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AAA Surveillance — RACP Adult Medicine MCQ

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EasyCardiologyAAA SurveillanceRACP Adult Medicine

A 70-year-old man has an incidental 4.5 cm infrarenal AAA found on ultrasound screening. He is asymptomatic. He is a current smoker with hypertension. What is the most appropriate management?

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Correct answer: A — Surveillance ultrasound every 12 months

Asymptomatic AAA 4.0-5.4 cm — surveillance with serial ultrasound. Frequency: every 12 months for 4.0-4.9 cm, every 6 months for 5.0-5.4 cm. Intervention threshold: ≥5.5 cm (or >5.0 cm in women), rapid expansion (>1 cm/year), or symptomatic. Cardiovascular risk reduction: smoking cessation (most important modifiable risk factor — slows expansion rate by ~20%), statin, antihypertensive (beta-blockers may slow expansion), and antiplatelet therapy.

Reference: ESVS – 2024 – AAA Guidelines; eTG Cardiovascular 2024