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Pancreatic cancer — MCCQE Part 1 MCQ

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ModerateWeight LossPancreatic cancerMCCQE Part 1

A 72-year-old man has painless jaundice, pruritus, pale stools, dark urine, an 8 kg weight loss and a non-tender palpable gallbladder. Which of the following is the most appropriate next step?

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Correct answer: BArrange urgent abdominal imaging for pancreaticobiliary malignancy

Arrange urgent abdominal imaging for pancreaticobiliary malignancy is the single best answer because the age, timing, examination findings and investigations in the vignette fit Pancreatic 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 cancer referral guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian cancer referral guidance