American Board of Internal Medicine (ABIM) Certification Practice Exam

What size of the aortic diameter is considered a repair threshold for genetically predisposed patients?

1. 4.0 cm

2. 5.0 cm

3. 5.5 cm

4. 6.0 cm

The correct answer is: 5.0 cm

For genetically predisposed patients, such as those with conditions like Marfan syndrome or Ehlers-Danlos syndrome, the threshold for surgical repair of the aorta is typically lower than that for the general population due to their increased risk of aortic dissection and rupture. In these high-risk individuals, an aortic diameter of 5.0 cm is generally considered the point at which surgical intervention is recommended. This is important in clinical practice to prevent potentially life-threatening complications associated with aortic dilation. In contrast, for the general population without genetic predispositions, the typical threshold for surgical repair is usually set at 5.5 cm. Thus, recognizing the difference in management for those with familial or genetic risk factors is crucial in determining the appropriate timing for intervention.