Medical Council of Canada MCCQE 問題集 : MCCQE Part 1 Exam

A 56-year-old woman is admitted to hospital with gastrointestinal bleeding. Her hemoglobin level is low and the physician who saw her in the Emergency Department has recommended a blood transfusion. You attend her on the unit and tell her that a blood transfusion will help her feel better. Which one of the following is the best next step?

• A. Review the patient's chart to see if she consented to transfusions in the past.
• B. Discuss with the patient the potential risks and benefits of having a transfusion.
• C. Give the patient a blood transfusion before her condition becomes unstable.
• D. Ask a colleague to see the patient and make the same recommendation.
• E. Withhold the transfusion to avoid any risk for liability.

One of your patients presents to your clinic for a consultation regarding their recurrent hemoptysis. On review of their chart, you realize that although you had ordered chest radiography 2 months ago, the result cannot be found in the chart. You call the radiology department and are relieved to find that the chest radiography was done and that it did not reveal any pathology. After informing the patient of this lapse in reporting, which one of the following is the best next step?

• A. Review your clinic ' s filing procedures and make any needed improvements.
• B. Send a letter of complaint to the radiology department for not sending a report.
• C. Remind the patient that they are responsible for calling for outstanding test results.
• D. Reassure the patient that this is a rare occurrence in your clinic.

A 35-year-old maintenance worker presents to your office because he thinks he has been exposed to asbestos and is afraid of developing asbestosis. He has no respiratory symptoms and is a non-smoker. Which one of the following is the best next step?

• A. Refer him to a respirologist.
• B. Ask him further about his work.
• C. Order pulmonary function testing.
• D. Order a chest radiograph.
• E. Provide reassurance, since he is asymptomatic.

A 47-year-old man has been training for a marathon. After a long run, he develops mild pain and swelling in his left knee. Examination shows a mild joint effusion and a soft tissue mass in the popliteal fossa. The knee radiograph is normal. Which one of the following is the best method of confirming the diagnosis?

• A. Arthrocentesis.
• B. Ultrasound.
• C. Arthroscopy.
• D. Computed tomography.
• E. Aspiration of the popliteal mass.

The developers of a urinary protein dipstick test have indicated that they have reduced the problem of false positive results by changing the test so that it becomes positive at a higher concentration of protein. Which one of the following statements best describes how this screening test will be affected?

• A. The positive predictive value will remain the same.
• B. The accuracy of the test will be reduced.
• C. The validity of the test will be reduced.
• D. There will be more false negatives.
• E. Both sensitivity and specificity will improve.