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100 Free MCCQE1 Exam Questions and Answers 100% Solved
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100 Free MCCQE1 Exam Questions and Answers 100% Solved An 80-year-old woman comes to the urgent care clinic with dyspnoea on exertion. On physical examination, her blood pressure is 100/70, and her pulse is 75. She has no pulsus paradoxus. Her jugular veins are distended, and she has distant h...

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  • October 10, 2024
  • 76
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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  • MCCQE1
  • MCCQE1

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©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.

100 Free MCCQE1 Exam Questions and

Answers 100% Solved


An 80-year-old woman comes to the urgent care clinic with dyspnoea on

exertion. On physical examination, her blood pressure is 100/70, and her

pulse is 75. She has no pulsus paradoxus. Her jugular veins are distended,

and she has distant heart sounds. In addition, she has extra third and

fourth heart sounds. Her liver is enlarged, and she has pedal oedema. She

has occasional premature ventricular contractions on her

electrocardiogram. A chest x-ray reveals clear lung fields with a dilated

cardiac silhouette. Her echocardiogram reveals ventricular walls with a

"speckled pattern". Which of the following is the most likely diagnosis?

- Alcoholic cardiomyopathy

- Amyloidosis

- Haemochromatosis

- Tuberculosis

- Viral myocarditis - ✔✔Amyloidosis

Restrictive cardiomyopathy with 'speckled' left ventricular wall

, ©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.

Primary cardiac amyloidosis usually develops into diastolic dysfunction

Alcoholic cardiomyopathy: biventricular dilated cardiomyopathy

A 92-year-old man with a 45-year history of chronic obstructive pulmonary

disease is intubated in the ICU because of a bout of viral pneumonia that

fails to improve after 72 hours of antibiotics. Although the inspired fraction

of oxygen is 100%, the patient's pO2 remains at 57 mmHg. Positive-end

expiratory pressure (PEEP) is added to allow the inspired fraction of

oxygen. Twelve hours after the introduction of PEEP the patient suddenly

become hypotensive. At the same time, his oxygen saturation drops from

92% to 61%. On physical examination, his BP is 80/50 mmHg and his

pulse is 124/min. He has distended neck veins and distant heart sounds.

Which of the following would also most likely be seen on this patient's

physical examination?

- Absence of breath sounds in the right hemithorax

- High amplitude carotid artery upstroke

- A pleural friction rub

- Pulsus alternans

- Splenomegaly - ✔✔Absence of breath sounds in the right hemithorax

, ©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.

Patient has developed a tension pneumothorax, characterised by PEEP

followed by sudden hypotension and decreased oxygenation

Jugular venous distention occurs because venous return to the right side of

the heart is being compressed

Rx: immediate needle/tube thoracostomy

A 46-year-old man with a history of hypertension and hypercholesterolemia

visits the physician for a routine followup. The patient's job involves a lot of

travelling, and he admits to occasionally forgetting to take his medications

with him when he travels. He complains of several episodes of chest pain

in the past few months. The pain is sharp in nature, mainly over his lower

chest and epigastrium, and tends to come on when walking. He believes

these episodes are due to indigestion and has been taking antacids. There

is a family history of heart disease, and his father died of a heart attack at

age 48. On physical examination, his blood pressure is 150/80 mmHg and

heart rate is 86/min. His lungs are clear to auscultation. Cardiac

auscultation reveals normal rate and rhythm, without rubs, gallops, or

murmurs. There is no pedal oedema. He is sent for an exercise stress test.

Five minutes into the test, he develops ST - ✔✔Coronary angiography

Multiple risk factors for atherosclerotic coronary artery disease

, ©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.

A stress test is considered positive when there are ST depression of >1mm

for longer than 0.08 seconds

Positive stress test = coronary angiography

A 74-year-old woman, who has been followed for the past 25 years for

chronic obstructive pulmonary disease comes to the ED complaining of 48

hours of temperature to 38.6 C and worsening shortness of breath. She

has a chronic productive cough, which has become more copious. On

physical examination, she has rhonchi and increased fremitus in the

posterior mid-lung field. A Gram's stain reveals many epithelial cells and

multiple gram-positive and gram-negative organisms; no neutrophils are

seen. Which of the following is the most likely organism causing the

symptoms?

- Escherichia coli

- Haemophilus influenzae

- Klebsiella pneumoniae

- Mycobacterium tuberculosis

- Mycoplasma pneumoniae - ✔✔Haemophilus influenzae

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