An Imaging Study Detects an Incidental 3

question 395

Multiple Choice

An imaging study detects an incidental 3.5-cm infrarenal abdominal aortic aneurysm in a 70-year-old man.  He has no associated symptoms.  Medical history is significant for hypertension, type 2 diabetes, and hypercholesterolemia.  The patient is maintained on anticoagulation due to paroxysmal atrial fibrillation.  He has smoked 1-2 packs of cigarettes a day for the past 40 years, and he drinks 1 or 2 glasses of wine daily.  The patient is physically active, bikes regularly, and enjoys hiking.  On physical examination, blood pressure is 150/78 mm Hg and pulse is 80/min.  Heart sounds are normal, and the lungs are clear.  Laboratory results are as follows: Which of the following is most strongly associated with aneurysm progression in this patient?

• A)Active smoking
• B)Anticoagulation
• C)Exercise activities
• D)LDL >130 mg/dL
• E)Systolic hypertension
• F)Uncontrolled diabetes mellitus

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