American Board of Internal Medicine (ABIM) Certification Practice Exam

What is one of the criteria for diagnosing serrated polyposis syndrome?

1. One serrated polyp greater than 10 mm

2. Five or more serrated polyps proximal to the sigmoid colon

3. Any serrated polyp in family history of colon cancer

4. No polyps with a family history

The correct answer is: Five or more serrated polyps proximal to the sigmoid colon

One of the criteria for diagnosing serrated polyposis syndrome involves the presence of five or more serrated polyps proximal to the sigmoid colon. This is significant because serrated polyps, particularly hyperplastic and sessile serrated adenomas, have been recognized as important precursors to colorectal cancer. The accumulation of these polyps in the proximal colon is indicative of an increased risk of malignancy and aligns with the diagnostic criteria established for this syndrome. Serrated polyposis syndrome is a condition characterized by specific polyp patterns that warrant close surveillance and management due to the elevated risk of colorectal cancer. The count of five or more serrated polyps in the proximal colon serves as a critical threshold for diagnosis, reflecting the propensity for these lesions to lead to colorectal pathology. Other options present divergent criteria that do not align with the established diagnostic framework for serrated polyposis syndrome. For example, a single polyp of significant size may indicate the need for surveillance but does not meet the threshold for diagnosis. Family history alone, without specific polyp count or location criteria, does not fulfill the diagnostic requirements. Additionally, having no polyps in the presence of a family history does not address the presence of serrated lesions, which are essential for this