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Medical Council of Canada Qualifying Examination Part 1 Exam
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You are covering for your colleague who is on vacation this week. You receive the resultsfrom an ultrasonography that had been ordered for a 32-year-old woman, gravida 2, para 1,aborta 0. The ultrasonography-estimated fetal weight is below the fifth percentile for 30weeks' gestation; gestational age was confirmed by an earlier ultrasonogram. The amnioticfluid volume is within normal range. Her first child's birth weight was 2800 g at full term.Which one of the following is the best next step?
A 34-year-old man sustained a blunt testicular trauma 2 hours ago. On physicalexamination, the patient has a 1.5-cm tall scrotal hematoma. You cannot palpate thetesticle. Which one of the following is the best initial management?
A 29-year-old woman presents with vaginal spotting after 6 weeks of amenorrhea. She isasymptomatic otherwise. Serum -hCG is 2150 IU/L, and pelvic ultrasound shows an emptyuterus. She has been trying to conceive for 7 months. Which one of the following is thebest next step?
A 55-year-old woman presents with a 6-month history of poor memory and impairedconcentration. She has bipolar I disorder that has been treated with lithium carbonate for 4years. She has gained a lot of weight since starting lithium. Physical examination findingsare otherwise normal. She is concerned about her memory issues, but there are no otherperception, mood, or cognition abnormalities. Which one of the following tests is most likelyto have abnormal findings?
You are being consulted for a 79-year-old man who is about to undergo a total hiparthroplasty. His orthopedic surgeon is aware of the diagnosis of Alzheimer disease andwould like your suggestions to help avoid acute postsurgical delirium. To that end, whichone of the following is the most effective strategy?
A 44-year-old woman presents to the office to discuss contraception. During thegynecologic examination, you notice an anterior cystocele to the hymenal ring. The womandenies any bulge symptoms but does report dribbling of urine, especially when she coughsor jogs.Which one of the following is the best next step?
A 30-year-old woman presents to the office with her partner and reports that they areplanning for her to conceive soon. They visited Mexico recently and are concerned aboutexposure to the Zika virus. Which one of the following is the best next step?
A 34-year-old woman, gravida 3, para 2, aborta 0, presents at 38 weeks' gestation. She isin early labor with ruptured membranes. Her previous pregnancy was complicated by feverduring labor. Which one of the following would increase the risk of fever recurrence?
A 58-year-old woman presents with a 1-year history of functional decline. She reportsseeing rodents and little children invading her bedroom. Her partner tells you she has aslow, unsteady gait and tends to fall. On examination, she cannot sustain her attentionduring cognitive testing. Which one of the following is most likely to be found on brainimaging?
You are counselling the wife of a 75-year-old man admitted under your care after a fall. Thepatient is confused, disoriented, barely sleeps at night and has complex visualhallucinations of animals running through his room. Given his state, which one of thefollowing is the best advice for the wife?