The Medical Council of Canada Qualifying Examination (MCCQE) Part I is an important milestone for medical students, signifying a culmination of years of training in basic science and clinical medicine. The Medical Council of Canada (MCC) recommends numerous separate texts as reference for this exam preparation. Such a vast reading list is neither a practical nor a feasible means of approaching this critical exam for most candidates. The singular intent of this text is to provide a succinct yet complete review for the MCCQE Part I using the most efficient and effective means.

This book is based entirely on the MCC’s O bjectives for the Q ualifying Examination, 3rd edition, which “lay out exactly what you have to know for any of the MCC examinations.” This text contains only the specific and essential information required to meet the O bjectives—all extraneous information has been deliberately omitted.

This text avoids time-wasting prose and effusive lists. Information is presented only in concise and easily assimilated visual formats. A focus on tables and flow charts allows complex and detailed concepts to be swiftly and effectively reviewed for comprehension and retention. Text within boxes signals the reader to key competencies highlighted by the O bjectives.

This text is a collaborative project that combines the perspective and insights of students preparing for the examination with the experience of residents and acumen of faculty. The result is a novel and innovative resource to aid in the process of preparing for the MCCQE Part I. As medical school curricula are becoming more tailored to the exam, we believe it will also prove useful in your general studies as well.

Contents

۱. Introduction 1
۲. What is the MCCQE Part I? 1
۳. How to Use this Text? 2
۴. Clinical Presentation: Objectives Based 2
۵. CanMEDS 4
۶. Health Advocate 4
۷. Collaborator 6
۸. Communicator 9
۹. Leader (formerly Manager) 11
۱۰. Professional 13
۱۱. Scholar 17
۱۲. Legal, Ethical and Organizational Aspects of Medicine 19
۱۳. CanMEDS Summary 27
۱۴. Cardiology 31
۱۵. Hypertension 31
۱۶. Hypertensive Crises: Emergencies and Urgencies 35
۱۷. Pregnancy-Associated Hypertension 37
۱۸. Heart Failure 39
۱۹. Hypotension 42
۲۰. Anaphylaxis 45
۲۱. Chest Pain 46
۲۲. Cardiac Arrest 52
۲۳. Syncope 55
۲۴. Abnormal Pulse 57
۲۵. Dyslipidemia 60
۲۶. Abnormal Heart Sounds 63
۲۷. Systolic and Diastolic Murmurs 64
۲۸. Palpitations 68
۲۹. Dermatology 75
۳۰. Skin Rash, Macules 75
۳۱. Skin Rash, Papules 78
۳۲. Skin Tumors / Ulcers 83
۳۳. Skin Rash, Vesicles / Bullae 86
۳۴. Pruritus 87
۳۵. Hair Disorders 90
۳۶. Nail Disorders 91
۳۷. Dermatologic Emergencies 93
۳۸. Skin Changes in Systemic Disease 93
۳۹. Emergency Medicine 95
۴۰. Allergies, Urticaria, and Anaphylaxis 95
۴۱. Bites: Human, Animal, and Insect 97
۴۲. Burns 100
۴۳. Facial Injuries 105
۴۴. Hyperthermia 107
۴۵. Hypothermia 110
۴۶. Poisoning 112
۴۷. Skin Wounds and Regional Anesthesia 116
۴۸. Submersion Injuries 118
۴۹. Trauma 120
