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Barrett HGD Management — RACP Adult Medicine MCQ

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HardGastroenterologyBarrett HGD ManagementRACP Adult Medicine

A 72-year-old with a known 7.2 cm infrarenal aneurysm develops abrupt back pain, syncope and persistent systolic pressure 75 mmHg. Bedside ultrasound confirms the aneurysm; the regional vascular team is ready. What should happen next?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Activate immediate rupture repair with permissive resuscitation and vascular control

Explanation lettering: B = shown as A · D = shown as B · E = shown as C · C = shown as D · A = shown as E

D is correct. This is haemodynamically unstable ruptured AAA: immediate vascular activation, blood-product-led permissive resuscitation and operative control take priority. A may be used only if stability permits and must not delay control. B disrupts clot and worsens bleeding. C haemoglobin can initially be normal. E is incompatible with shock and rupture.

Reference: Australian and New Zealand Society for Vascular Surgery, Abdominal aortic aneurysm: https://anzsvs.org.au/patient-information/abdominal-aortic-aneurysm/