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Obstructing colon cancer — USMLE Step 2 CK MCQ

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HardSurgeryObstructing colon cancerUSMLE Step 2 CK

A 32-year-old White woman comes to the hospital because of progressive symptoms. History and focused examination are notable for progressive constipation, weight loss, iron deficiency anemia, and apple-core lesion. 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?

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Correct answer: B — Colonoscopy with biopsy

The vignette describes Obstructing colon cancer, supported by progressive constipation, weight loss, iron deficiency anemia, and apple-core lesion. Colonoscopy with biopsy 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-27