I am going to answer the sample USMLE Step 1 Questions with Explanation. These questions are available at USMLE.org
Q- A 68-year-old man with alcohol use disorder comes to the office because of a 3-month history of intermittent blood in his urine; he has had no pain. He is a retired laboratory technician from a company that produces naphthylamine. He has smoked 1½ packs of cigarettes daily for 45 years. A CT scan of the abdomen shows a mass in the pelvis of the left kidney. A photograph of the surgically resected kidney is shown.
The neoplastic process in this kidney is most likely to be which of the following?
(A) Angiomyolipoma
(B) Metastatic melanoma
(C) Nephroblastoma
(D) Oncocytoma
(E) Urothelial carcinoma
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Answer
History of smoking, chemical exposure to naphthylamine and alcohol use major risk factors for urothelial carcinoma. Painless hematuria and absence of infection and kidney stones also suggest this diagnosis. Urothelial carcinoma (transitional cell carcinoma) is the most common malignant tumor of the urinary tract.
The correct answer is E