Free MCCQE Practice Test Questions 2026

A 65-year-old woman presents to the office for follow-up regarding vaginal bleeding. Her last visit was 2 months ago. At that visit, the results of a pelvic examination and a Papanicolaou test were normal. She also had an endometrial biopsy but there was "insufficient material for diagnosis." She reports that she is still losing small amounts of blood almost every day. On history, she has been taking continuous combined hormone replacement therapy for 10 years because of vasomotor symptoms. Which one of the following is the most appropriate next step in management?

A. Change hormones to a selective estrogen receptor modulator.

B. Organize a hysteroscopy.

C. Order a colposcopy.

D. Refer for a hysterectomy.

E. Decrease the dosage of progestin.

A 9-year-old girl from a remote community is brought to the clinic with a 2-week history of swelling in her neck. She has been afebrile but has had some night sweats. On examination, you note a fixed, unilateral, and nontender supraclavicular lymph node measuring 3 cm. The overlying skin color is unremarkable. In addition, you note a slightly enlarged spleen and liver. Which one of the following is the most likely diagnosis?

A. Lymphoma

B. Cat-scratch disease

C. Kawasaki disease

D. Acute bacterial lymphadenitis

E. Viral reactive lymphadenopathy

You are called to attend an 18-year-old woman, gravida 2, para 1, aborta 0, who is in precipitous labour. She did not realize she was pregnant and has not had any prenatal care. After the delivery, you examine the newborn boy; he is vigorous, and it appears that he was born at full term. Physical examination findings of the newborn are normal. Review of the prenatal record from the mother's last pregnancy shows the following:

HIV: Negative
Hepatitis B surface antibody: Positive
Hepatitis C: Negative
Syphilis serology: Negative

The mother's previous child was placed in foster care. The mother is withdrawn and uncommunicative after delivery. Which one of the following is the best next step?

A. Administer hepatitis B vaccine to the newborn

B. Initiate feeding with donor breast milk

C. Collect urine from the newborn for a drug screen

D. Recommend immediate skin-to-skin care

You are the emergency physician on duty in a rural hospital when heavy rains in the community cause a large landslide. There are multiple casualties expected to arrive in the emergency department. Your colleague has heard about the incident and arrives to help. Which one of the following is the best next step?

A. Send your colleague to set up an emergency type O blood bank collecting unit

B. Ask your colleague to help triage incoming patients in the emergency department

C. Send your colleague to the affected area to evaluate the health risks involved

D. Ask your colleague to handle media inquiries

An 18-year-old woman presents to the Emergency Department with a 3-day history of vomiting and right upper quadrant pain. She is alert but appears unwell and jaundiced. She was previously healthy and has not travelled recently. She has no risk factors for bloodborne pathogens. She denies hematemesis or hematochezia. On further history, she reports that she took a full bottle of pills that she found in her parents’ medicine cabinet several hours before she started vomiting. Without intervention, which one of the following is the most likely outcome?

A. Status epilepticus

B. Acute renal failure

C. Rapid-onset cerebral edema

D. Fulminant hepatic failure

E. Ventricular fibrillation

An 83-year-old woman presents to your office with a 2-day history of confusion. Her past medical history is significant for lung cancer, and she is being treated with radiation. On physical examination, she is euvolemic. Her blood work reveals a serum sodium of 118 mmol/L (135–140) as compared with 134 mmol/L (8 days ago). Which one of the following will be most helpful in establishing the cause of her laboratory abnormality?

A. Urinalysis

B. Urine sodium

C. Serum osmolality

D. Creatinine clearance

E. Parathyroid hormone-related peptide

A 66-year-old woman suffering from a progressive neurological disease is admitted to a long-term care centre. Her husband does not wish to participate in discussions about the seriousness of his wife's disease and is convinced that she will soon come back home. During his 2nd visit to the centre, he gives you a cheque for a substantial sum made out to you, the treating physician, for your own research. Which one of the following is the best response to your patient's husband?

A. Suggest he donate to your medical group

B. Accept the money as a contribution to the long-term care centre's fundraising campaign

C. Decline to accept the cheque

D. Refer the husband to the centre's social worker

E. Inform him you would only be able to accept a smaller amount of money

A 76-year-old man is brought to the emergency department in an unresponsive state. He has a history of chronic kidney disease with a baseline serum creatinine level of 300 μmol/L (49–93) and a history of dilated cardiomyopathy with an ejection fraction of 30%. On assessment, he has no pulse or blood pressure. Cardiac monitor demonstrates a wide complex tachycardia. Which one of the following recently started medications is the most likely cause of this arrhythmia?

A. Spironolactone

B. Hydrochlorothiazide

C. Metoprolol

D. Clopidogrel

E. Diltiazem

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. Reassure the parents and prescribe a topical antibiotic

D. Advise warm compresses every 2 to 3 hours until discharge is cleared

E. Recommend lacrimal sac massage

You are evaluating a 75-year-old man with recently diagnosed prostate cancer and 2 painful metastases of the lumbar spine. Which one of the following therapeutic options is the most appropriate?

A. Intrathecal steroid injection

B. Surgical castration (orchidectomy)

C. Oral anti-androgen plus gonadotropin-releasing hormone agonist

D. Fentanyl patch and breakthrough opioids

E. Palliative radiotherapy to the lumbar spine

A 42-year-old woman presents with a 2-day history of a low-grade fever and a painful left breast mass. On examination, there is a fluctuant erythematous tender mass with surrounding induration in the left breast and enlarged lymph nodes in the left axilla. An ultrasound shows a loculated cystic mass. Which one of the following is the most likely diagnosis?

A. Abscess

B. Ductal ectasia

C. Fibroadenoma

D. Fibrocystic changes

E. Inflammatory breast cancer

Three months ago, a physician colleague approached you in the hospital corridor for advice regarding one of his patients. You are now being named by this patient in a malpractice action. Which one of the following is the most likely reason why you may be found liable?

A. You were given confidential patient health information

B. You advised the physician to consult one of your colleagues

C. You were given the patient's name

D. You gave advice on how to treat the patient

E. You did not see the patient