American Board of Internal Medicine (ABIM) Certification Practice Exam

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Which increase in diameter within a 6-month interval indicates a need for AAA repair?

0.2 cm
0.4 cm
0.5 cm
0.7 cm

The correct answer is: 0.5 cm

An increase in the diameter of an abdominal aortic aneurysm (AAA) is a crucial factor in determining the need for surgical intervention. According to established guidelines, a significant increase in size, particularly of 0.5 cm or more within 6 months, typically signals a high risk of rupture and therefore necessitates consideration for repair. This threshold is based on the understanding that larger and rapidly expanding aneurysms are more likely to rupture, thereby increasing the urgency for surgical management. In this context, an increase of 0.5 cm within that timeframe is clinically significant and indicates that the aneurysm may pose a threat to the patient’s health if not addressed promptly. Consequently, monitoring of an AAA typically includes regular imaging studies to evaluate changes in size, and a rapid increase in diameter provides concrete evidence for selecting the appropriate timing for surgical correction. This is why the increase of 0.5 cm is acknowledged as a critical marker for AAA repair.