SAEM ED Practice Test – Comprehensive Exam Prep 2025

The condition characterized by pain, hypotension, and a palpable abdominal mass is a ruptured abdominal aortic aneurysm (AAA). When an AAA ruptures, it leads to significant internal bleeding, which can cause hypotension due to the rapid loss of blood volume. The pain associated with a ruptured AAA is often severe and acute, typically occurring in the abdomen or back.

Additionally, as the aneurysm expands and eventually ruptures, there may be a palpable mass in the abdomen where the aneurysm is located. This mass can sometimes be felt during a physical examination, particularly in cases where the rupture has resulted in significant bleeding into the peritoneal cavity.

In contrast, mesenteric ischemia typically presents with severe abdominal pain but would not usually cause a palpable mass. Acute pancreatitis is more associated with severe abdominal pain, often radiating to the back, but may not present with hypotension unless there is significant fluid loss. Cholecystitis often presents with right upper quadrant pain and does not typically cause hypotension or a significant palpable mass like that found in an AAA. Therefore, the distinctive combination of symptoms in the case of a ruptured AAA clearly points to it as the correct condition.