۵۰. Endocrinology 124
۵۱. Weight Gain / Obesity 124
۵۲. Gynecomastia 127
۵۳. Hirsutism / Virilization 129
۵۴. Hyperglycemia: Diabetes Mellitus (DM) 132
۵۵. Hypoglycemia 137
۵۶. Adrenocortical Insufficiency (AI) 140
۵۷. Thyroid Disease 142
۵۸. Gastroenterology 147
۵۹. Dysphagia 147
۶۰. Vomiting / Nausea 149
۶۱. Chronic Abdominal Pain 153
۶۲. Blood From GI Tract 155
۶۳. Hematemesis 156
۶۴. Hematochezia 160
۶۵. Acute Diarrhea 163
۶۶. Chronic Diarrhea 165
۶۷. Adult Constipation 169
۶۸. Fecal / Stool Incontinence 172
۶۹. Adult Hepatomegaly 174
۷۰. Abnormal Liver Function Tests 177
۷۱. Adult Jaundice 181
۷۲. Allergic Reactions / Food Allergies, Intolerance, Atopy 184
۷۳. General Surgery 189
۷۴. Abdominal Distension 189
۷۵. Abdominal Mass 194
۷۶. Abdominal and Groin Hernias 197
۷۷. Acute Abdominal Pain 199
۷۸. Anorectal Pain 204
۷۹. Breast Lump / Screening 207
۸۰. Chest Injuries 213
۸۱. Abdominal Injuries 194
۸۲. Vascular Injuries 218
۸۳. Preoperative Medical Evaluation 220
۸۴. Geriatric Medicine 223
۸۵. Hypertension in the Elderly 223
۸۶. Elder Abuse 226
۸۷. Falls 228
۸۸. Frailty in the Elderly 232
۸۹. Gynecology 237
۹۰. Amenorrhea and Oligomenorrhea 237
۹۱. Dysmenorrhea 239
۹۲. Abnormal Vaginal Bleeding 243
۹۳. Premenstrual Syndrome / Premenstrual Dysphoric Disorder 249
۹۴. Contraception 252
۹۵. Early Pregnancy Loss / Spontaneous Abortion 258
۹۶. Menopause 263
۹۷. Vulvar Itch, Vaginal Discharge, and Sexually Transmitted
۹۸. Disease 267
۹۹. Cervical Cancer Screening 274
۱۰۰. Pelvic Masses 279
۱۰۱. Pelvic Pain 286
۱۰۲. Pelvic Prolapse 291
۱۰۳. Female Urinary Incontinence 293
۱۰۴. Female Infertility 295
۱۰۵. Hematology 299
۱۰۶. Fever of Unknown Origin 299
۱۰۷. Fever in the Immune Compromised Host / Recurrent Fever 301
۱۰۸. White Blood Cell Abnormalities 303
۱۰۹. Bleeding Tendency and Bruising 305
۱۱۰. Venous Thrombosis, Hypercoagulable State 308
۱۱۱. Splenomegaly 309
۱۱۲. Anemia 312
۱۱۳. Polycythemia / Elevated Hemoglobin 316
۱۱۴. Lymphadenopathy 317
۱۱۵. Nephrology 321
۱۱۶. Acid–Base Disturbances 321
۱۱۷. Hypomagnesemia 324
۱۱۸. Hyperkalemia 325
۱۱۹. Hypokalemia 329
۱۲۰. Proteinuria 331
۱۲۱. Hypernatremia 335
۱۲۲. Hyponatremia 336
۱۲۳. Acute Renal Failure 340
۱۲۴. Chronic Renal Failure 345
۱۲۵. Hematuria 349
۱۲۶. Polyuria and Polydipsia 351
۱۲۷. Hypercalcemia 353
۱۲۸. Hypocalcemia 356
۱۲۹. Hyperphosphatemia 358
۱۳۰. Hypophosphatemia 359
۱۳۱. Neurology / Neurosurgery 364
۱۳۲. Overview 364
۱۳۳. Neuroanatomy 365
۱۳۴. The Neurologic Approach 366
۱۳۵. Weakness 372
۱۳۶. Stroke 376
۱۳۷. Sensory Complaints 379
۱۳۸. Speech and Language Abnormalities 382
۱۳۹. Movement Disorders 385
۱۴۰. Gait Disturbances 388
۱۴۱. Headache 390
۱۴۲. Episodic Transient Impairment / Loss of Consciousness 392
۱۴۳. Altered / Impaired Mental Status 396
۱۴۴. Coma 398
۱۴۵. Head Trauma 399
۱۴۶. End of Life in the Neurologic Patient 401
۱۴۷. Obstetrics 404
۱۴۸. Pregnancy—Prenatal Care 404
۱۴۹. Preterm Labor 418
۱۵۰. Pregnancy—Intrapartum Care 423
۱۵۱. Pregnancy—Postpartum Care 432
