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Ruptured abdominal aortic aneurysm — MCCQE Part 1 MCQ

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HardBack PainRuptured abdominal aortic aneurysmMCCQE Part 1

A 78-year-old man collapses with sudden back and abdominal pain. He is hypotensive, has a pulsatile abdominal mass, and bedside ultrasound shows a 7.8 cm abdominal aortic aneurysm with free fluid. What is the most appropriate next step in management?

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Correct answer: A — Activate vascular surgery for emergent aneurysm repair while resuscitating

Shock, back pain, a pulsatile mass, and ultrasound findings indicate ruptured abdominal aortic aneurysm. Immediate vascular surgery involvement and controlled resuscitation are required. Outpatient imaging and observation are unsafe. Thrombolysis could be catastrophic. Spine radiography ignores a life-threatening vascular diagnosis.

Reference: Canadian Society for Vascular Surgery AAA guidance