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Renal cell carcinoma — USMLE Step 2 CK MCQ

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ModerateSurgeryRenal cell carcinomaUSMLE Step 2 CK

A 55-year-old Hispanic woman comes to the hospital because of progressive symptoms. History and focused examination are notable for hematuria, flank mass, weight loss, and enhancing renal 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. Laboratory studies show creatinine 2.1 mg/dL, BUN 34 mg/dL, and urinalysis findings consistent with the presentation. Which of the following is most likely to confirm the diagnosis?

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Correct answer: A — Contrast-enhanced CT abdomen

The vignette describes Renal cell carcinoma, supported by hematuria, flank mass, weight loss, and enhancing renal lesion. Contrast-enhanced CT 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: https://www.ncbi.nlm.nih.gov/books/#stage-9-order-28