American Board of Internal Medicine (ABIM) Certification Practice Exam

In the context of membranous glomerulopathy, what additional evaluation is generally recommended?

1. Comprehensive cancer screening

2. CT imaging of the abdomen

3. Screening only in high-risk patients

4. Ophthalmologic examination

The correct answer is: Screening only in high-risk patients

In the context of membranous glomerulopathy, which is often associated with underlying conditions that may include malignancies, autoimmune diseases, and infections, the appropriate strategy involves evaluating the patient based on their individual risk factors. Screening only in high-risk patients is a tailored approach that recognizes the need to identify underlying causes, such as malignancies, particularly in older adults or those exhibiting significant proteinuria or other clinical red flags. This targeted screening allows for necessary investigations without subjecting all patients to extensive testing, which could lead to unnecessary anxiety or intervention. Taking into account the clinical context and individual patient history significantly influences the need for further evaluation. If a patient presents with atypical features or is in a demographic group with a higher association with underlying conditions linked to membranous glomerulopathy, then a more proactive approach toward screening for malignancies or other risks becomes warranted. Hence, this method not only conserves resources but also ensures that patients most likely to benefit from additional evaluation receive it.