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Ulcerative colitis surveillance — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)Ulcerative colitis surveillanceUSMLE Step 3

A 47-year-old man has ulcerative colitis controlled with mesalamine. Colonoscopy shows extensive colitis for 10 years with no dysplasia. He is asymptomatic. Which of the following is the most appropriate next step in management?

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Correct answer: C — Schedule surveillance colonoscopy at recommended intervals

Long-standing extensive ulcerative colitis increases colorectal cancer risk and requires surveillance colonoscopy even when symptoms are controlled.

Reference: ACG ulcerative colitis guideline