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Ruptured abdominal aortic aneurysm — RCPSC EM MCQ

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HardGI/Abdominal emergenciesRuptured abdominal aortic aneurysmRCPSC EM

CTAS 1: A 76-year-old man has sudden abdominal and back pain with near-syncope. Vitals are BP 82/50, HR 122, RR 24, SpO2 96% on oxygen. He has a pulsatile abdominal mass and cool extremities. Bedside ultrasound shows a 7.2 cm infrarenal aorta with free intraperitoneal fluid. What is the most likely diagnosis?

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

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Correct answer: B — Ruptured abdominal aortic aneurysm

Shock, back or abdominal pain and a large aneurysm on bedside ultrasound are diagnostic enough to mobilise vascular surgery and permissive resuscitation.

Reference: Canadian vascular surgery emergency practice; Royal College EM Objectives