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Acute mesenteric ischemia — USMLE Step 2 CK MCQ

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EasySurgeryAcute mesenteric ischemiaUSMLE Step 2 CK

A 37-year-old Middle Eastern man comes to the clinic because of abdominal pain or gastrointestinal symptoms. History and focused examination are notable for severe abdominal pain out of proportion to examination with atrial fibrillation. 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 appropriate initial diagnostic study?

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

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Correct answer: C — CT angiography of the abdomen

The vignette describes Acute mesenteric ischemia, supported by severe abdominal pain out of proportion to examination with atrial fibrillation. CT angiography of the abdomen 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: World Society of Emergency Surgery 2022 Mesenteric Ischemia Guideline