Free MCCQE1 Practice MCQs

Question ID: MCCQE1-FREE-CARD-0001

A 58-year-old man presents with 40 minutes of central chest pressure radiating to the left arm. He is diaphoretic. ECG shows ST-segment elevation in leads II, III, and aVF. Blood pressure is 96/60 mmHg and heart rate is 48/min.

What is the most appropriate next step?

A. Arrange outpatient exercise stress testing B. Initiate urgent reperfusion pathway and antiplatelet therapy C. Wait for serial troponins before treatment D. Give immediate intravenous beta-blocker E. Treat as reflux and reassess in 6 hours

Correct answer: B

Inferior STEMI with ischemic symptoms requires immediate reperfusion planning and antiplatelet therapy according to local protocol. Troponin should not delay reperfusion. Bradycardia and hypotension make immediate beta-blockade unsafe.

Question ID: MCCQE1-FREE-PEDS-0002

A 2-year-old child has fever, barking cough, hoarse voice, and inspiratory stridor only when agitated. Oxygen saturation is 97% on room air. The child is alert and drinking small amounts.

What is the most appropriate initial management?

A. Immediate endotracheal intubation B. Oral antibiotics and discharge without observation C. Give corticosteroid and monitor severity D. Chest physiotherapy every 2 hours E. Routine chest radiograph before treatment

Correct answer: C

This presentation is consistent with mild to moderate viral croup. Corticosteroid therapy reduces symptom severity and return visits. Nebulized epinephrine is used when stridor occurs at rest or distress is more significant.

Question ID: MCCQE1-FREE-OBGYN-0003

A 28-year-old pregnant patient at 30 weeks has painless bright red vaginal bleeding. She is hemodynamically stable and the fetal heart rate is reassuring.

What should be avoided until placental location is confirmed?

A. Digital vaginal examination B. Ultrasound assessment C. Maternal vital sign assessment D. Fetal heart rate assessment E. Intravenous access if bleeding continues

Correct answer: A

Painless third-trimester bleeding suggests placenta previa until proven otherwise. Digital vaginal examination can provoke severe hemorrhage and should be avoided until ultrasound clarifies placental location.

Question ID: MCCQE1-FREE-PSYCH-0004

A 35-year-old patient reports low mood, anhedonia, poor sleep, and guilt for 6 weeks. When asked about safety, he says, “Sometimes I think my family would be better without me.”

What is the most appropriate next step?

A. Reassure him that passive thoughts are low risk B. Focus only on antidepressant adverse effects C. Delay risk assessment until the next visit D. Assess suicidal intent, plan, means, protective factors, and supports E. Avoid asking more because it may increase suicidal thoughts

Correct answer: D

Any suicidal statement requires a direct suicide risk assessment, including intent, plan, access to means, prior attempts, substance use, supports, and protective factors. Asking directly does not create suicidal ideation.

Question ID: MCCQE1-FREE-ETHICS-0005

A competent adult refuses a recommended blood transfusion after a clear explanation of risks, benefits, and alternatives. The physician believes refusal increases the risk of death.

What is the most appropriate approach?

A. Transfuse because the physician knows best B. Ask the family to override the refusal C. Document refusal but provide no further care D. Delay care until the patient changes their mind E. Respect the informed refusal and offer acceptable alternatives

Correct answer: E

A capable patient may refuse recommended treatment, even if refusal carries serious risk. The physician should confirm understanding, document informed refusal, and continue supportive care using acceptable alternatives.

Question ID: MCCQE1-FREE-ID-0006

A 72-year-old woman has fever, productive cough, pleuritic chest pain, and oxygen saturation of 89% on room air. She appears confused and has a respiratory rate of 31/min.

What is the most appropriate disposition?

A. Discharge with oral antibiotics and phone follow-up B. Hospital assessment and treatment for pneumonia C. Reassure because cough is usually viral D. Delay antibiotics until sputum culture returns E. Treat only with inhaled bronchodilator therapy

Correct answer: B

Hypoxemia, confusion, tachypnea, and advanced age suggest higher-risk community-acquired pneumonia requiring urgent hospital-based assessment, oxygen support, investigations, and empiric antimicrobial therapy.

Question ID: MCCQE1-FREE-ENDO-0007

A patient with type 2 diabetes takes metformin and a sulfonylurea. He has sweating, tremor, and confusion before lunch that improve with juice. Fasting glucose readings are often normal.

What is the best next clinical step?

A. Increase the sulfonylurea because A1c may be high B. Stop all diabetes medications permanently C. Review meal timing, glucose logs, and medication-related hypoglycemia risk D. Ignore symptoms because fasting glucose is normal E. Begin very-low-carbohydrate diet without medication review

Correct answer: C

Adrenergic and neuroglycopenic symptoms relieved by carbohydrate suggest hypoglycemia. Sulfonylureas can cause hypoglycemia, especially with delayed meals or inconsistent intake. Logs and medication timing should be reviewed before intensifying therapy.

Question ID: MCCQE1-FREE-NEURO-0008

A 66-year-old man develops sudden right-sided weakness and aphasia 45 minutes ago. Capillary glucose is normal. He is within the acute stroke window.

What is the most appropriate immediate investigation?

A. Urgent non-contrast CT head with stroke pathway activation B. Outpatient carotid Doppler ultrasound C. Routine EEG D. Lumbar puncture before imaging E. Observation until symptoms resolve

Correct answer: A

Acute focal neurologic deficit within a reperfusion window requires urgent stroke pathway activation and brain imaging to exclude hemorrhage and determine eligibility for reperfusion therapy.

Question ID: MCCQE1-FREE-SURG-0009

A 23-year-old man has acute scrotal pain, nausea, and a high-riding tender testis. The cremasteric reflex is absent.

What is the most appropriate management?

A. Schedule outpatient urology review in 1 week B. Treat only with oral antibiotics C. Reassure and recommend scrotal support D. Urgent surgical/urologic assessment for suspected torsion E. Delay care until urine culture returns

Correct answer: D

Acute unilateral scrotal pain with nausea, high-riding testis, and absent cremasteric reflex suggests testicular torsion. Time-sensitive urologic assessment is required to preserve testicular viability.

Question ID: MCCQE1-FREE-PREVENT-0010

A 52-year-old average-risk patient asks about colorectal cancer screening. There is no family history and no bowel symptoms.

Which approach is most appropriate?

A. No screening is needed until symptoms develop B. Annual CT abdomen for screening C. Colonoscopy every year for all average-risk adults D. Tumour markers as the preferred screening test E. Offer guideline-based colorectal cancer screening options

Correct answer: E

Average-risk adults in this age range should be offered colorectal cancer screening according to jurisdictional guidance, commonly with stool-based testing and/or colonoscopy depending on local program recommendations and patient factors.

BoardQBank

Try Free Practice MCQs before subscription

Free practice format

Exam Mode

Review Mode

Upgrade Path