American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the management protocol for solitary juvenile polyps?

1. Remove and monitor every year

2. Remove without need for further surveillance

3. Perform periodic imaging

4. Leave untreated and observe for symptoms

The correct answer is: Remove without need for further surveillance

The management protocol for solitary juvenile polyps typically involves removing the polyp without the need for further surveillance. Juvenile polyps are generally benign lesions found in children, and solitary juvenile polyps have a low potential for malignancy. Once a solitary juvenile polyp is identified, it is usually excised during endoscopy or through surgical intervention if necessary. The removal of the polyp effectively eliminates the concern for complications such as obstruction or bleeding, as well as the very low risk of cancer associated with these lesions. After excision, follow-up surveillance is not routinely required, particularly if the polyp was solitary and there are no concerning features that would relocate concern about recurrence. This approach minimizes unnecessary medical intervention while ensuring the child's health and safety. In contrast to the other choices, monitoring every year, performing periodic imaging, or leaving the polyp untreated and only observing for symptoms would not align with the best practices for managing solitary juvenile polyps, given their benign nature and low risk for complications when appropriately treated.