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These 10 free AAA questions are organized by exam domain, so you can see how each part of the POCUS - Abdominal Aortic Aneurysm (AAA) blueprint is tested. Reveal the answer and explanation under each question.
During a scheduled aortic examination, bowel gas obscures the mid aorta despite tolerated graded compression. The patient is comfortable and hemodynamically stable, and the tissues superficial to the gas are well seen. Which adjustment offers the best chance of recovering the missing acoustic window?
Correct answer: B - Move the transducer off midline and angle back toward the aorta.
The transducer marker points to the patient's right, and its corresponding display marker is on screen left. A short anterior branch of the proximal abdominal aorta divides into a broad Y on the transverse view. The limb extending toward screen left is the:
Correct answer: A - Common hepatic artery
In a patient with right-sided heart failure, a round vessel anterior to the spine is pulsatile and shows little respiratory change in caliber. Color Doppler confirms flow. Which additional observation would establish that this vessel is the inferior vena cava rather than the aorta?
Correct answer: B - It receives hepatic veins and can be traced into the right atrium.
A slender vessel crosses anterior to the aorta but posterior to the superior mesenteric artery, carrying flow toward the inferior vena cava. Spectral Doppler shows respiratory-phasic variation rather than an arterial upstroke. These relationships identify the:
Correct answer: C - Left renal vein
At the widest part of a fusiform infrarenal aneurysm, a correctly aligned short-axis image measures 4.9 cm anteroposteriorly and 5.3 cm transversely, both outer wall to outer wall. Mural thrombus leaves a 2.2-cm flow channel. The aneurysmal segment is 7.0 cm long. What maximum aneurysm diameter should be documented?
Correct answer: C - 5.3 cm
The largest image of a tortuous aorta is an elongated oval with sharply defined walls. An orthogonal view shows that the local aortic axis passes obliquely through that imaging plane. Before accepting the diameter, the operator should:
Correct answer: A - Reangle the transducer perpendicular to the local aortic axis.
An asymptomatic man undergoing screening has several evenly spaced bright lines on one sagittal aortic image. The lines cross the lumen and continue beyond the posterior wall. The outer diameter is 2.3 cm. Which response is justified at this stage?
Correct answer: D - Change the insonation angle and check an orthogonal view for reverberation.
A 76-year-old man collapses after sudden severe back pain. His blood pressure remains 78/46 mm Hg during initial resuscitation. Bedside ultrasound shows a 6.6-cm AAA but no free fluid in the abdominal FAST views. Which action takes priority while resuscitation continues?
Correct answer: D - Activate the suspected ruptured-AAA pathway and involve vascular surgery immediately.
At vascular follow-up, an asymptomatic 72-year-old woman has a well-visualized 4.7-cm fusiform infrarenal AAA, unchanged on comparable studies over the past year. Under the 2022 ACC/AHA guideline, which plan fits this finding?
Correct answer: D - Continue ultrasound surveillance at 6-month intervals.
A 69-year-old former smoker attends one-time AAA screening without abdominal or back symptoms. B-mode imaging adequately shows the aorta from the diaphragm through the iliac bifurcation in both planes. The aorta tapers normally, measures at most 2.3 cm, and has no focal enlargement. Color Doppler is not performed. Which conclusion belongs in the aortic report?
Correct answer: A - No abdominal aortic aneurysm is identified.
The AAA exam also covers these domains. Drill them in the full free practice test:
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