۱۵۲. Ophthalmology 434
۱۵۳. Diplopia 434
۱۵۴. Red Eye 440
۱۵۵. Strabismus and/or Amblyopia 445
۱۵۶. Visual Disturbances / Loss 449
۱۵۷. Pupil Abnormalities 453
۱۵۸. Orthopaedic Surgery 458
۱۵۹. Bone or Joint Injury 458
۱۶۰. Neck and Back Pain and Related Symptoms 460
۱۶۱. Fractures and Dislocations 464
۱۶۲. Hand and Wrist Injuries 468
۱۶۳. Spinal Trauma 471
۱۶۴. Limp in Children 474
۱۶۵. Otolaryngology 477
۱۶۶. Ear Pain 477
۱۶۷. Dizziness / Vertigo 479
۱۶۸. Epistaxis 483
۱۶۹. Tinnitus 485
۱۷۰. Hearing Loss 488
۱۷۱. Sore Throat / Rhinorrhea 490
۱۷۲. Smell and Taste Dysfunction 492
۱۷۳. Mouth Problems 494
۱۷۴. Neck Mass 495
۱۷۵. Pediatrics 498
۱۷۶. Newborn Assessment 498
۱۷۷. Abnormal Weight in the Newborn 503
۱۷۸. Neonatal Jaundice 505
۱۷۹. Childhood Immunizations 509
۱۸۰. Inconsolable Crying (Crying or Fussing Child) 512
۱۸۱. Fever without a Source 515
۱۸۲. Sore Throat and Rhinorrhea 520
۱۸۳. Respiratory Distress in Children 522
۱۸۴. Common Rashes of Childhood 527
۱۸۵. Abdominal Pain in Pediatrics 531
۱۸۶. Pediatric Diarrhea 539
۱۸۷. Pediatric Constipation 543
۱۸۸. Failure to Thrive 547
۱۸۹. Child with Pain and Limp 551
۱۹۰. Developmental Delay 552
۱۹۱. Seizures in Childhood 556
۱۹۲. Hypertension in Childhood 559
۱۹۳. Sexual Maturation and Abnormal Pubertal Development 562
۱۹۴. Ambiguous Genitalia 565
۱۹۵. Child Abuse and Neglect 568
۱۹۶. Psychiatry 574
۱۹۷. Psychosis 574
۱۹۸. Mania / Hypomania 579
۱۹۹. Depressed Mood 582
۲۰۰. Suicidal Behavior 587
۲۰۱. Anxiety Disorders 589
۲۰۲. Eating Disorders: Anorexia Nervosa / Bulimia Nervosa 592
۲۰۳. Substance-Related or Addictive Disorders 595
۲۰۴. Adults with Developmental Disabilities 599
۲۰۵. Sexually Concerned Patient 603
۲۰۶. Personality Disorders 605
۲۰۷. Sleep Disorders 609
۲۰۸. Fatigue 611
۲۰۹. Adult Abuse / Intimate Partner Abuse 612
۲۱۰. Elder Abuse 614
۲۱۱. Public Health 616
۲۱۲. Periodic Health Exam 616
۲۱۳. Health Status Assessment and Measurement 619
۲۱۴. Population Health and its Determinants 620
۲۱۵. Work-Related Health 622
۲۱۶. Outbreak Management 623
۲۱۷. Environment 624
۲۱۸. Pulmonary Medicine 626
۲۱۹. Dyspnea 626
۲۲۰. Acute Dyspnea 629
۲۲۱. Chronic Dyspnea 631
۲۲۲. Upper Respiratory Tract Disorders: Wheeze 633
۲۲۳. Cyanosis / Hypoxemia / Hypoxia 636
۲۲۴. Cough 637
۲۲۵. Blood in Sputum 639
۲۲۶. Lower Respiratory Tract Disorders 642
۲۲۷. Asthma 643
۲۲۸. Pleural Effusion / Pleural Abnormalities 646
۲۲۹. Pneumothorax 648
۲۳۰. Unilateral / Local Edema 649
۲۳۱. Respiratory Allergy 652
۲۳۲. Rheumatology 656
۲۳۳. Inflammatory Arthritis 656
۲۳۴. Mechanical Joint Pain 663
۲۳۵. Nonarticular Musculoskeletal Pain 665
۲۳۶. Generalized Pain Syndromes And Myopathies 668
۲۳۷. Urology 671
۲۳۸. Dysuria, Urinary Frequency and Urgency, and/or Pyuria 671
۲۳۹. Erectile Dysfunction 676
۲۴۰. Hematuria 677
۲۴۱. Incontinence—Adult 679
۲۴۲. Incontinence—Child 682
۲۴۳. Infertility 684
۲۴۴. Scrotal Mass 687
۲۴۵. Scrotal Pain 689
۲۴۶. Urinary Tract Injury 690
۲۴۷. Urinary Tract Obstruction 692