College of Family Physicians of Canada (CFPC)
Certification Exam Test Questions And Correct Answers
(Verified Answers) Plus Rationales 2025/2026 Q&A |
Instant Download Pdf
1. A 54-year-old man presents with new-onset chest pain while climbing
stairs. What is the most appropriate first investigation?
Electrocardiogram (ECG)
Rationale: Chest pain with exertion raises concern for ischemia; ECG is the
fastest, most accessible, and immediately diagnostic test.
2. A 7-year-old has a fever, sore throat, and tonsillar exudates but no cough.
What is the next step?
Rapid strep test or throat culture
Rationale: Centor criteria suggest streptococcal pharyngitis; confirm with
testing before starting antibiotics.
3. Which vaccine is recommended for adults over 65 years?
Pneumococcal vaccine
Rationale: Pneumococcal vaccination reduces morbidity and mortality
from pneumonia in older adults.
4. A patient with COPD presents with increased dyspnea and purulent
sputum. What is the best management?
Antibiotics and bronchodilators
, Rationale: Purulent sputum indicates bacterial exacerbation, requiring
antibiotics in addition to bronchodilator support.
5. A 30-year-old woman with type 1 diabetes is planning pregnancy. What
should be optimized before conception?
Hemoglobin A1c
Rationale: Tight glycemic control before conception reduces risk of
congenital malformations.
6. A patient presents with sudden severe headache, “the worst ever.” What is
the first diagnostic step?
CT scan of the head without contrast
Rationale: Subarachnoid hemorrhage must be excluded urgently; CT is the
fastest initial test.
7. Which screening is recommended for colorectal cancer in average-risk
adults in Canada?
Fecal immunochemical test (FIT) every 2 years starting at age 50
Rationale: FIT is the first-line population screening tool for colorectal
cancer in Canada.
8. What is the first-line treatment for generalized anxiety disorder?
Cognitive behavioral therapy (CBT)
Rationale: Evidence shows CBT is as effective as medication and should be
considered first-line.
9. A 3-week-old infant presents with projectile vomiting after feeds and
weight loss. What is the likely diagnosis?
Pyloric stenosis
, Rationale: Projectile vomiting and poor weight gain in a neonate are
classic for pyloric stenosis.
10.What is the most effective intervention for smoking cessation?
Combination of counseling and pharmacotherapy
Rationale: Behavioral counseling plus medications (NRT, varenicline,
bupropion) yields the highest quit rates.
11.What is the most appropriate next step for an elderly patient with
suspected delirium?
Identify and treat underlying cause
Rationale: Delirium is usually secondary to acute illness, infection, or
medications and requires correction of cause.
12.A 24-year-old presents with dysuria and urethral discharge. What is the
initial management?
Empiric antibiotics for gonorrhea and chlamydia
Rationale: Treat both pathogens empirically before culture results to
prevent complications and transmission.
13.A 65-year-old male presents with progressive memory loss and impaired
daily functioning. What is the most likely diagnosis?
Alzheimer’s disease
Rationale: Progressive memory decline with loss of independence is
typical of Alzheimer’s dementia.
14.In a patient with new-onset atrial fibrillation, what is the most important
factor to determine anticoagulation?
CHA₂DS₂-VASc score
Certification Exam Test Questions And Correct Answers
(Verified Answers) Plus Rationales 2025/2026 Q&A |
Instant Download Pdf
1. A 54-year-old man presents with new-onset chest pain while climbing
stairs. What is the most appropriate first investigation?
Electrocardiogram (ECG)
Rationale: Chest pain with exertion raises concern for ischemia; ECG is the
fastest, most accessible, and immediately diagnostic test.
2. A 7-year-old has a fever, sore throat, and tonsillar exudates but no cough.
What is the next step?
Rapid strep test or throat culture
Rationale: Centor criteria suggest streptococcal pharyngitis; confirm with
testing before starting antibiotics.
3. Which vaccine is recommended for adults over 65 years?
Pneumococcal vaccine
Rationale: Pneumococcal vaccination reduces morbidity and mortality
from pneumonia in older adults.
4. A patient with COPD presents with increased dyspnea and purulent
sputum. What is the best management?
Antibiotics and bronchodilators
, Rationale: Purulent sputum indicates bacterial exacerbation, requiring
antibiotics in addition to bronchodilator support.
5. A 30-year-old woman with type 1 diabetes is planning pregnancy. What
should be optimized before conception?
Hemoglobin A1c
Rationale: Tight glycemic control before conception reduces risk of
congenital malformations.
6. A patient presents with sudden severe headache, “the worst ever.” What is
the first diagnostic step?
CT scan of the head without contrast
Rationale: Subarachnoid hemorrhage must be excluded urgently; CT is the
fastest initial test.
7. Which screening is recommended for colorectal cancer in average-risk
adults in Canada?
Fecal immunochemical test (FIT) every 2 years starting at age 50
Rationale: FIT is the first-line population screening tool for colorectal
cancer in Canada.
8. What is the first-line treatment for generalized anxiety disorder?
Cognitive behavioral therapy (CBT)
Rationale: Evidence shows CBT is as effective as medication and should be
considered first-line.
9. A 3-week-old infant presents with projectile vomiting after feeds and
weight loss. What is the likely diagnosis?
Pyloric stenosis
, Rationale: Projectile vomiting and poor weight gain in a neonate are
classic for pyloric stenosis.
10.What is the most effective intervention for smoking cessation?
Combination of counseling and pharmacotherapy
Rationale: Behavioral counseling plus medications (NRT, varenicline,
bupropion) yields the highest quit rates.
11.What is the most appropriate next step for an elderly patient with
suspected delirium?
Identify and treat underlying cause
Rationale: Delirium is usually secondary to acute illness, infection, or
medications and requires correction of cause.
12.A 24-year-old presents with dysuria and urethral discharge. What is the
initial management?
Empiric antibiotics for gonorrhea and chlamydia
Rationale: Treat both pathogens empirically before culture results to
prevent complications and transmission.
13.A 65-year-old male presents with progressive memory loss and impaired
daily functioning. What is the most likely diagnosis?
Alzheimer’s disease
Rationale: Progressive memory decline with loss of independence is
typical of Alzheimer’s dementia.
14.In a patient with new-onset atrial fibrillation, what is the most important
factor to determine anticoagulation?
CHA₂DS₂-VASc score
