American Board of Internal Medicine (ABIM) Certification Practice Exam

What classification do low-risk gastric ulcers fall under?

1. Clean-based or nonprotuberant pigmented spot

2. Ulcers larger than 2 cm

3. Necrotic ulcerations

4. Ulcers with bleeding

The correct answer is: Clean-based or nonprotuberant pigmented spot

Low-risk gastric ulcers are classified as clean-based or nonprotuberant pigmented spots. This classification indicates that the ulcer does not exhibit significant necrosis or active bleeding, which are markers commonly associated with higher risks of complications. A clean-based ulcer usually signifies superficial damage to the gastric mucosa, which is less likely to result in serious issues such as perforation or major hemorrhage. The absence of active bleeding also suggests that the ulcer is not currently contributing to the patient's immediate clinical instability. Therefore, when evaluating gastric ulcers, the presence of a clean base is a reassuring sign that points toward a lower risk profile for complications. In contrast, ulcers larger than 2 cm, necrotic ulcerations, or those with bleeding indicate higher-risk situations that necessitate more aggressive monitoring and management strategies, as they are associated with increased likelihood of serious outcomes. Recognizing this classification allows healthcare providers to ascertain the urgency of intervention and tailor treatment strategies accordingly.