MCCQE 試験問題を無料オンラインアクセス

A 1-week-old boy born at full term is brought by his parents to the office with a 2-day history of eye swelling and watery discharge. This morning, the discharge became thick and yellow. On physical exam, he is afebrile and fussy with bilateral eyelid edema, purulent discharge, and erythematous conjunctivae. After taking appropriate cultures of the eyes, which one of the following is the best next step?

• A.Admit the patient and start antibiotic therapy
• B.Prescribe an oral antibiotic and reassess in 48 hours
• C.Recommend lacrimal sac massage
• D.Reassure the parents and prescribe a topical antibiotic
• E.Advise warm compresses every 2 to 3 hours until discharge is cleared

A 30-year-old woman presents to your office for a follow-up assessment of a sports-related musculoskeletal injury to her right leg. She requests a letter for her employer regarding her return to work. You feel she should be able to manage some aspects of her factory work. Which one of the following is most appropriate to include in your medical note to this patient's employer?

• A.Required workplace accommodations
• B.Treatment options
• C.Medical imaging results
• D.Physiotherapist's evaluation
• E.Diagnosis

A 66-year-old woman has a 3-month history of dry cough and weight loss. A new chest radiograph reveals a large 2-cm mass in her right upper lobe, which is consistent with carcinoma. You look at her previous films and realize that you had read her chest radiograph as normal 1 year ago, but now clearly see a faint opacity in precisely the same location as her current lesion. Which one of the following is the best next step?

• A.Write a report only after communicating with your professional insurer
• B.Comment on the previous chest radiograph and the new one in your report
• C.Prepare a report only after communicating with your department head
• D.Create a report only after communicating with your medical regulatory authority
• E.Remark only on the new chest radiograph in your report

A 14-year-old girl, accompanied by her mother, presents to your office with a 3-month history of feeling
"dizzy." After you take an initial history, which one of the following is the most appropriate next step?

• A.Do a bedside glucometer reading
• B.Interview the girl without the mother present
• C.Perform a detailed cardiac and neurological examination
• D.Obtain growth parameters and vital signs
• E.Order a urine pregnancy test

A 25-year-old woman presents to the Emergency Department with a 4-hour history of severe left flank pain.
Her vital signs are as follows:
* Heart rate: 94/min
* Blood pressure: 130/80 mm Hg
* Temperature: 37.3 °C
A non-contrast computed tomography shows a 6 mm stone in the distal left ureter with mild associated hydronephrosis. In addition to appropriate analgesia, which one of the following is the best next step?

• A.Prescribe antibiotics
• B.Refer for urology consultation
• C.Increase intravenous fluids
• D.Administer an alpha blocker
• E.Provide reassurance