MCCQE1 exam “Medical Council of Canada Qualifying
Examination Part I.” EXAM 2026-2027 LATEST VERSION
QUESTIONS AND VERIFIED CORRECT ANSWERS JUST
RELEASED
A 19-year-old college freshman comes to the university health clinic because of
recurrent episodes of wheezing during basketball practices. He has been a starting
shooting guard for this team and has usually been hampered by shortness of breath
shortly after beginning practice and during games. The symptoms are accompanied by a
nonproductive cough and chest tightness. He denies and symptoms at rest. The
symptoms occur whether the practices are indoors or outdoors. On physical
examination, he is comfortable and denies any symptoms. His physical examination is
unremarkable. Which of the following cells are most likely to mediate his symptoms?
- Eosinophils
- Lymphocytes
- Mast cells
- Monocytes
- Neutrophils - answer>>>Mast cells
Suspect exercise-induced asthmam due to mast cell release of histamines
Rx: prophylactic administration of inhaled cromolyn
Eosinophils: allergen-induced asthma
A 64-year-old patient with a long history of "heart burn" comes to the ED with 6
episodes of haematemesis. He denies alcohol use, smoking, or drug use. He also denies
significant nonsteroidal antiinflammatory drug use. He has no known liver disease. His
laboratory results are normal with the exception of a haemoglobin of 7.1 gm/dL. He is
taken for an emergent oesophageal gastroduodenoscopy, which reveals a gastric ulcer
with a bleeding visible vessel. Compared with duodenal ulcer, which of the following
statements about gastric ulcers is correct?
- Better response to medication
- Less commonly associated with significant gastrointestinal bleeding
- Lower gastric pH
- More commonly associated with H. pylori
- More commonly associated with malignancy - answer>>>More commonly associated
with malignancy
,A 9-year-old boy is brought to the paediatric clinic by his mother, who noticed that the
left side of his mouth has started to droop over the past several days. In addition, he is
unable to close his left eye completely and complains of it burning. Review of systems
reveals a cold approximately 2 weeks ago and recent decreased taste sensation.
Physical sensation reveals a well nourished male with normal vital signs. There is left eye
ptosis and mild erythema of the left conjunctiva. His smile is asymmetrical on the left.
Laboratory evaluation, including a complete blood count and chemistry profile, are
normal. Which of the following infections is most closely associated with this patients
condition?
- EBV
- Group A Streptococcus
- HIV
- Influenza
- Measles - answer>>>EBV
Bell palsy: post-infectious allergic or immune demyelinating facial neuritis. EBV is
preceding infection in ~20% of cases. 85% of patients have their symptoms resolve on
their own over a period of several weeks and 5% have permanent severe facial
weakness
A patient with AIDS and a CD4 cell count of 16 comes to medical attention because of
the recent onset of motor and sensory neurologic deficits and mental status changes.
CSF examination reveals mild lymphocytosis. Neuroimaging studies show multiple ill-
defined areas of T2 changes, interpreted as evidence of demyelination. These areas are
located in the white matter of both cerebral hemispheres and cerebellum. Which of the
following is the most likely diagnosis?
- AIDS-dementia complex
- Cerebral toxoplasmosis
- CMV encephalitis
- Progressive multifocal leukoencephalopathy
- Multiple sclerosis` - answer>>>Progressive multifocal leukoencephalopathy (PML)
The history of severe HIV-related immune compromise and evidence of destruction of
myelin at multiple sites in the CNS points to PML. This condition is caused by JC virus - a
parvovirus that produces asymptomatic infections in immunocompetent hosts.
