American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the management protocol for sporadic gastric fundic gland polyps?

1. Require excision and surveillance

2. Do not require excision or surveillance

3. Should be monitored every year

4. Need to be treated with proton pump inhibitors

The correct answer is: Do not require excision or surveillance

Sporadic gastric fundic gland polyps are often benign and typically arise in individuals without the genetic predisposition seen in familial forms of the condition. The current guidelines suggest that these polyps generally do not require excision or surveillance because they have a low risk of malignant transformation. In most cases, the management approach for sporadic gastric fundic gland polyps is based on the overall clinical context, including the number of polyps and the presence of symptoms. Since these polyps are often asymptomatic and found incidentally during endoscopic procedures, routine excision or regular monitoring is unnecessary in the absence of concerning features. Monitoring options like annual follow-ups, intended primarily for polyps with potential for neoplastic changes, do not apply here due to the benign nature of sporadic fundic gland polyps. Similarly, while proton pump inhibitors are considered in the management of other gastric conditions like gastritis or ulcers, they are not a specific treatment for sporadic gastric fundic gland polyps themselves, as these polyps are not driven by acid secretion. Thus, the recommended management protocol indicates that for sporadic gastric fundic gland polyps, no excision or surveillance is necessary.