American Board of Internal Medicine (ABIM) Certification Practice Exam

Which condition is associated with adenomatous and hyperplastic gastric polyps?

1. Atrophic gastritis

2. Inflammatory bowel disease

3. Peptic ulcer disease

4. Chronic pancreatitis

The correct answer is: Atrophic gastritis

Adenomatous and hyperplastic gastric polyps are primarily associated with atrophic gastritis. This condition involves the chronic inflammation of the gastric mucosa, which leads to the destruction of gastric glands and often results in intestinal metaplasia. The chronicity of this inflammation predisposes individuals to the development of both adenomatous and hyperplastic polyps. Atrophic gastritis can occur due to various factors, including chronic infection with Helicobacter pylori, autoimmune conditions, or long-standing exposure to irritating substances, which can significantly alter the gastric environment. As the normal architecture of the gastric mucosa is disrupted, there is an increased risk for both types of polyps. In contrast, while inflammatory bowel disease, peptic ulcer disease, and chronic pancreatitis can affect the gastrointestinal tract, they do not have the same strong association with the formation of gastric polyps seen in patients with atrophic gastritis. Hence, the link between atrophic gastritis and the development of adenomatous and hyperplastic gastric polyps makes it the correct choice.