AIDS-dementia complex: no focal brain lesions, progressive dementia, often associated
with incontinence and disorientation
Cerebral toxoplasmosis: round, well-circumscribed lesions that shows a peripheral rim
of contrast enhancement
,CMV encephalitis: predilection for periventricular gray matter and ependyma, as well as
the retina
MS: does not develop in the context of immune impairment; demyelinating plaques are
typically well-demarcated and most commonly located in periventricular regions
A 20-year-old college football player is rushed to the ED after being knocked
unconscious during a training session. The accident occurred when a linebacker
accidentally head butted the patient during a pass rush. He was "out of it" for
approximately 2 minutes. Although the other player was "shaken-up," he sustained no
serious injuries. Currently he cannot remember any of the events just before the
accident or just after the accident. He complains of a severe headache and tingling in his
left hand. His temperature is 37 C, BP 110/60, pulse 73, and RR 18. He is in mild distress.
There is a contusion above his right eye but no other signs of trauma. Neurologic
examination reveals a slight decrease in strength in his left eye but is otherwise within
normal limits. Which of the following is the most appropriate next step in management?
- CT scan of head
- Intubation, hyperventilation, and mannitol
- Reassurance, acetamin - answer>>>CT scan of head
Suspect epidural or subdural haematoma
A 75-year-old man is brought to the physician by his daughter because of "forgetfulness
and "disorientation" that has been gradually worsening over the past 2 years. She is
concerned that he may leave the house and get lost. HE has been confused and
disorientated from time to time, but last week on 2 occasions he left the house and the
neighbours found him in the street. He is forgetful, misplaces things, and often gets
confused when he tries to dress himself. He often insists that he has taken a bath when
in fact he has not. The family has to take care of his bills because he can no longer
manage his money. He has not suffered any major illnesses in the past. A complete
evaluation rules out thyroid disease, metabolic and endocrine disorders, depression,
drug effects, vitamin deficiencies, vascular disease, infectious disease, and normal
pressure hydrocephalus. MSE reveals cognitive deficits. Which of the following n -
answer>>>Acetylcholine
ACh is known to modulate attention, novelty seeking, and memory by way of basal
forebrain projections to cortex and limbic structures. In Alzheimer dementia there is a
deficit of ACh, causing cognitive deficits.
Dopamine: Parkinson disease and related subcortical dementias
Glutamate: formation of long-term memory - stroke, seizures, and neuronal cell death
Norepinephrine: modulates sleep cycles, mood, appetite, and cognition
, Serotonin: mood disorders
A 10-year-old girl is brought to the physician by her parents. She was recently diagnosed
with generalised tonic-clonic epilepsy during a clinic visit that her grandmother took her
to. Both of her parents are concerned with the diagnosis and are seeking advice
regarding what they should do when the child has a seizure. Which of the following
suggestions is appropriate?
- Call an ambulance immediately as soon as seizure begins
- Put something in the child's mouth at onset of seizure
- Try to place the child on her side during the seizure
- Try to restrain the child during the seizure
- Do not allow the child to return to her activities after recovery - answer>>>Try to place
the child on her side during the seizure
During a seizure episode DO:
- Place the patient on their side
- Put a pillow/soft object under head
- Loosen tight clothing around the neck
- Remove sharp objects from surroundings
DON'T:
- Put any object into patient's mouth
- Call ambulance unless lasts >10 mins
- Try to restrain the patient
After the seizures, remains with the patient until he/she is full alert and allow him/her
to return to usual activities.
A 29-year-old man is brought to the ED in a comatose state a few hours after
complaining of sudden onset of excruciating headache. His friend does not know if the
patient has any underlying medical conditions. Neurological examination reveals dilated
pupils poorly responsive to light. A CT scan of the head without contrast demonstrates
hyperdensity within the suprasellar cistern, while MRI is unremarkable. Lumbar
puncture shows haemorrhagic CSF. Which of the following is the most likely diagnosis?
