Free MCCQE Practice Test Questions 2026

A 26-year-old woman, gravida 2, para 2, aborta 0, has just delivered a full-term newborn via spontaneous vaginal delivery after 4 hours of labor. Following oxytocin administration and placental expulsion, there continues to be a steady trickle of bright red blood from her vagina. On examination, the placenta is intact and the fundus feels firm. Her vital signs are within normal range. Which one of the following is the most likely diagnosis?

A. Uterine atony

B. Vaginal or cervical tear

C. Retained products of conception

D. Uterine rupture

E. Disseminated intravascular coagulopathy

A 66-year-old woman has a 3-month history of dry cough and weight loss. A new chest radiograph reveals a large 2-cm mass in her right upper lobe, which is consistent with carcinoma. You look at her previous films and realize that you had read her chest radiograph as normal 1 year ago, but now clearly see a faint opacity in precisely the same location as her current lesion. Which one of the following is the best next step?

A. Remark only on the new chest radiograph in your report

B. Comment on the previous chest radiograph and the new one in your report

C. Prepare a report only after communicating with your department head

D. Write a report only after communicating with your professional insurer

E. Create a report only after communicating with your medical regulatory authority

A 67-year-old man underwent his first endoscopy. He has long-term reflux and heartburn, treatedintermittently with antacids. Biopsies of the distal esophagus reveal Barrett epithelium. Which one of the following is most important in determining the frequency of surveillance endoscopy?

A. Length of Barrett segment

B. Depth of intestinal metaplasia

C. Stricture formation

D. Grade of dysplasia

E. Family history of gastrointestinal malignancy

A 30-year-old woman presents to your office for a follow-up assessment of a sports-related musculoskeletal injury to her right leg. She requests a letter for her employer regarding her return to work. You feel she should be able to manage some aspects of her factory work. Which one of the following is most appropriate to include in your medical note to this patient's employer?

A. Treatment options

B. Diagnosis

C. Physiotherapist's evaluation

D. Required workplace accommodations

E. Medical imaging results

A 26-year-old man presents with pain, numbness, and weakness in his right upper extremity. He works as a computer programmer, and his BMI is 32. Symptoms have worsened since he started spending more time on the keyboard. He reports that his right hand feels clumsier while he is typing. Physical examination reveals mild weakness in the intrinsic muscles of that hand, with a positive Tinel sign at the ulnar nerve. Which one of the following is the best next step?

A. Wrist splint to test for carpal tunnel.

B. Physiotherapy.

C. Elbow extension brace for use during sleep.

D. Magnetic resonance imaging of the cervical spine.

E. Nerve conduction studies to localize the level of the lesion.

You are asked to see a 50-year-old man 2 hours after he underwent a laparotomy for gastric resection. Lab results are as follows: pH 7.28 (7.35–7.45) PaCO 60 mm Hg (35–40) PaO 60 mm Hg (85–105) with 4 L/min via nasal prongs Bicarbonate (HCO) 24 mmol/L (24–30) Which one of the following is most consistent with this clinical presentation?

A. Normal recovery from an inhalation anesthetic

B. Respiratory insufficiency

C. Metabolic acidosis

D. Compensatory respiratory alkalosis

E. Postoperative hypermetabolic period

A 3-year-old boy is brought to the office because he is not using his right arm after a fall from a swing. Radiographs reveal a new fracture and old healing fractures. The parents deny any previous injuries. In addition to providing care for the fracture, which one of the following is the best next step?

A. Notify child protection services.

B. Advise the parents to better supervise the patient.

C. Investigate the patient to rule out metabolic or endocrine disorders.

D. Monitor the patient for future injuries.

E. Refer the family to the social work department.

You performed a surgical procedure on a 32-year-old woman for a herniated disk that was causing neurologic impairment. At the 8-month follow-up visit, she has healed well; however, she requests a prescription renewal of her narcotic analgesics (hydromorphone). Her pharmacy confirms that the patient adheres to the dosage you prescribed, that she has not consulted other physicians, and that her behavior has always been respectful. You think that she no longer requires narcotic analgesics. Which one of the following approaches is most helpful to the patient?

A. Replace short-acting hydromorphone with transdermal fentanyl.

B. Decline the renewal of further hydromorphone and discharge the patient.

C. Advise the provincial or territorial agency responsible for following patients who have potential substance use disorders.

D. Counsel the patient regarding substance use disorder and arrange follow-up with her family physician.

E. Change the patient’s prescription from short-acting hydromorphone to once-daily methadone.

A 24-year-old woman with chronic anorexia nervosa presents to the Emergency Department with diarrhea, chest pain and palpitations. She is noted to have a BMI of 13, a heart rate of 48/min, significant orthostatic hypotension and a temperature of 35.9 °C. Her electrocardiogram shows frequent premature ventricular contractions. Her blood work indicates elevated liver transaminases and evidence of acute kidney injury from dehydration. She agrees to admission for medical stabilization only if she does not receive fluids either orally or intravenously, as they will cause her to gain weight and to feel bloated. Which one of the following is the best next step? A.

A. Refuse to admit her unless she agrees to full treatment

B. Obtain a psychiatric consultation

C. Assess her capacity to consent for medical treatment

D. Start intravenous fluids and physically restrain if necessary

E. Ask her if she has a substitute decision-maker

You are asked to see a 30-year-old woman, gravida 8, para 4, aborta 1, for symptoms of postpartum depression. She immigrated to Canada 8 months ago. She has been reluctant to speak to members of the medical team without her family members, even when an interpreter is present. Which one of the following is the best next step?

A. Insist on conducting the interview with the patient alone

B. Interview the patient and the family together

C. Allow 1 family member to stay and act as the interpreter

D. Ask the patient to write down her history and have it translated

A 35-year-old woman presents to your clinic with double vision and a gritty sensation in her eyes for the past several weeks. On examination, you notice her eyes are bulging. There is inflammation of her conjunctivae and swelling around her eyes. Which one of the following is the most likely diagnosis?

A. Orbital pseudotumor

B. Myasthenia gravis

C. Allergic conjunctivitis

D. Periorbital cellulitis

E. Graves ophthalmopathy

A 48-year-old woman presents with a 2-year history of regular, heavy menstrual flow. She has a BMI of 54, poorly controlled type 2 diabetes, and obstructive sleep apnea. Laboratory results are as follows:

Hemoglobin: 82 g/L (123–157)
Ferritin: 6 μg/L (11–307)

Endometrial biopsy: Absence of hyperplasia or malignancy Transvaginal ultrasound:

• Uterus: 12 cm × 8.2 cm × 6 cm
• Intramural fibroids
• Endometrial thickness: 14 mm
• Ovaries: Normal

Which one of the following is the best next step?

A. Hysterectomy

B. Levonorgestrel-releasing intrauterine system

C. Continuous combined oral contraception

D. Cyclic medroxyprogesterone