Título De Especialista Em Gastroenterologia (FBG) Practice Questions - Título De Especialista Em Gastroenterologia - Federação Brasileira De Gastroenterologia (FBG AMB) Exam

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A 58-year-old male with a 15-year history of chronic GERD undergoes screening endoscopy. The endoscopist identifies salmon-colored columnar mucosa extending 3 cm circumferentially and reaching a maximal extent of 5 cm above the gastroesophageal junction (Prague C3M5). Biopsies confirm intestinal metaplasia with goblet cells and no dysplasia. According to standard gastroenterology guidelines, what is the appropriate surveillance strategy?

Repeat high-definition upper endoscopy with 4-quadrant biopsies every 2 cm (Seattle protocol) in 3 to 5 years. Perform immediate radiofrequency ablation (RFA) to eliminate non-dysplastic Barrett's esophagus. Perform repeat endoscopy in 6 months with 4-quadrant biopsies every 1 cm. Discontinue endoscopic surveillance because non-dysplastic Barrett's esophagus carries zero progression risk.

Correct Answer:

Repeat high-definition upper endoscopy with 4-quadrant biopsies every 2 cm (Seattle protocol) in 3 to 5 years.

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