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The fact that the med tek quest marker doesn't show up is a known bug that affects everyone.
The fact Maccready doesn't open the door can be due to another bug i report from the wiki:
"Keep in mind that there is a password for a terminal in Covenant called Jacob's Password. If this is in the player's inventory when they enter the Med-Tek Research building, MacCready may not give them the password for the executive terminal on the top floor, instead waiting until he gets to the terminal."
So if you collected that holotape at the Covenant and already used it, ditch it, otherwise store it somewhere before going to med tek.
Other workarounds involve the console:
Open console, select Maccready and type: getav ca_affinity
That will give you the exact affinity you have with Maccready. For the quest to start it should be > 750. If it went below you can try to raise it legit, or if the quest is already activated
setav ca_affinity 751 should suffice, but probably you have to do this before entering medtek
Alteratively you can toggle collision after the door, get to the objective item, collect it, exit the building, and the dialogue with Maccready might appear.
Last solution, serach the ID of the quest item on the wiki, the: player.placeatme ID
after that the item will spawn near your feet (and not directly in your inventory) and you can pick it up, that might trigger the next queststage.
Worst case scenario, give up with the quest, set Maccready affinity to 1000, and manually give you the perk via the console. This way you won't be able to romance him and won't have the "idolized" dialogues, but you can pretend you conpleted the quest if anything else fails.
On my last ending play through I received the final dialogue from Preston multiple times as he gained more affinity.
You could try going to do something things McCready likes (stealing owned items) and see if it redoes the dialogue?
Least his headshot perk was fixed, that was WAY too overpowered at release.
Well you are supposed to post the solution so we know if we were right and anyone searching the forums because they have same problem can find a solution :P
And turns out my affinity with him was still fine..it was at 855.
The only doofus is the one who lies about never having a doofus moement in the game. We all have had those doofus moments.
As for not seeing stairs going up, that happens. I have 1900 hours in game and I still find areas I have never explored, lol.
The funny thing is the last time I did McGreedy quests he was the doofus. The dumbass fell through the floor all the way back to the start once I got to the terminal.
http://steamcommunity.com/sharedfiles/filedetails/?id=717586942