- Amyloid angiopathy-related haemorrhage
- Caverous sinus thrombosis
- Haemorrhagic infarction
- Pituitary apoplexy
- Ruptured berry aneurysm - answer>>>Ruptured berry aneurysm
Rupture of berry aneurysm is most common cause of subarachnoid bleeding
Examination Part I.” EXAM 2026-2027 LATEST VERSION
QUESTIONS AND VERIFIED CORRECT ANSWERS JUST
RELEASED
A 19-year-old college freshman comes to the university health clinic because of
recurrent episodes of wheezing during basketball practices. He has been a starting
shooting guard for this team and has usually been hampered by shortness of breath
shortly after beginning practice and during games. The symptoms are accompanied by a
nonproductive cough and chest tightness. He denies and symptoms at rest. The
symptoms occur whether the practices are indoors or outdoors. On physical
examination, he is comfortable and denies any symptoms. His physical examination is
unremarkable. Which of the following cells are most likely to mediate his symptoms?
- Eosinophils
- Lymphocytes
- Mast cells
- Monocytes
- Neutrophils - answer>>>Mast cells
Suspect exercise-induced asthmam due to mast cell release of histamines
Rx: prophylactic administration of inhaled cromolyn
Eosinophils: allergen-induced asthma
A 64-year-old patient with a long history of "heart burn" comes to the ED with 6
episodes of haematemesis. He denies alcohol use, smoking, or drug use. He also denies
significant nonsteroidal antiinflammatory drug use. He has no known liver disease. His
laboratory results are normal with the exception of a haemoglobin of 7.1 gm/dL. He is
taken for an emergent oesophageal gastroduodenoscopy, which reveals a gastric ulcer
with a bleeding visible vessel. Compared with duodenal ulcer, which of the following
statements about gastric ulcers is correct?
- Better response to medication
- Less commonly associated with significant gastrointestinal bleeding
- Lower gastric pH
- More commonly associated with H. pylori
- More commonly associated with malignancy - answer>>>More commonly associated
with malignancy
,A 9-year-old boy is brought to the paediatric clinic by his mother, who noticed that the
left side of his mouth has started to droop over the past several days. In addition, he is
unable to close his left eye completely and complains of it burning. Review of systems
reveals a cold approximately 2 weeks ago and recent decreased taste sensation.
Physical sensation reveals a well nourished male with normal vital signs. There is left eye
ptosis and mild erythema of the left conjunctiva. His smile is asymmetrical on the left.
Laboratory evaluation, including a complete blood count and chemistry profile, are
normal. Which of the following infections is most closely associated with this patients
condition?
- EBV
- Group A Streptococcus
- HIV
- Influenza
- Measles - answer>>>EBV
Bell palsy: post-infectious allergic or immune demyelinating facial neuritis. EBV is
preceding infection in ~20% of cases. 85% of patients have their symptoms resolve on
their own over a period of several weeks and 5% have permanent severe facial
weakness
A patient with AIDS and a CD4 cell count of 16 comes to medical attention because of
the recent onset of motor and sensory neurologic deficits and mental status changes.
CSF examination reveals mild lymphocytosis. Neuroimaging studies show multiple ill-
defined areas of T2 changes, interpreted as evidence of demyelination. These areas are
located in the white matter of both cerebral hemispheres and cerebellum. Which of the
following is the most likely diagnosis?
- AIDS-dementia complex
- Cerebral toxoplasmosis
- CMV encephalitis
- Progressive multifocal leukoencephalopathy
- Multiple sclerosis` - answer>>>Progressive multifocal leukoencephalopathy (PML)
The history of severe HIV-related immune compromise and evidence of destruction of
myelin at multiple sites in the CNS points to PML. This condition is caused by JC virus - a
parvovirus that produces asymptomatic infections in immunocompetent hosts.
