Practice MCCQE Questions (V8.02) to Achieve Success 2026: Read MCCQE Free Dumps (Part 1, Q1-Q40)

1. A 37-year-old man comes to the office for follow-up of his opioid use disorder. He receives opioid agonist treatment, including some take-home doses. At this follow-up visit, he reports some nonprescription opioid use since his last visit.

Which one of the following is the best next step?

2. A 6-week-old boy is brought to your office by his parents for a follow-up following a recent urinary tract infection. His abdominal ultrasound shows dilated urinary bladder and ureters as well as bilateral hydronephrosis.

Which one of the following historical findings would be most helpful in establishing the correct diagnosis?

3. 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 (135C140) 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?

4. An otherwise healthy 43-year-old woman presents to your clinic for a left breast mass. Six months ago, she underwent a bilateral breast magnetic resonance imaging (MRI) after watching a television program on breast cancer prevention. An ultrasound-guided biopsy of a 1.5 cm mass confirmed, at the time, that she had fibroadenoma. The follow-up ultrasound now reveals a mass measuring 1.7 cm.

Which one of the following is the best next step in the management of this patient?

5. A 68-year-old man with a history of diabetes, hypertension, delirium tremens, and tobacco addiction comes to the Emergency Department with his daughter. She tells you that his behavior has become unmanageable and she feels he may require an increased level of care.

His vital signs are:

Blood pressure: 162/105 mm Hg

Heart rate: 112/min, regular

Temperature: 37.8°C

On history, his daughter explains she had to confiscate a half-empty bottle of alcohol from his room yesterday. He is now convinced that there are bugs crawling all over him and he will not relax. He appears pale, sweaty, and shaky. His most recent blood glucose is 7.8 mmol/L (3.8C11.1).

Which one of the following is the best next step?

6. A 30-year-old woman presents to the office with her partner and reports that they are planning for her to conceive soon. They visited Mexico recently and are concerned about exposure to the Zika virus.

Which one of the following is the best next step?

7. A 72-year-old man presents to your clinic with worsening lower leg edema. He has hypertension, type 2 diabetes, and a history of heavy drinking. On examination, he is pale and has a BMI of 35.

Vital signs are as follows:

Blood pressure: 110/60 mm Hg

Heart rate: 102/min

Temperature: Afebrile

His jugular venous pressure is 4 cm above the sternal angle. Cardiac auscultation is normal, and his lungs are clear. His liver is not palpable; he has abdominal distension, bulging flanks, and pitting edema below the knees.

While awaiting test results, which one of the following is the best next step?

8. 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

9. A 60-year-old man presents because of a 6-month history of involuntary lip smacking and tongue movements. His medical history is significant for schizophrenia, which has been very stable with haloperidol for the past 20 years. When educating the patient about these particular symptoms, which one of the following statements is accurate?

10. A 14-month-old boy is brought to see you for a well-baby check-up and is noted to have only one testis. Ultrasound confirms an undescended testis.

Which one of the following is the best next step?

11. A 29-year-old woman presents with vaginal spotting after 6 weeks of amenorrhea. She is asymptomatic otherwise. Serum #-hCG is 2150 IU/L, and pelvic ultrasound shows an empty uterus. She has been trying to conceive for 7 months.

Which one of the following is the best next step?

12. A 25-year-old woman presents to the Emergency Department with a 2-hour history of pelvic pain associated with no other symptoms. The first day of her last menstrual period was 14 days ago.

On examination, her vital signs are as follows:

Blood pressure

108/72 mm Hg

Heart rate

110/min

Temperature

37 °C

Abdominal examination reveals rebound tenderness and guarding. Pelvic examination reveals exquisite left adnexal tenderness.

Which one of the following is the most likely diagnosis?

13. A 38-year-old marathon runner presents to your office with a 6-month history of increasing right hip pain. The pain is worse with acclivity and has prevented him from running for the last 4 months. He denies fever or chills. His wife adds that she is concerned because he is increasingly disengaged with the family and not interested in other activities he usually enjoys, including sex.

