skip to main content

Familial Adenomatous Polyposis — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

HardGeneral Internal MedicineFamilial Adenomatous PolyposisRACP Adult Medicine

Expert pathology confirms high-grade dysplasia in a Barrett segment. Repeat high-definition endoscopy shows a subtle 8 mm raised lesion but staging demonstrates no invasive carcinoma or nodal disease. Which treatment sequence is preferred?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Resect the lesion endoscopically, then ablate residual Barrett mucosa

Explanation lettering: B = shown as A · E = shown as B · D = shown as C · A = shown as D · C = shown as E

C is correct. Visible Barrett neoplasia is resected first for accurate histological staging, followed by eradication of the remaining Barrett field when invasion is excluded. A destroys staging information. B is excessive without invasive high-risk disease. D leaves high-grade dysplasia untreated. E focal ablation cannot provide the required specimen and leaves the field untreated.

Reference: Cancer Council Australia, Barrett’s oesophagus clinical guidelines: https://www.cancer.org.au/clinical-guidelines/oesophageal-cancer/barretts-oesophagus