AIDS-dementia complex: no focal brain lesions, progressive dementia, often associated
with incontinence and disorientation
Cerebral toxoplasmosis: round, well-circumscribed lesions that shows a peripheral rim
of contrast enhancement
,CMV encephalitis: predilection for periventricular gray matter and ependyma, as well as
the retina
MS: does not develop in the context of immune impairment; demyelinating plaques are
typically well-demarcated and most commonly located in periventricular regions
A 20-year-old college football player is rushed to the ED after being knocked
unconscious during a training session. The accident occurred when a linebacker
accidentally head butted the patient during a pass rush. He was "out of it" for
approximately 2 minutes. Although the other player was "shaken-up," he sustained no
serious injuries. Currently he cannot remember any of the events just before the
accident or just after the accident. He complains of a severe headache and tingling in his
left hand. His temperature is 37 C, BP 110/60, pulse 73, and RR 18. He is in mild distress.
There is a contusion above his right eye but no other signs of trauma. Neurologic
examination reveals a slight decrease in strength in his left eye but is otherwise within
normal limits. Which of the following is the most appropriate next step in management?
- CT scan of head
- Intubation, hyperventilation, and mannitol
- Reassurance, acetamin - answer>>>CT scan of head
Suspect epidural or subdural haematoma
A 75-year-old man is brought to the physician by his daughter because of "forgetfulness
and "disorientation" that has been gradually worsening over the past 2 years. She is
concerned that he may leave the house and get lost. HE has been confused and
disorientated from time to time, but last week on 2 occasions he left the house and the
neighbours found him in the street. He is forgetful, misplaces things, and often gets
confused when he tries to dress himself. He often insists that he has taken a bath when
in fact he has not. The family has to take care of his bills because he can no longer
manage his money. He has not suffered any major illnesses in the past. A complete
evaluation rules out thyroid disease, metabolic and endocrine disorders, depression,
drug effects, vitamin deficiencies, vascular disease, infectious disease, and normal
pressure hydrocephalus. MSE reveals cognitive deficits. Which of the following n -
answer>>>Acetylcholine
ACh is known to modulate attention, novelty seeking, and memory by way of basal
forebrain projections to cortex and limbic structures. In Alzheimer dementia there is a
deficit of ACh, causing cognitive deficits.
Dopamine: Parkinson disease and related subcortical dementias
Glutamate: formation of long-term memory - stroke, seizures, and neuronal cell death
Norepinephrine: modulates sleep cycles, mood, appetite, and cognition
, Serotonin: mood disorders
A 10-year-old girl is brought to the physician by her parents. She was recently diagnosed
with generalised tonic-clonic epilepsy during a clinic visit that her grandmother took her
to. Both of her parents are concerned with the diagnosis and are seeking advice
regarding what they should do when the child has a seizure. Which of the following
suggestions is appropriate?
- Call an ambulance immediately as soon as seizure begins
- Put something in the child's mouth at onset of seizure
- Try to place the child on her side during the seizure
- Try to restrain the child during the seizure
- Do not allow the child to return to her activities after recovery - answer>>>Try to place
the child on her side during the seizure
During a seizure episode DO:
- Place the patient on their side
- Put a pillow/soft object under head
- Loosen tight clothing around the neck
- Remove sharp objects from surroundings
DON'T:
- Put any object into patient's mouth
- Call ambulance unless lasts >10 mins
- Try to restrain the patient
After the seizures, remains with the patient until he/she is full alert and allow him/her
to return to usual activities.
A 29-year-old man is brought to the ED in a comatose state a few hours after
complaining of sudden onset of excruciating headache. His friend does not know if the
patient has any underlying medical conditions. Neurological examination reveals dilated
pupils poorly responsive to light. A CT scan of the head without contrast demonstrates
hyperdensity within the suprasellar cistern, while MRI is unremarkable. Lumbar
puncture shows haemorrhagic CSF. Which of the following is the most likely diagnosis?
- Amyloid angiopathy-related haemorrhage
- Caverous sinus thrombosis
- Haemorrhagic infarction
- Pituitary apoplexy
- Ruptured berry aneurysm - answer>>>Ruptured berry aneurysm
Rupture of berry aneurysm is most common cause of subarachnoid bleeding
