American Board of Internal Medicine (ABIM) Certification Practice Exam

What precaution should patients with unruptured intracranial aneurysms be advised to take?

1. Increase physical activity

2. Stop smoking

3. Reduce salt intake

4. Drink more fluids

The correct answer is: Stop smoking

Patients with unruptured intracranial aneurysms should be advised to stop smoking due to the significant evidence linking smoking to vascular health deterioration. Smoking contributes to the weakening of blood vessels and can increase the risk of aneurysm formation and rupture. For individuals with existing aneurysms, continuing to smoke poses additional risks as it can lead to hypertension and other cardiovascular complications, which may heighten the likelihood of an aneurysm rupturing. Thus, smoking cessation is a critical preventive strategy for managing the risk associated with unruptured intracranial aneurysms. In contrast, while increasing physical activity, reducing salt intake, and drinking more fluids may have health benefits, these measures do not have the same direct impact on the management of unruptured intracranial aneurysms as smoking cessation. Interestingly, some studies have suggested that controlled exercise may even be beneficial, and dietary changes, while generally healthy, do not specifically address the risks posed by smoking in this context. Therefore, advising patients to stop smoking is the most pertinent precaution when managing unruptured intracranial aneurysms.