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* pedunculated polyp
  bijjar - 10/29/06 21:42
  According to the American College of Gastroenterology Guidelines, if all of the following conditions are met in a high-risk patient with a recent resection of a single small pedunculated polyp and ,

The polyp is considered to be completely excised.

There is accurate determination of the depth of invasion, grade of differentiation and completeness of excision of the carcinoma.

The cancer is not poorly differentiated.

There is no vascular or lymphatic involvement.

The margins of the excision and the stalk of the pedunculated adenoma are not involved.

Which of the following is the most appropriate next step in the management of this patient?

A. Repeat the colonoscopy in one year.

B. Refer the patient for an elective sigmoid resection.

C. Repeat the colonoscopy in three years.

D. Schedule the patient for an elective right hemicolectomy.

E. Refer the patient to a colorectal surgeon for further evaluation.
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* Re:pedunculated polyp
  logic - 10/29/06 22:02
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* Re:pedunculated polyp
  ss - 10/30/06 00:18
  C. Repeat the colonoscopy in three years.

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* Re:pedunculated polyp
  union_station - 10/30/06 09:23
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* Re:pedunculated polyp
  drsri - 10/30/06 10:41
  a-high risk  
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* Re:pedunculated polyp
  hiraaz - 10/30/06 12:54
  is the Qsn rightly written?
wha does "not poorly differentiated" mean?
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* Re:pedunculated polyp
  ria007 - 10/30/06 13:46

why have you been asking all the usmleworld questions, especially when they have given the explanations to all these questions so nicely.I didnt get your point.Also if your posting them to discuss then post the answers as well and discuss them.
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* Re:pedunculated polyp
  bijjar - 10/31/06 19:20
are you reminding me some copy right issue or what, if you guys don't like or think that these Qs are not useful, so I will sure not post, happy.
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* Re:pedunculated polyp
  ss - 10/31/06 19:39

you are doing a good job. the q's that you post sure helps to refresh what we have been studying. so keep it going.

as for ria007
if you think that it is not useful for you, just don't participate. don't discourage others. why do you think others are answering bijjar's q's?
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* Re:pedunculated polyp
  erythro - 11/01/06 01:55
  To Bijjar..
Though I have stopped participating actively but bijjar carry on the good work..We all appreciate this,and very politely i want to also remind you tht plzz make sure tht u post the answer after a day...its just a request....i knw by tht time many guys have symptomatic alopecia..U r doing fantastic job brother..

To Ria,
I guess uer subscription of UW has not expired or u are not done completely with uer UW,so u dont want to see this question earlier before attempting uer block...But Ria I guess u will agree with me tht we alll need knowledge,irrespective of source and time, and wht bijjar is doing is tht he is refreshing the questions we have attempted earlier but may have just do them and learn them and it also gives u the opportunity to compare uerslef frm other..I hope u got my point..and GL guys..May we all pass..amen....
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* Re:pedunculated polyp
  sunny06 - 11/01/06 15:15
  if the above lesion was diagnosed on flexible sigmoidoscopy,urgen coloncoscoy should be done.
if this lesion was found on colonoscpy,repeat colonoscy should be done on 3 years.(if no recur next survel in 5yr)
further if lesion is low grade,<1cm,non vilous.repeat should be done in 5 years

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