Free Medical Council of Canada MCCQE Practice Test & Real Exam Questions

A 65-year-old man presents to your clinic with a 2-month history of persistent erectile dysfunction. He reports having difficulties maintaining an erection. His last hemoglobin A1c level result was 6.4% (4.8-6.0). He had a negative result on his cardiac stress test 1 month ago. He has been taking stable dosages of citalopram, metformin, and ramipril for the past 2 years. His physical examination findings are normal, and his mood appears euthymic. Which one of the following investigations should be ordered before initiating treatment with sildenafil?

A 7-year-old boy is brought to your clinic with a 2-day history of being mildly unwell with malaise and decreased appetite but no fever. This morning, it was discovered that he had oral lesions as shown in the attached image. His mother wonders how she can prevent this from spreading to his younger siblings.
Which one of the following is the best advice?

A 43-year-old car mechanic, with no prior history, comes to the Emergency Department because of a sudden loss of balance at work. He also feels lightheaded, slightly disoriented and nauseous. Physical examination and basic blood work-up are normal. He tells you this is the 3rd time this has happened at work. Which one of the following is the most likely diagnosis?

You are counselling a couple that is concerned about the risk that their second child could be affected by the same X-linked recessive disorder (hemophilia A) as their last child, a boy. Neither parent has this disorder.
What is the probability that their second child will be affected?

A 42-year-old woman presents to your clinic requesting an increase in her stimulant dosage for the treatment of her adult attention-deficit/hyperactivity disorder. Her medical history includes hypertension and type 1 diabetes with associated nephropathy. She has been taking methylphenidate daily for 15 years. Which one of the following would need to be addressed before the dosage can be increased?

A mother brings her 1-month-old infant for routine health examination. The infant was born at term with no complications. He is exclusively breastfed every 3-4 hours and growth parameters are normal. His mother tells you that feedings are difficult (the baby cries any time she tries to put him down) and that she is exhausted. Her husband has been on a military mission since the infant was 2-weeks-old. Which one of the following is the most appropriate next step in management?

You have just completed a well-baby check on a 6-month-old in the office where you have recently begun to practice. You ask the registered nurse to give the immunizations. She refuses, saying this is not within her scope of practice. Which one of the following is the best next step?

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 72-year-old man presents to your clinic accompanied by his 70-year-old husband. The patient reports that, over the last several months, his libido has been very low. Which one of the following would be the best next step?