Epidemiology & Prevention USMLE Step 1 Practice Question
A hospital develops a two-step screening program for a rare but serious endocrine cancer. A 52-year-old woman presents with fatigue and weight loss; initial laboratory work shows elevated 24-hour urinary metanephrines (420 ng/24h; normal <90). Blood pressure is 168/104 mmHg, heart rate 98/min, temperature 37.2°C. The first screening test should identify nearly all true cases, while the second confirmatory test optimizes specificity. Which test combination is most appropriate for this sequential strategy?
Answer choices
- ABoth tests with low specificity
- BBoth tests with low sensitivity
- CFirst test with high specificity, second test with high sensitivity
- DFirst test with low negative predictive value, second test with low positive predictive value
- EFirst test with high sensitivity, second test with high specificityCorrect answer
- FBoth tests requiring high specificity at all stages
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