American Board of Internal Medicine (ABIM) Certification Practice Exam

What action is required after colectomy for its potential complications concerning familial adenomatous polyposis?

1. Continued surveillance for duodenal cancer

2. Regular liver function tests

3. Psychological counseling

4. Ultrasound of the abdomen

The correct answer is: Continued surveillance for duodenal cancer

Following a colectomy for familial adenomatous polyposis (FAP), continued surveillance for duodenal cancer is particularly important due to the inherent risk factors associated with this genetic condition. FAP is characterized by the development of numerous polyps in the colon, and individuals diagnosed with this syndrome are also at an increased risk for other types of cancers, including duodenal cancer. The risk of developing duodenal adenomas, which can progress to duodenal cancer, necessitates ongoing surveillance, typically through endoscopic evaluations. Regular monitoring can lead to early detection and management of any precancerous lesions, which is crucial given the potentially aggressive nature of cancers associated with FAP. In contrast, while liver function tests may be relevant depending on the clinical scenario, they are not specific to the complications arising post-colectomy in FAP. Psychological counseling may be beneficial for emotional support but is not a requirement following the surgery. Similarly, abdominal ultrasounds would not specifically address the heightened risk of duodenal cancer that follows a colectomy in this context.