MCCQE - Medical Council of Canada Qualifying Examination Cardiovascular Disease Management Questions and Answers

Question 1

A 68-year-old male with a history of hypertension and type 2 diabetes presents for a routine follow-up.
His blood pressure is 145/92 mmHg despite adherence to lifestyle modifications.
According to the 2025 Hypertension Canada guidelines, which of the following is the most appropriate initial pharmacological treatment?

Accepted Answer

A single-pill combination of an ACE inhibitor and a dihydropyridine calcium channel blocker

Answer

Amlodipine monotherapy

Answer

Lisinopril monotherapy

Answer

Hydrochlorothiazide monotherapy

Question 2

A 55-year-old woman with no prior history of cardiovascular disease is found to have a non-fasting LDL-cholesterol level of 5.2 mmol/L. Her 10-year cardiovascular disease risk is calculated to be 18% using the Framingham Risk Score. According to the 2021 Canadian Cardiovascular Society (CCS) Dyslipidemia Guidelines, what is the most appropriate next step in management?

Accepted Answer

Initiate moderate-intensity statin therapy.

Answer

Initiate high-intensity statin therapy.

Answer

Recommend lifestyle modifications only and recheck lipids in 5 years.

Answer

Initiate ezetimibe therapy.

Question 3

A 72-year-old male with a new diagnosis of non-valvular atrial fibrillation has a CHADS2 score of 3. He is being started on anticoagulation for stroke prevention. Which of the following is a key component of his management plan according to the Canadian Cardiovascular Society (CCS) guidelines?

Accepted Answer

Screening for and managing modifiable cardiovascular risk factors such as hypertension and obesity.

Answer

Prescribing a reduced dose of a direct oral anticoagulant (DOAC) to minimize bleeding risk, regardless of specific criteria.

Answer

Initiating dual antiplatelet therapy in addition to oral anticoagulation.

Answer

Scheduling an elective cardioversion within the first month of diagnosis.

Question 4

A 62-year-old man underwent a percutaneous coronary intervention (PCI) with a drug-eluting stent for stable ischemic heart disease. He has no history of bleeding or stroke. Based on the Canadian Cardiovascular Society/Canadian Association of Interventional Cardiology (CCS/CAIC) antiplatelet therapy guidelines, what is the recommended duration of dual antiplatelet therapy (DAPT)?

Accepted Answer

6 months

Answer

1 month

Answer

3 months

Answer

12 months

Question 5

Which of the following is the primary goal of initiating a rhythm-control strategy in a symptomatic patient with atrial fibrillation, according to current Canadian cardiovascular guidelines?

Accepted Answer

To improve quality of life and reduce AF-related symptoms.

Answer

To eliminate the need for long-term oral anticoagulation.

Answer

To reduce the risk of stroke and systemic embolism.

Answer

To decrease the risk of heart failure development.

Question 6

A 66-year-old female with a history of myocardial infarction 3 years ago presents for follow-up. She is on aspirin, a beta-blocker, and a high-intensity statin. Her blood pressure is well-controlled. She asks if she should stop her statin now that she feels well. According to secondary prevention guidelines for cardiovascular disease, what is the most appropriate advice?

Accepted Answer

Continue the high-intensity statin indefinitely.

Answer

Stop the statin as it is no longer needed for secondary prevention after 3 years.

Answer

Reduce the statin to a low-intensity dose for maintenance.

Answer

Switch from the statin to a fibrate for long-term management.