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Bladder cancer — MCCQE Part 1 MCQ

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ModerateBlood in UrineBladder cancerMCCQE Part 1

A 68-year-old man with a 45-pack-year smoking history has painless visible haematuria; urinalysis confirms blood and culture is negative. Which of the following is the most appropriate next step?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: BRefer for cystoscopy and upper-tract imaging

Refer for cystoscopy and upper-tract imaging is the single best answer because the age, timing, examination findings and investigations in the vignette fit Bladder cancer better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian Urological Association haematuria guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: https://mcc.ca/objectives/medical-experts/