an SDM is Identified

9. 9A patient with a new, painless genital chancre has laboratory-confirmed syphilis. There is no rash or evidence of later complications. Which stage best fits this presentation?

   1. A.Primary syphilisCorrect answer: A
   2. B.Secondary syphilis
   3. C.Early latent syphilis
   4. D.Tertiary syphilis

   Explanation: The Canadian guide states that "The primary manifestation is a painless lesion (chancre)." Secondary disease typically presents with a rash; latent infection is asymptomatic, and tertiary disease has later complications.

   Reference: Syphilis guide: Risk factors and clinical manifestations — Clinical manifestations, Primary syphilis

10. 10A patient with suspected opioid overdose has markedly reduced breathing. Emergency support is being arranged. Which medication reverses opioid effects temporarily?

    1. A.NaloxoneCorrect answer: A
    2. B.Flumazenil
    3. C.Fomepizole
    4. D.N-acetylcysteine

    Explanation: The Public Health Agency of Canada states, "Naloxone is a drug that temporarily reverses the effects of opioid medications." The other agents are used for different poisoning situations and do not serve as the opioid antagonist.

    Reference: Chief Public Health Officer statement: Pharmacists help address the opioid public health crisis — Learn how to administer naloxone