MCCQE Part1 Test Trial
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1 / 10

A 28 year old non-smoking Female presents for a follow-up appointment with her primary care physician. At a routine health maintenance visit 6 months earlier, her blood pressure was 182/95 mm Hg. Since then she has adhered to a low-fat diet and exercises regularly. On repeat measurement 2 months later, her blood pressure was still elevated, despite her compliance with the prescribed diuretics and ACEI. Today, she has no complaints and denies any headaches, chest pain, or mental status changes. On physical examination, she is a thin young woman with a clear chest. On abdominal examination, a continuous bruit that localized to the left of her umbilicus is heard. Her blood pressure is 179/ 98 mm Hg in her left arm and 183/ 96 mm Hg in her right arm. A complete blood count is within the normal range. What is the most appropriate next step in the management of this patient?

 

2 / 10

A 37 year-old schizophrenic patient visits her psychiatrist because her caregiver has noticed that she has recently developed involuntary, stereotyped facial grimacing, and repetitive thrusting of the tongue. The patient began haloperidol therapy 6 months prior to the visit. Both the patient and her psychiatrist conclude that the patient continues to require treatment for her psychotic symptoms, so the psychiatrist writes a prescription for a different medication. The new medication still has antipsychotic properties but is less frequently reported to contribute to oromotor symptoms. What is a serious adverse effect of the new medication most likely prescribed by the psychiatrist?

3 / 10

A 8 year-old kid is brought to his pediatrician by his mother after a troubling parent-teacher conference. The teacher informed the mother that the child is disruptive in class and generally does not finish his homework assignments. The mother reports that the child’s room is always messy and that he has difficulty completing chores in a timely fashion. In the office, the child is restless and interrupts his mother often. Which of the following is the most likely diagnosis?

4 / 10

A group of researchers conducted a large double-blind, randomized trial comparing the efficacy of a new antibiotic with penicillin in treating streptococcal pneumonia. The results showed that 95% of the patients taking the new antibiotic cleared their pneumonia, while 90% of those taking penicillin cleared their pneumonia. A Large sample size was chosen in order to generate a statistical power of 80% with a P value of .21. Which of the following represents the probability that there is a difference between the two treatment groups despite the study’s failure to show this difference?

5 / 10

A 73 year old patient complains of a 5 months history of low back and buttock pain that worsens with walking and is relieved by sitting or bending forward. He has hypertension and takes ACEI but has otherwise been healthy. There is no history of back trauma, fever, or weight loss. On examination, the patient has a slightly stooped posture, pain on lumbar extension, and has a slightly wide-based gait. Popliteal pulses are normal bilaterally. The examination of peripheral joints and skin is normal. What is the most likely diagnosis?

6 / 10

A 24 year-old woman has a known family history of breast cancer in her first-degree relatives. She undergoes genetic testing and is found to be a BRCA1 mutation carrier. She does not currently desire bilateral prophylactic mastectomy. Which of the following is the next best option to manage her risk for breast cancer?

7 / 10

A 60 year-old black male non-smoker is seen with a history of dyspnea on walking two blocks and chronic chest congestion and cough. He has been followed for progressive shortness of breath after his CABG. Recently, he was ill with a flu-like illness, but he denies any fever or chills presently. Past history reveals a GI clinic follow-up for inflammatory bowel disease for which he has been on chronic steroid therapy off and on. On physical examination, vital signs are pulse 111 bpm; temperature normal; respirations 22/min; blood pressure 110/76 mm Hg. General exam: The patient appears frail but in no distress. Pertinent findings: coarse rhonchi and scattered expiratory wheeze with squeaks. Heart exam reveals normal S1-S2 with no gallop. There is no hepatomegaly or pedal edema. Laboratory data: Hb 11.2 g; Hct 34%; WBCs 16.0/µL; differential normal. PFTs/spirometry: FVC 3.43 L (78% of predicted); FEV1: 2.16 L (63% of predicted); FEV1/FVC 73%; TLC 5.33 L (69% of predicted); DLCO 14 cc/min/mm Hg (57% of predicted). An echocardiogram shows an ejection fraction of 55% with no focal dyskinesia. The chest radiograph is shown. Which of the following risks might increase during therapy in this patient?

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8 / 10

A 40-year-old woman presents to a psychiatrist after a referral from her family physician due to the fact that she feels anxious all of the time. Her family physician diagnosed her with a generalized anxiety disorder and prescribed buspirone; however, the patient does not report feeling any better. She works as a computer programmer and spends most of her day in a private cubicle. She has no close friends and lives by herself. She says that occasionally people from work invite her out at night, but she never goes (even though she would like to). She is not dating currently and is worried that people won’t like her. Which of the following personality disorders best describes this patient?

9 / 10

A 28 year old African American male presents to the emergency room and is diagnosed as having a urinary tract infection. After 2 days of antibiotics, the patient becomes jaundiced. His hematocrit is 31% (decreased from 42% on admission), reticulocyte count is 5%, and indirect bilirubin value is 5.5 mg/dL. Peripheral blood smear demonstrates Heinz bodies. The patient recalls a similar problem when he has given antibiotics 7 years ago for acute sinusitis. What is the most likely cause of his condition?

10 / 10

A 43 year old woman presents to her private physician with the chief complaint of hoarseness. She is a teacher her friends noticed a voice change. Her past medical history is significant for heart arrhythmias, which are well controlled for 3 years with amiodarone. Physical examination reveals a woman with coarse hair and dry skin. Her fingernails are thick and her eyes appear puffy. The thyroid gland is normal and nontender. Her muscle strength is excellent, but the relaxation phase of her ankle reflex is prolonged. Which of the following is the most likely diagnosis?

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