رجل عمره ٧٢ سنة، مدخن من ٤٠ سنة وعنده ارتفاع ضغط، جاء لفحص روتيني بدون شكوى. الضغط ١٥٢/٩٠، والنبض ٧٦. أثناء فحص البطن لاحظ الممرض كتلة نابضة فوق السرة وسمع لغطاً فوقها. ما التصرف الصحيح؟

A 72-year-old man with 40 years of smoking and hypertension attends a routine check with no complaints. BP 152/90, HR 76. On abdominal examination the nurse notes a pulsatile mass above the umbilicus with a bruit. What is the correct action?

1. Reassure him that this is normal in older adults
2. Report it and avoid deep palpation of the mass
3. Massage the abdomen to aid digestion
4. Palpate the mass firmly to measure its size accurately

Answer: B) Report it and avoid deep palpation of the mass. A pulsating abdominal mass may be an abdominal aortic aneurysm. It is reported for imaging, and repeated deep palpation is avoided. Older male smokers are a high-risk group.