American Board of Internal Medicine (ABIM) Certification Practice Exam

When is AAA screening recommended for men?

1. At age 60

2. Every year after age 75

3. One-time screening ages 65 to 75 for smokers

4. Every 5 years if risk factors are present

The correct answer is: One-time screening ages 65 to 75 for smokers

AAA screening, or abdominal aortic aneurysm screening, is specifically recommended for men who are at higher risk. The guidelines suggest one-time screening for men aged 65 to 75 who have ever smoked. This recommendation is based on evidence indicating that smoking significantly increases the prevalence of AAA, thus justifying targeted screening in this demographic. The rationale behind this specific age range is that AAA is more commonly diagnosed in older adults, and the benefits of early detection can lead to life-saving interventions before an aneurysm ruptures. Men who have never smoked are at a lower risk, and current recommendations do not include routine screening for this group because the potential benefits do not outweigh the risks of unnecessary procedures or anxiety associated with false positives. The other age-related screenings or intervals mentioned do not align with current evidence-based guidelines. For instance, while men over 75 may still hold higher risk factors owing to age, the screening is not recommended on a yearly basis unless they present specific indications. Routine five-year screening for individuals with risk factors lacks sufficient supporting evidence compared to the focused approach for the 65 to 75 age group who are smokers. Thus, the recommendation emphasizes a risk-based strategy rather than a blanket one for all older men.