Free MCCQE Practice Test Questions 2026

A 31-year-old man presents to the office with concerns about his heart. Three months ago, his father died of a myocardial infarction at age 58 years. He states that since the death of his father, he has experienced episodes in which his heart will start racing, causing him to feel short of breath, dizzy, and nauseous. He is afraid that he will die during these episodes. Findings from a physical examination, electrocardiogram, Holter monitoring, echocardiogram, and complete blood count are normal. Serum electrolyte level, troponin level, and thyroid function studies are all within normal limits. Which one of the following options is the most appropriate?

A. Cardiac stress test

B. Lorazepam at bedtime

C. Metoprolol

D. Grief therapy

A 29-year-old concert pianist with severe chronic kidney disease presents with a 6-month history of loss of appetite and pruritus. Although the issue of initiating dialysis has been discussed with him and his questions answered, he has declined dialysis thus far. You understand his concerns that it will interfere with his concert tour and recording schedule. Which one of the following is the best next step?

A. Offer to arrange for him to meet patients in the peritoneal dialysis clinic.

B. Warn him of the consequences of refusing dialysis.

C. Explain to him you will see him again when he decides to start dialysis.

D. Provide him access to his medical records and full chart.

E. Explore employment alternatives that would better accommodate the dialysis schedule.

A 6-year-old girl is found to have a blood pressure of 130/75 mm Hg. She was born prematurely at 32 weeks' gestation and required ventilation. There is a family history of hypertension in 3 grandparents. Clinical examination reveals a grade 1/6 mid-systolic murmur, no renal bruits, and femoral pulses are difficult to feel. Which one of the following is the most likely diagnosis?

A. Ventricular septal defect

B. Reflux nephropathy

C. Renal artery thrombosis

D. Essential hypertension

E. Aortic coarctation

A 38-year-old man is brought by his wife to the Emergency Department with fatigue, dizziness, and nausea after completing a hiking tour on a hot, humid day. His wife became worried after he had collapsed. He has been sweating heavily and vomited twice on the drive in. His medical history is unremarkable, and he takes no medications. His vital signs on arrival are as follows:

Blood pressure
85/57 mm Hg
Heart rate
120/min
Respiratory rate
18/min
Temperature
40.1 °C
Oxygen saturation
95%, room air
—

On physical examination, the patient's skin is dry, flushed, and warm to the touch. He has a diffuse erythematous papular rash. Findings of a thorough physical examination are otherwise unremarkable. An electrocardiogram shows sinus tachycardia. Which one of the following is the best next step?

A. Serum creatine kinase test

B. Serum thyrotropin (thyroid-stimulating hormone)

C. Computed tomography of the head

D. Serum C-reactive protein test

E. Blood cultures

A 73-year-old woman is seen in the office 2 weeks after a coronary bypass surgical procedure. The site of saphenous vein removal in the left thigh shows an area of tenderness and a 3 × 5 cm palpable mass. The skin is intact. Her temperature is 37.7 °C, hemoglobin is 110 g/L (125–167), and white blood cell count is 8 × 10/L (4–10). Which one of the following is the most likely diagnosis?

A. Acute venous bleeding

B. Femoral artery aneurysm

C. Thrombophlebitis

D. Wound hematoma

E. Wound abscess

A 62-year-old woman is taken to the operating room for an elective laparoscopic cholecystectomy. Induction of anesthesia triggers a severe hypertensive crisis that ultimately resolves after administration of a 5 mg bolus of phentolamine. Which one of the following is most consistent with this presentation?

A. Increased thyrotropin (thyroid-stimulating hormone) level

B. Elevated plasma catecholamines

C. Low renal vein renin

D. High plasma cortisol

E. Low urinary metanephrines

A 25-year-old woman who is at 8 weeks' gestation plans to travel to rural Cambodia to care for her ill mother. Which one of the following treatments should be provided to her before the trip?

A. Antimalarial chemoprophylaxis

B. Hepatitis B immunoglobulin

C. Ciprofloxacin for travellers' diarrhea

D. Tetanus and diphtheria booster if last received more than 5 years ago

A 23-year-old woman with borderline personality disorder is brought to the Emergency Department having ingested non-lethal substances after her boyfriend broke up with her. The staff tells you that she has consulted 8 times under similar circumstances in the past 3 years. Which one of the following pieces of information would be useful to provide to the staff?

A. Not much can be done with personality disorders

B. She will never commit suicide

C. Suicidal thoughts must be an indication of major depressive disorder

D. She is overusing health care services

E. Symptoms of borderline personality disorder will likely attenuate over time

One of your patients presents to your clinic for a consultation regarding their recurrent hemoptysis. On review of their chart, you realize that although you had ordered chest radiography 2 months ago, the result cannot be found in the chart. You call the radiology department and are relieved to find that the chest radiography was done and that it did not reveal any pathology. After informing the patient of this lapse in reporting, which one of the following is the best next step?

A. Remind the patient that they are responsible for calling for outstanding test results.

B. Review your clinic's filing procedures and make any needed improvements.

C. Send a letter of complaint to the radiology department for not sending a report.

D. Reassure the patient that this is a rare occurrence in your clinic.

A 17-year-old boy presents to your clinic with a 6-month history of recurrent headaches. The headaches are excruciating, and he describes them as a stabbing pain, usually around his right eye. They occur several times daily for 2 to 3 weeks and recur every few months. The headaches are associated with tearing from his right eye and tend to get worse when he is overtired. Which one of the following is the most likely diagnosis?

A. Sinusitis

B. Migraine

C. Brain tumour

D. Cluster headache

E. Post-concussive headache

A 40-year-old woman presents to your clinic for follow-up regarding her major depressive disorder, which is being treated with the starting dosage of escitalopram. Most of her symptoms have now improved. However, she has noted anorgasmia since taking this medication. This has significantly affected her relationship with her wife. Which one of the following is the best next step?

A. Increase the patient's dosage of escitalopram

B. Switch escitalopram to venlafaxine

C. Add bupropion

D. Maintain the current medication

Your colleague's receptionist asks you to assess her 4-year-old daughter who has had 2 episodesof acute otitis media in the last month. The mother wants you to arrange a consultation with an ear, nose and throat (ENT) specialist to get a tympanostomy before her daughter starts school. You do not believe there is a surgical indication at this time. Which one of the following is the best next step?

A. Explain that there is no indication for the surgery but refer her daughter for consultation.

B. Suggest that the next time they go to the Emergency Department for quicker access to the ENT consultant.

C. Ask another family physician to see the daughter due to a conflict of interest.

D. Decline to send her daughter for consultation and explain your decision.

E. Call the ENT consultant on call to discuss your dilemma.