AAA screening — MCCQE Part 1 MCQ

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MediumPreventive MedicineAAA screeningMCCQE Part 1

A medically fit 79-year-old man has no symptoms of abdominal aortic aneurysm and has never undergone AAA screening. According to the Canadian Task Force on Preventive Health Care, what is the most appropriate screening approach?

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Correct answer: B — Offer one-time abdominal ultrasonography

The Canadian Task Force recommends one-time abdominal ultrasound screening for men ages 65 to 80, so a previously unscreened 79-year-old man remains within the recommended age range and B is correct. The recommendation is weak, making discussion of preferences appropriate, but it does not stop at age 75. Ultrasound is the screening test; CT angiography exposes the patient to contrast and radiation and is not used for population screening. Annual ultrasound is not the recommended initial screening schedule, and abdominal palpation is insufficiently sensitive to replace imaging. Management and surveillance intervals after an aneurysm is detected depend on aneurysm size and are separate from this screening decision.

Reference: Canadian Task Force on Preventive Health Care, Abdominal Aortic Aneurysm: https://canadiantaskforce.ca/guidelines/published-guidelines/abdominal-aortic-aneurysm/