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		<swivt:creationDate rdf:datatype="http://www.w3.org/2001/XMLSchema#dateTime">2026-07-31T07:51:27+00:00</swivt:creationDate>
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		<rdfs:label>WBR0913</rdfs:label>
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		<property:AnswerA rdf:datatype="http://www.w3.org/2001/XMLSchema#string">A focused abdominal ultrasonography to confirm the aneurysm before the surgery</property:AnswerA>
		<property:AnswerAExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">'''Incorrect'''-A focused abdominal ultrasonography to confirm the aneurysm before the surgery can be done on hemodynamically unstable patients without a previously known history of AAA and systolic blood pressure &gt; 90 mmHg.</property:AnswerAExp>
		<property:AnswerB rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Emergent transfer of the patient to the operating room for immediate control of hemorrhage and repair of the aneurysm</property:AnswerB>
		<property:AnswerBExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">'''Correct'''-Hemodynamically unstable and known AAA patients with systolic blood pressure &lt; 90 mmHg should be emergently rushed to the operating room for immediate control of hemorrhage and repair of the aneurysm while hemodynamically unstable patients without a previously known history of AAA and systolic blood pressure &gt; 90 mmHg can be taken for a focused ultrasound examination to confirm the aneurysm prior to abdominal exploration.</property:AnswerBExp>
		<property:AnswerC rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Abdominal CT to confirm the aneurysm rupture and for evaluating whether an endovascular repair is feasible or not</property:AnswerC>
		<property:AnswerCExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">'''Incorrect'''-Abdominal CT to confirm the aneurysm rupture and for evaluating whether an endovascular repair is feasible or not can be done on hemodynamically stable patients suspected of having a ruptured AAA.</property:AnswerCExp>
		<property:AnswerD rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Conservative management of the patient while observing</property:AnswerD>
		<property:AnswerDExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">'''Incorrect'''-Conservative management of the patient with nasal oxygen, intra venous fluids, cardiac and blood pressure monitoring should be started while transferring the patient to the operating room.  But then having the patient on observation will increase the risk of mortality.</property:AnswerDExp>
		<property:AnswerE rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Decision for a comfort care</property:AnswerE>
		<property:AnswerEExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">'''Incorrect'''-Decision for a comfort care can be done on patients who deny treatment and on those who are high-risk poor candidates for surgery with several comorbidities.</property:AnswerEExp>
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		<property:ExamType rdf:resource="&wiki;USMLE_Step_3"/>
		<property:MainCategory rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Inpatient Facilities</property:MainCategory>
		<property:MainCategory rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Emergency Room</property:MainCategory>
		<property:PageAuthor rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Vendhan Ramanujam</property:PageAuthor>
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		<property:Prompt rdf:datatype="http://www.w3.org/2001/XMLSchema#string">A 71 year old man is brought to the ER following an acute episode of abdominal and back pain.  He also complains of nausea accompanying his abdominal pain.  He is a known hypertensive and hypercholesterolemia patient for the past 15 years who is on regular treatment.  He was diagnosed with an abdominal aortic aneurysm during routine ultrasound screening of his abdomen before 6 years.  He is a known smoker for the past 20 years smoking half pack a day and denies taking alcohol or illicit drugs.  On physical examination, he looks diaphoretic and his abdomen is diffusely mildly tender.  Patient is relatively obese and thus no mass is palpated.  His vitals are found to be blood pressure of 80/50 mmHg, pulse rate of 118/minute, respiratory rate of 18/minute and temperature of 36.4 C.  Suspecting a rupture of his abdominal aortic aneurysm, the next best step in management of this patient is?</property:Prompt>
		<property:RightAnswer rdf:datatype="http://www.w3.org/2001/XMLSchema#string">B</property:RightAnswer>
		<property:SubCategory rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Cardiovascular</property:SubCategory>
		<property:SubCategory rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Surgery</property:SubCategory>
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		<swivt:wikiPageModificationDate rdf:datatype="http://www.w3.org/2001/XMLSchema#dateTime">2020-10-28T02:03:42Z</swivt:wikiPageModificationDate>
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