American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommended follow-up time for patients with small, asymptomatic meningiomas after their initial MRI?

1. 1 to 2 months

2. 3 to 6 months

3. 6 to 12 months

4. 12 to 18 months

The correct answer is: 3 to 6 months

The appropriate follow-up time for patients with small, asymptomatic meningiomas after their initial MRI is typically within a range of 3 to 6 months. This time frame is recommended because it allows for monitoring any potential growth of the tumor while recognizing that many small meningiomas may remain stable for long periods without intervention. In the context of clinical guidelines, patients with small, asymptomatic meningiomas are often managed conservatively with periodic imaging. The initial follow-up interval of 3 to 6 months allows for an early reassessment of the tumor, as this is a period during which changes may be observed. Subsequent follow-up intervals can often be extended if no significant changes in the size or characteristics of the meningioma are noted. This approach balances the need for active surveillance with the understanding that many meningiomas have a relatively slow growth rate, thereby minimizing unnecessary imaging and anxiety for patients. In contrast, shorter follow-up intervals may lead to overtreatment or procedures that are not warranted due to a lack of growth, while longer intervals could risk missing significant growth that might require timely intervention.