AAA Screening

Read this adapted from from UpToDate 2010 then answer the following questions from the AFP 2005:

M.G., a 70-year-old black man, requests refills for his medicines. His medications include lisinopril, atorvastatin, glipizide, and daily aspirin. He smoked heavily when he was younger but quit about 15 years ago. He also asks that you order “whatever tests should be done at my age.”

1. You review MG’s chart and find he is up to date on most age-appropriate immunizations and screening. You consider screening him for abdominal aortic aneurysm (AAA). Which of the following screening regimens reflects the U.S. Preventive Services Task Force (USPSTF) recommendations on screening for AAA?
A. Screen men and women aged 65 to 75 years.
B. Screen men yearly between the ages of 65 and 75 years.
C. Do not screen men who quit smoking more than 10 years ago.
D. Screen men aged 65 to 75 years who have ever smoked.
E. Screen women aged 75 to 85 years who have ever smoked.

2. Which one of the following statements about AAA is correct?
A. Blacks and patients with diabetes are at increased risk for AAA.
B. There is a low risk for surgical complications from AAA repair.
C. Operative mortality for open surgical repair of an AAA is less than 1 percent.
D. Men generally die from AAA rupture at an older age than women.
E. An age of 65 or older, male sex, and a history of smoking are the major risk factors for AAA.

3. After you discuss the risks and benefits of AAA screening with MG, he decides to proceed with screening. Which of the following statements about screening for AAA is/are are correct?
A. Ultrasonography is the screening test of choice.
B. An estimated 500 men aged 65 to 74 years who have ever smoked would need to be screened to prevent one AAA-related death over five years.
C. Screening and surgical repair of large AAAs in older men decreases all-cause mortality.
D. Abdominal palpation is an adequate screening alternative.

Answers