Free MCCQE Practice Test Questions 2026

An 87-year-old man presents with a 2-week history of stiffness in both shoulders and both hips. On further questioning, he tells you that he has experienced a 2 kg unintentional weight loss over the last month. His past medical history is otherwise unremarkable and he is on no medications. On examination, he has limited range of motion due to pain in his shoulders and hips. The remainder of his examination, including muscle strength and joint exam, is normal. Which one of the following will you specifically ask about regarding his history?

A. Unilateral headache

B. Anhedonia

C. Tremor

D. Night sweats

E. Recent diarrheal illness

A 62-year-old man, who has not seen a physician in 20 years, presents to your clinic with a burning sensation in his feet. The symptoms have been progressing slowly over the last 6 months. There is no associated motor weakness or skin changes. He reports no significant past medical history and takes no medications. His alcohol intake is minimal. On examination, he has reduced pinprick/vibration sensation and proprioception in the ankles with absent ankle reflexes. Which one of the following blood tests would you expect to be abnormal?

A. Anti-acetylcholine receptor antibodies

B. Folate

C. Hemoglobin A1c

D. Uric acid

E. Ferritin

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. Perform a detailed cardiac and neurological examination

B. Do a bedside glucometer reading

C. Interview the girl without the mother present

D. Order a urine pregnancy test

E. Obtain growth parameters and vital signs

You are meeting an otherwise healthy 10-year-old boy in your office for the first time. His BMI is at the 80th percentile. He has no symptoms and his physical examination is normal. Which one of the following is the best next step?

A. No investigations

B. Fasting lipid profile

C. Thyroid function testing

D. Morning serum cortisol

E. Hemoglobin A1c

72-year-old woman is brought to the Emergency Department by her daughter because of significant functional decline and progressive shortness of breath. She has widespread metastatic breast cancer and recently stopped chemotherapy due to progression and intolerance. She has been bedridden for 4 weeks. On examination:

BP: 100/70 mm Hg with pulsus paradoxus of 20 mm Hg
HR: 99/min
Temp: 36.5°C
SpO: 94% room air
JVP: elevated
Heart sounds: muffled
Chest X-ray: large globular heart

Labs:

Hemoglobin: 90 g/L
Sodium: 118 mmol/L
Creatinine: 94 μmol/L

Which one of the following is the best next step?

A. Pericardiocentesis

B. Normal saline infusion

C. Discussion on goals of care

D. Blood transfusion

E. Consult with the Intensive Care Unit

A 40-year-old woman presents to the Emergency Department with confusion and fever (38.5°C). She has a history of hypothyroidism managed with levothyroxine. Key findings include:

Blood pressure
114/78 mm Hg
Heart rate
85/min
Temperature
38.5°C
Hemoglobin
90 g/L123-157 g/L
Platelet count
25 × 10/L130-400 × 10/L
Peripheral blood film
Schistocytes present
Creatinine
200 mol/L50-90 mol/L

A. Cirrhosis

B. Acute myelogenous leukemia

C. Human immunodeficiency virus

D. Idiopathic thrombocytopenic purpura

E. Thrombotic thrombocytopenic purpura

A 35-year-old woman, gravida 3, para 0, aborta 3, presents with her male partner because she has been unable to conceive despite trying for more than 1 year. Her menstrual cycles have been absent for 9 months, and she has occasional mild cyclic pain. She has a medical history of 3 suction curettages. Her BMI is 24. Investigation results are as follows: Hysterosalpingogram: Obliterated uterine cavity, no tubal dye spill Progesterone (midluteal): 48.0 nmol/L (16.4–59.0) Partner's semen: All parameters normal Which one of the following is the most likely diagnosis?

A. Fibroids

B. Perimenopause

C. Intrauterine synechiae

D. Hypothalamic insufficiency

E. Polycystic ovary syndrome

A 45-year-old woman presents with a 2-week history of a sore left breast. It has become red and swollen. She was previously well, and her menstrual cycles are regular. She has no history of breast cancer, and she has no children. On examination, she has a red, tender, indurated area in her left breast that has only partially responded to oral antibiotics after 10 days. Which one of the following is the most appropriate next step?

A. Proceed with incision and drainage.

B. Perform a breast biopsy.

C. Start nonsteroidal anti-inflammatory agents.

D. Change the oral antibiotic.

E. Start intravenous antibiotics.

A 27-year-old woman presents to her family physician's office and states that she is pregnant and would like to be referred for an abortion. She is at approximately 9 weeks' gestation by dates. The family physician has personal conscience-based objections to the procedure. Which one of the following would be the best next step for this physician?

A. Explain their personal views about therapeutic abortion to the patient

B. Refer the patient to another physician

C. Ask the patient to return in 2 weeks to give her time to consider her options

D. Recommend that the patient consider adoption

A 26-year-old man presents to the office with a tender mass in his right neck. He was recently treated for a dental infection but is otherwise well. On examination, there is a 2-cm tender, mobile lymph node in the right anterior cervical chain. No other lymphadenopathy or abnormalities are found on physical examination. Which one of the following is the best next step?

A. Follow-up in 8 weeks

B. Lymph node biopsy

C. Computed tomography of the neck

D. Bone marrow biopsy

E. Ultrasonography of the spleen

A 32-year-old man presents to the clinic for assessment of a dog bite sustained 3 days ago while traveling in another country. He recalls having seen the dog eat where he was staying, and the animal did not appear well. On examination, the patient has 2 distinct deep puncture wounds on his left leg. There is an erythematous border but no exudate. He is unsure of his immunization status. Which one of the following is the most appropriate management?

A. Give rabies immunoglobulin and vaccine

B. Arrange for wound debridement

C. Start antibiotic treatment with ciprofloxacin

D. Order serum creatine kinase

E. Irrigate the wounds with hydrogen peroxide

A 61-year-old man presents to the office for follow-up of recent laboratory test results. He has hypertension for which he takes amlodipine daily. His blood pressure is 148/94 mm Hg. His creatinine level is 140 μmol/L (normal 70–120), and his urine protein-to-creatinine ratio is persistently elevated. You would like to prescribe ramipril, but he refuses to take any additional medication. Which one of the following is the best next step?

A. Determine why the patient is refusing to take more medication.

B. Explain to the patient the importance of preventing the progression of his chronic kidney disease.

C. Inform the patient that he eventually may need dialysis if he refuses the medication.

D. Agree to stop the patient’s amlodipine if he takes ramipril.

E. Provide the patient with free samples of ramipril.