CCFP SAMP Exam Prep: Sample Questions Guide

The written SAMPs (Short-Answer Management Problems) component is four hours of case-based questions. A real, current format change: starting April 2026, cases are transitioning from write-in answers to multiple-choice and short-menu questions — up to 25% of 2026 exam cases use MCQ/short-menu format, with all cases moving to that format by 2027 and write-in fully retired. That means MCQ/short-menu practice is now directly representative of a real, growing share of the actual exam, not a supplementary format.

Below are four practice questions in that MCQ/short-menu style — TopQbank's own original items, written to match the real target format, not real CFPC exam questions (CFPC's own small official sample set is published separately as Sample-SAMPs.pdf).

Question 1

A 68-year-old man with type 2 diabetes and hypertension presents for a routine visit. He reports no symptoms. His most recent labs show an eGFR of 55 mL/min/1.73m² and a urine albumin-to-creatinine ratio of 45 mg/mmol (elevated). He is currently on metformin and amlodipine. What is the most appropriate next step in management?

A) Add an ACE inhibitor or ARB

B) Discontinue metformin immediately

C) Refer for urgent dialysis planning

D) No change needed; repeat labs in 1 year

Correct answer: A) Add an ACE inhibitor or ARB. This patient has diabetic kidney disease (reduced eGFR with elevated albuminuria). ACE inhibitors or ARBs are recommended in this setting for their renal-protective effect, independent of blood pressure control alone. His eGFR does not require discontinuing metformin at this level, and dialysis planning is not indicated for this stage of kidney disease — ongoing monitoring and risk-factor management are the priority, not simply repeating labs in a year without intervention.

Question 2

A 45-year-old woman presents with a 6-month history of low mood, anhedonia, poor sleep, and decreased concentration, meeting criteria for major depressive disorder. She has no history of mania or psychosis. Which of the following is the most appropriate first-line pharmacologic option? Select the single best answer.

A) An SSRI

B) A benzodiazepine

C) An antipsychotic

D) A stimulant

Correct answer: A) An SSRI. SSRIs are first-line pharmacologic treatment for major depressive disorder in primary care, given their efficacy and favorable safety profile relative to older agents. Benzodiazepines aren't appropriate as monotherapy for depression (and carry dependence risk), antipsychotics are reserved for psychotic features or specific augmentation strategies, and stimulants aren't indicated for uncomplicated MDD.

Question 3

A 3-year-old boy is brought in for a well-child visit. His parents report he is not yet combining words and has limited eye contact and repetitive hand movements. What is the most appropriate next step?

A) Reassurance; boys often talk later than girls

B) Referral for a formal developmental/autism assessment

C) Immediate referral to psychiatry for medication

D) Hearing test only, no other workup needed

Correct answer: B) Referral for a formal developmental/autism assessment. Language delay combined with reduced eye contact and repetitive behaviors are red flags for autism spectrum disorder, warranting a timely referral for formal developmental assessment — early identification and intervention improve outcomes. A hearing test is a reasonable part of a broader workup (to rule out hearing loss as a contributor to language delay) but is not sufficient alone, and medication referral is not the appropriate first step for a developmental concern in a young child.

Question 4

A 72-year-old woman with osteoporosis on alendronate presents with new-onset jaw pain and an area of exposed bone in her mandible following a dental extraction 6 weeks ago. What is the most likely diagnosis?

A) Medication-related osteonecrosis of the jaw

B) Simple dry socket

C) Dental abscess unrelated to her medication

D) Temporomandibular joint dysfunction

Correct answer: A) Medication-related osteonecrosis of the jaw. Exposed bone persisting after a dental extraction in a patient on a bisphosphonate (alendronate) is characteristic of medication-related osteonecrosis of the jaw (MRONJ), a recognized complication of long-term bisphosphonate therapy, particularly following invasive dental procedures. Dry socket typically resolves within a couple of weeks and does not present with persistent exposed bone; the medication history here is the key clue distinguishing this from an unrelated dental abscess or TMJ dysfunction.