MCCQE Medical Council of Canada Exam Lab Questions

Accurate dating is critical in pregnancies at high risk for preeclampsia and intrauterine growth restriction. First-trimester ultrasound is used to establish gestational age, which guides monitoring and interventions.

Toronto Notes 2023 – Obstetrics, High-Risk Pregnancy:

“In women with a history of preeclampsia, early and accurate dating allows for appropriate fetal surveillance and timely delivery.”

MCCQE1 Objectives – Obstetrics > Prenatal Care:

“Candidates should recognize the importance of accurate pregnancy dating in high-risk pregnancies.”

Prophylactic labetalol (E) is not indicated in normotensive patients. Genetic testing (A, B) is not appropriate unless additional risk factors are present. Bed rest (D) is not evidence-based for preeclampsia prevention.

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MCCQE objectives emphasize the distinction between ethical obligations and legal duties in emergency “Good Samaritan” situations. Physicians generally do not have a legal obligation to provide care outside of a formal physician–patient relationship, nor are they legally required to accompany a patient to hospital. Good Samaritan laws are designed primarily to protect healthcare providers from liability when they voluntarily provide emergency assistance in good faith and within the scope of their competence; they do not compel physicians to act.

Professional ethical standards, however, state that physicians should render reasonable assistance in emergencies , considering their own safety, competence, and available resources. This reflects the profession’s commitment to beneficence and social responsibility. In this case, the physician appropriately provided emergency resuscitation. Subsequent poor outcome (irreversible brain injury due to hypoglycemia) does not imply negligence if care was reasonable and provided in good faith. Therefore, the most accurate statement is that professional ethics require physicians to render reasonable

This child presents with bilateral red, itchy, watery eyes for 2 weeks without purulent discharge, pain, or visual changes—classic features of allergic conjunctivitis . MCCQE objectives emphasize distinguishing allergic conjunctivitis from infectious causes. Allergic conjunctivitis is characterized by pruritus (key symptom), tearing, conjunctival injection, and often a history of atopy or seasonal triggers. Vision remains normal, and there is no mucopurulent discharge (which would suggest bacterial infection) or vesicular lesions/dendritic ulcers (suggesting viral/herpetic causes).

Topical antihistamines (often combined with mast cell stabilizers) are first-line therapy and effectively reduce itching and redness by blocking histamine-mediated inflammation.

Topical antibiotics are unnecessary without bacterial features. Antivirals are reserved for suspected herpetic disease. Antifungals are rarely indicated in routine conjunctivitis. Topical glucocorticoids are not first-line and may cause adverse effects (e.g., increased intraocular pressure) and should only be used under ophthalmologic supervision.

Therefore, a topical antihistamine is the most appropriate initial treatment.

Persistent bloody diarrhea with negative stool cultures and ova/parasite testing in an older adult suggests inflammatory bowel disease (IBD) or another colitis such as ischemic or microscopic colitis. Colonoscopy is the best next diagnostic step to evaluate for ulcerative colitis, Crohn disease, ischemic colitis, or malignancy.

Toronto Notes 2023 – Gastroenterology, " Inflammatory Bowel Disease " :

“Persistent bloody diarrhea with negative infectious work-up should prompt colonoscopic evaluation to rule out IBD or other forms of colitis.”

MCCQE1 Objectives (Internal Medicine > Gastrointestinal > 47-1):

“Candidates must assess and investigate chronic or persistent diarrhea. In the presence of red flag features such as bleeding, weight loss, or anemia, colonoscopy is indicated.”

Antibiotics (A) are not indicated with negative stool cultures. Observation (C) and loperamide (D) risk delaying diagnosis. Steroids (E) may be required later but only after confirmation of diagnosis.