American Board of Internal Medicine (ABIM) Certification Practice Exam

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What does postoperative surveillance for colorectal cancer entail?

  1. Only routine blood tests

  2. Physical examination and carcinoembryonic antigen measurement

  3. Follow-up colonoscopies every 6 months only

  4. CT scans bi-annually

The correct answer is: Physical examination and carcinoembryonic antigen measurement

Postoperative surveillance for colorectal cancer is focused on monitoring patients after they have undergone surgery to remove cancerous tissue. This is an important process to detect any recurrence of cancer early and manage it effectively. The correct option includes physical examination and carcinoembryonic antigen (CEA) measurement. Regular physical examinations help assess the patient's overall health and detect any new symptoms or concerns that could indicate a recurrence. Carcinoembryonic antigen is a tumor marker that can be elevated in patients with colorectal cancer. Measuring CEA levels periodically post-surgery can provide valuable information, as a rise in CEA levels may suggest disease recurrence or progression. In contrast, routine blood tests alone (the first option) do not provide specific information regarding cancer recurrence. Follow-up colonoscopies every 6 months only (the third option) may be insufficient on their own without the incorporation of physical exams and tumor marker monitoring. Lastly, CT scans bi-annually (the fourth option) might be used in specific cases for patients at higher risk, but routine surveillance generally emphasizes physical examinations and CEA testing as key components of monitoring after surgery. Thus, the combination of physical examination and CEA measurement is integral to a comprehensive surveillance strategy for patients recovering from colorectal cancer surgery.