ADPKD Aneurysm Screening — RACP Adult Medicine MCQ
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Correct answer: C — Non-invasive cerebral magnetic-resonance angiography after counselling about potential downstream findings
The best answer is “Non-invasive cerebral magnetic-resonance angiography after counselling about potential downstream findings”. ADPKD plus a first-degree family history of intracranial aneurysm or subarachnoid haemorrhage is a recognised reason to offer screening. Non-contrast MRA avoids radiation and iodinated contrast and is suitable for initial screening. Catheter angiography is invasive and reserved for selected diagnostic or treatment planning; symptoms are not required for an unruptured aneurysm.
Reference: CARI Guidelines: Living guidelines for autosomal dominant polycystic kidney disease: https://www.cariguidelines.org/living-guidelines/ Kidney Health Australia: Living kidney donation: https://kidney.org.au/resources/booklets/an-introduction-to-kidney-donation-by-live-donors-booklet/