Which one of the following is the best next step in management?

14. A 37-year-old woman diagnosed with schizophrenia comes to her family physician because she has been choking on her food lately. She has a history of mild spasmodic dysphonia. She was recently started on haloperidol for auditory hallucinations.

Which one of the following is the best short-term management?

15. You are caring for a 17-year-old girl who has end-stage renal disease. She is receiving dialysis at the hospital 3 times a week. She requests medical assistance in dying (MAID).

Which of the following is the best next step?

16. A 28-year-old woman presents to the office in great distress because she has no money for groceries or rent. She is a single mother of a 7-year-old girl. She has a history of gambling disorder. She has felt unable to cope for the last 3 months and has started gambling again. Today, she is crying, and she shares that her boyfriend became violent with her yesterday.

Which one of the following is the highest priority for assessment?

17. An 84-year-old woman is brought by ambulance to the emergency department after she was found by a neighbour. She had fallen, sustained a hip fracture, and was unable to move for the past 2 days. After starting rehydration, she reports hip pain and numbness and tingling in both her legs. Physical examination reveals faint pulses in both legs and severely swollen lower legs that are painful to palpation. The urine in the Foley catheter bag seems to be darker than normal.

Which one of the following is the best next step?

18. 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?

19. You are treating a 78-year-old man for recent onset of diarrhea, tenesmus, and minor bleeding when he wipes. He has a history of prostate cancer that was treated by radiotherapy. Rectal examination findings are normal. Colonoscopy reveals a pale rectum with ulcerations and areas of mucosal hemorrhage.

Which one of the following is the most likely explanation for this clinical presentation?

20. An 80-year-old woman presents to the Emergency Department with dizziness. She has a medical history of coronary artery disease. On examination, she is alert and oriented.

Her vital signs are as follows:

Her electrocardiogram is shown in the image.

Which one of the following is the most likely diagnosis?

Blood pressure

80/60 mm Hg

Heart rate

40/min

Respiratory rate

12/min

Her electrocardiogram is shown in the attached image.

Which one of the following is the most likely diagnosis?

21. A 24-year-old woman has had several episodes of left lower lobe pneumonia. She has a chronic productive cough with occasional blood-streaked sputum. Physical examination is normal except for rales at the left base. Chest radiograph shows a linear infiltrate in this area.

Which one of the following is the most likely diagnosis?

22. A 22-year-old woman presents to the office for episodic mood changes that her boyfriend has noticed. During such episodes, she cries suddenly, is irritable and sad, and withdraws from socializing.

Which one of the following would be most useful in establishing a diagnosis?

23. You are called to the Emergency Department to see a 6-month-old boy with a 3-day history of fever. Physical examination reveals an irritable infant with a temperature of 38.1°C.

His vital signs are:

Blood pressure: 87/50 mm Hg

Respiratory rate: 80/min

Heart rate: 140/min

Oxygen saturation: 92% on room air

The infant has no skin findings. On chest examination, you hear coarse crackles on the right side of the chest.

Which one of the following is the best next step in the management of this child?

24. A 52-year-old man presents to the Emergency Department with a history of back, neck, and shoulder pain sustained from a workplace incident 4 years ago. He is under observation by a multidisciplinary pain clinic, and his next appointment is not for another 4 weeks. He does not report any recent change in his symptoms.

His medications are as follows:

Acetaminophen

1000 mg orally 4 times daily

Naproxen

500 mg orally twice daily

Amitriptyline

25 mg orally at bedtime

Acetaminophen 1000 mg orally four times daily

Naproxen 500 mg orally twice daily

Amitriptyline 25 mg orally at bedtime

The patient has not taken his medications for several weeks because he thinks they are not working. He requests a prescription for oxycodone because he tried some that a friend sold him, and it worked very well.

After completing an assessment and providing counseling, which one of the following is the best next step?

