Rosh Emergency Medicine Practice Test

For a man with an abdominal aortic aneurysm and abdominal pain after a fatty meal, what is the most appropriate management strategy?

1. Admission for blood pressure control and vascular surgery consult

2. Initiation of antiplatelet therapy

3. Routine clinical evaluation and periodic imaging surveillance

4. Surgical consultation for endovascular aneurysm repair

The correct answer is: Admission for blood pressure control and vascular surgery consult

The most appropriate management strategy for a man with an abdominal aortic aneurysm (AAA) and abdominal pain after a fatty meal involves a proactive approach to ensure patient safety and address the potential complications associated with an AAA. In this situation, admission for blood pressure control and a vascular surgery consult is crucial. Blood pressure control is important because high blood pressure can increase the stress on the aneurysm wall, potentially leading to rupture. By admitting the patient, healthcare providers can monitor and manage his blood pressure more effectively, reducing the risk of complications. Additionally, a vascular surgery consult is essential, as it allows for a thorough evaluation of the aneurysm. Given the potential for increased risk of rupture with symptoms such as abdominal pain, timely intervention by a vascular surgeon can be lifesaving. While other strategies like antiplatelet therapy and routine clinical evaluation may play roles in managing the overall health of patients with an AAA in different contexts, they do not adequately address the immediate concerns presented by this patient's symptoms. Surgical consultation for endovascular aneurysm repair could also be an important step, but it follows the necessity of ensuring the patient is stabilized and under the care of specialists to evaluate if surgical intervention is indeed required at that moment. Thus, combining the immediate need for blood