American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the surgical intervention threshold for abdominal aortic aneurysms in men?

1. 4.5 cm

2. 5.0 cm

3. 5.5 cm

4. 6.0 cm

The correct answer is: 5.5 cm

The surgical intervention threshold for abdominal aortic aneurysms (AAAs) in men is established at a diameter of 5.5 cm. This threshold is based on evidence showing that the risk of rupture significantly increases when the aneurysm reaches this size. In general, recommendations for managing AAAs indicate that elective repair should be considered once the aneurysm exceeds 5.5 cm in men, as the annual risk of rupture rises to approximately 5-10% at this size. For smaller aneurysms, particularly those under 5.5 cm, the approach is usually more conservative, involving monitoring and follow-up imaging, as the risks associated with surgical intervention may outweigh the potential benefits. The management strategy for these smaller aneurysms depends on various factors, including the patient's overall health, age, and the rate of aneurysm growth. In summary, a threshold of 5.5 cm in men is critical for surgical intervention and is rooted in clinical guidelines meant to balance the risks of intervention with the potential for life-threatening complications from an aneurysm rupture.