Gestational diabetes mellitus — USMLE Step 2 CK MCQ

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HardObstetrics & GynecologyGestational diabetes mellitusUSMLE Step 2 CK

A 63-year-old man undergoes high-quality colonoscopy. A 28-mm sessile serrated lesion in the ascending colon is removed piecemeal by endoscopic mucosal resection; the endoscopist believes all visible tissue was removed. Pathology shows no dysplasia. When should surveillance colonoscopy be performed?

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Correct answer: E — In 6 months

Piecemeal resection of an adenoma or sessile serrated lesion larger than 20 mm requires surveillance at 6 months because microscopic residual tissue and local recurrence are more common even when the visible resection appears complete. The absence of dysplasia does not lengthen that early site-check interval. A 1-year interval applies to other high-risk patterns such as more than ten completely removed adenomas and follows the first examination in the intensive post-piecemeal sequence. Three- and five-year intervals apply to selected completely removed advanced or serrated lesions, and 10 years is reserved for normal or very-low-risk examinations.

Reference: US Multi-Society Task Force: Follow-up After Colonoscopy and Polypectomy: https://gastro.org/clinical-guidance/follow-up-after-colonoscopy-and-polypectomy-a-consensus-update-by-the-u-s-multi-society-task-force-on-colorectal-cancer/