American Board of Internal Medicine (ABIM) Certification Practice Exam

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What should patients undergo after SVR if they have stage 3 fibrosis or cirrhosis?

Regular blood tests
Endoscopic screening for varices
Weekly imaging studies
Stool testing for parasites

The correct answer is: Endoscopic screening for varices

Patients who have achieved a sustained viral response (SVR) after treatment for hepatitis C and have stage 3 fibrosis (F3) or cirrhosis (F4) require endoscopic screening for varices. This is due to the increased risk of complications associated with portal hypertension that can occur in advanced liver disease. Endoscopic screening for varices is an important part of managing patients with significant fibrosis or cirrhosis because it allows for the early detection and treatment of esophageal varices, which can lead to life-threatening hemorrhages. Regular monitoring in this population can help prevent complications and improve overall outcomes. In contrast, while regular blood tests are beneficial for monitoring liver function and health, and stool testing for parasites may be relevant in different contexts, they do not specifically address the complications related to portal hypertension. Weekly imaging studies are also not necessary after SVR in this case. Therefore, endoscopic screening for varices stands out as the appropriate and critical follow-up procedure for these patients.