The United States Preventative Services Task Force (USPSTF) recommends ultrasound screening for abdominal aortic aneurysm (AAA) in asymptomatic patients in which of the following populations?
1.Pregnant woman
2.Men and women ages 65-75 who have ever smoked
3.Men ages 65-75 who have ever smoked
4.Men ages 65-75 only if > 10pack year smoking history
5.Ultrasound screening for AAA is not recommended in asymptomatic patients
explanation
The USPSTF recommends one-time ultrasound screening for AAA in men ages 65-75 years who have ever smoked.
AAA is a dilatation of the abdominal aorta, most commonly secondary to atherosclerosis. AAA may be asymptomatic or may present with a pulsatile sensation or back pain. Ruptured AAA is immediately life-threatening and may present with hypotension and severe tearing abdominal pain radiating to the back. Ultrasound is the gold standard for diagnosis. Surgery is indicated for large lesions (>5.5 cm diameter), rapidly enlarging lesions (>0.6 to 0.8 cm per year), or rupture.
USPSTF, in the Annals of Internal Medicine in 2005, stated that screening for AAA and surgical repair of AAAs >5.5 cm in men age 65-75 years who have ever smoked (current and former smokers) leads to decreased AAA-specific mortality. Abdominal ultrasound has been shown to be an accurate screening test.
Illustration A shows the appearance of AAA on ultrasound. Note the focal dilation of the aorta. Normal abdominal aorta width is approximately 2 cm.