American Board of Family Medicine (ABFM) Practice Exam

What is the recommended screening method for abdominal aortic aneurysm (AAA) in males aged 65 to 75 who have a history of smoking?

1. CT scan

2. MRI

3. One-time abdominal duplex ultrasound

4. X-ray

The correct answer is: One-time abdominal duplex ultrasound

The recommended screening method for abdominal aortic aneurysm (AAA) in males aged 65 to 75 who have a history of smoking is a one-time abdominal duplex ultrasound. This screening is particularly targeted at this demographic due to their increased risk for AAA, which is significantly higher among older men who have a history of tobacco use. The abdominal duplex ultrasound is effective because it is a non-invasive, safe, and cost-effective method to visualize the aorta and detect any aneurysms. This method uses sound waves to produce images of the blood vessels and assess the size of the aorta, allowing for timely diagnosis and management of AAA. While CT scans and MRIs can provide detailed images of vascular structures and may be used for further evaluation if an aneurysm is suspected, they are not recommended as initial screening tools due to factors such as cost, exposure to radiation (in the case of CT), and accessibility in screening programs. X-rays, on the other hand, are not suitable for accurately assessing AAA as they do not provide adequate detail of the aorta and its condition. Thus, the one-time abdominal duplex ultrasound stands out as the appropriate and effective screening choice for this specific population.