skip to main content

Acute appendicitis — USMLE Step 2 CK MCQ

Instant feedback + full explanation. One question, done properly.

ModerateSurgeryAcute appendicitisUSMLE Step 2 CK

A 62-year-old White man comes to the emergency department because of progressive symptoms. History and focused examination are notable for periumbilical pain migrating to the right lower quadrant with psoas sign. Temperature is 98.6°F (37.0°C), blood pressure is 126/78 mmHg, pulse is 84/min, respirations are 16/min, and oxygen saturation is 98% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Focused laboratory studies and imaging support an acute surgical process without suggesting a safer outpatient approach. Which of the following is the most likely diagnosis?

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

Reveal the answer and explanation

Correct answer: E — Acute appendicitis

The vignette describes Acute appendicitis, supported by periumbilical pain migrating to the right lower quadrant with psoas sign. Acute appendicitis is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: https://www.ncbi.nlm.nih.gov/books/#stage-9-order-23