Free Medical Council of Canada MCCQE Exam Questions

A 38-year-old man is brought by his wife to the Emergency Department with fatigue, dizziness, and nauseaafter completing a hiking tour on a hot, humid day. His wife became worried after he had collapsed. He hasbeen sweating heavily and vomited twice on the drive in. His medical history is unremarkable, and he takesno medications. His vital signs on arrival are as follows:Blood pressure85/57 mm HgHeart rate120/minRespiratory rate18/minTemperature40.1 °COxygen saturation95%, room air—On physical examination, the patient's skin is dry, flushed, and warm to the touch. He has a diffuseerythematous papular rash. Findings of a thorough physical examination are otherwise unremarkable. Anelectrocardiogram shows sinus tachycardia. Which one of the following is the best next step?

A 25-year-old woman presents to the Emergency Department with a 4-hour history of severe left flank pain.Her vital signs are as follows:Heart rate: 94/minBlood pressure: 130/80 mm HgTemperature: 37.3 °CA non-contrast computed tomography shows a 6 mm stone in the distal left ureter with mild associatedhydronephrosis. In addition to appropriate analgesia, which one of the following is the best next step?

A 4-month-old girl is brought by a parent to your clinic with a history of recurrent vomiting since birth. Shecries with feeding and has not gained weight in the last 2 weeks. Her hemoglobin level is 95 g/L (100–125).The patient is currently being fed thickened hypoallergenic formula. Which one of the following is the mostappropriate therapy?

An 83-year-old woman presents to your office with a 2-day history of confusion. Her past medical history is significant for lung cancer, and she is being treated with radiation. On physical examination, she is euvolemic. Her blood work reveals a serum sodium of 118 mmol/L (135–140) as compared with 134 mmol/L (8 days ago). Which one of the following will be most helpful in establishing the cause of her laboratory abnormality?

A 4-month-old boy is brought to the office by his parents to ask about the rotavirus vaccine. They would liketo avoid the possibility of the infant coming down with gastroenteritis. Their older child was hospitalized withgastroenteritis at age 10 months. They have a friend who had intussusception after getting the rotavirusimmunization, and they are worried about a possible link to the vaccine. Which one of the following is themost appropriate response?