Gastroenterology: familial adenomatous polyposis: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Gastroenterology: familial adenomatous polyposis

Sample item

A 17-year-old has hundreds of colonic adenomas on colonoscopy and a family history of colon cancer. What is the definitive management?

APolypectomy only each yearBReassuranceCProphylactic colectomyDAnnual aspirin alone

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Prophylactic colectomy

FAP results from APC gene mutation and carries nearly 100 percent risk of colorectal cancer by middle age. Prophylactic colectomy, usually in the late teens or twenties, is advised. Duodenal adenomas need lifelong upper endoscopic surveillance.

Option by option

A. Polypectomy only each year
Polypectomy cannot clear hundreds of polyps.
B. Reassurance
Without surgery cancer is almost certain.
C. Prophylactic colectomy (correct)
Correct. Colectomy prevents inevitable malignancy.
D. Annual aspirin alone
Aspirin does not remove the cancer risk.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Prophylactic colectomy. FAP results from APC gene mutation and carries nearly 100 percent risk of colorectal cancer by middle age.

Why is "Polypectomy only each year" not the answer?

Polypectomy cannot clear hundreds of polyps.

Why is "Reassurance" not the answer?

Without surgery cancer is almost certain.

Why is "Annual aspirin alone" not the answer?

Aspirin does not remove the cancer risk.

What concept does this question test?

It tests Gastroenterology: familial adenomatous polyposis in General Medicine. Prophylactic colectomy, usually in the late teens or twenties, is advised. Duodenal adenomas need lifelong upper endoscopic surveillance.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gastroenterology: familial adenomatous polyposis?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.