American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the first step in the workup of testicular cancer after identifying a palpable mass?

1. Perform a radical orchiectomy

2. Conduct testicular ultrasonography

3. Measure serum testosterone levels

4. Start chemotherapy

The correct answer is: Conduct testicular ultrasonography

The first step in the workup of testicular cancer after identifying a palpable mass is conducting testicular ultrasonography. This imaging study is essential because it helps confirm the presence of a testicular abnormality, assess the characteristics of the mass, and differentiate between a solid tumor and other potential conditions, like a cyst. Ultrasonography is a non-invasive, readily available test that provides critical information about the size, location, and composition of the mass, helping guide further management. Once a solid mass is confirmed, additional steps, such as serum tumor markers testing and potentially radical orchiectomy, follow based on the findings. This initial imaging is crucial for diagnosis and subsequent treatment planning in suspected testicular cancer cases.