25. A 42-year-old man presents to your office with acute left knee pain and difficulty walking. He denies any trauma. He reports 2 painful episodes involving his right great toe in the last year. He smokes half a pack of cigarettes a day and drinks at least 3 beers daily. He has a temperature of 38.2°C and has a red, swollen and warm left knee.

Which one of the following is the best next step?

26. A 2-year-old boy is brought by his parents to your clinic because of sudden onset of high fever, refusal to drink, and drooling. Examination reveals cervical lymphadenopathy as well as multiple ulcers on the inner lips, tongue, and gums.

Which one of the following is the most likely diagnosis?

27. An 18-month-old boy is brought to the office by his guardians for a well-child visit. His guardians are concerned that his eyes do not look the same. On examination, his eyes appear as shown in the referenced photo.

Which one of the following best represents the patient's condition?

28. A patient's mother comes to you with a prospective cohort study linking autism to the measles, mumps and rubella vaccine. After reviewing the study carefully, you question the results because of problems with the study design and execution.

Which one of the following sources of error would be most important in the study design or execution?

29. You are covering for your colleague who is on vacation this week. You receive the results from an ultrasonography that had been ordered for a 32-year-old woman, gravida 2, para 1, aborta 0. The ultrasonography-estimated fetal weight is below the fifth percentile for 30 weeks' gestation; gestational age was confirmed by an earlier ultrasonogram. The amniotic fluid volume is within normal range. Her first child's birth weight was 2800 g at full term.

Which one of the following is the best next step?

30. A 63-year-old woman presents to your office with a history of progressive abdominal discomfort over the past five months. She reports bloating and difficult digestion with constipation. She has no urinary symptoms and denies vaginal or rectal bleeding. An abdominal ultrasound shows a large complex pelvic mass with internal multiloculation and moderate ascites. The cancer antigen 125 (CA 125) is elevated at 1023 U/mL (< 35 U /mL).

Which one of the following is the most likely diagnosis?

31. 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?

32. A 64-year-old man presents with a 3-month history of gradually increasing neck pain and stiffness. The pain radiates into his upper back, and he is having difficulty driving because of limitation of neck rotation secondary to pain. Physical examination shows restricted neck motion in all directions and neck muscle spasms. There is no abnormality on neurologic examination. A radiograph shows narrowing of all of the cervical disc spaces with prominent osteophytes.

Which one of the following is the most appropriate next step?

33. A 28-year-old woman presents because of spotting mid-menstrual cycle. Speculum examination reveals an ulcerated endocervical polyp.

Which one of the following is the most appropriate management?

34. A 16-year-old boy presents to the emergency department with a 12-hour history of fever and rigors. He has sickle cell anemia.

On examination, his vital signs include the following:

Heart rate

110/min (60C100)

Respiratory rate

20/min (12C18)

Temperature

38.8 °C, oral (36.5C37.5)

Which one of the following places this patient at risk for sepsis?

35. You have been asked to develop a program in your hospital for people who are at the highest risk of death by suicide. The hospital administrator asks you to describe the types of patients they should expect in the program.

Which one of the following groups is the most likely prominent demographic?

36. A 56-year-old woman presents to your office with a 9-month history of intolerable sweating, palpitations, and periodic anxiety. Her last period was 12 months ago. She continues to have regular Papanicolaou testing with no worrisome pathology. She is otherwise healthy.

Which one of the following is the most effective treatment for these symptoms?

37. A 62-year-old man (wealthy philanthropist) with emphysema from smoking and a 21-year-old woman (elementary teacher) with cystic fibrosis are both compatible matches for a lung transplant.

Which criterion determines organ allocation?

38. You are seeing a 78-year-old man for follow-up of metastatic cholangiocarcinoma diagnosed 8 months ago and currently being treated with thermotherapy. He has just completed his 2nd cycle and reports frequently feeling hopeless, worthless, and helpless, with no sense of a positive future. He states he is turning away invitations to socialize with family and friends. He feels like sleeping all the time and reports no appetite.

Which one of the following is the most likely diagnosis?

39. 1.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?

40. 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?