Not a great card tbh - but when you think of an aortic aneurysm, an AAA is what most think of. I think too easy whatever you do with it, imo.
I think it should be clarified in some way though, because flank and chest pain are also possible answers if it’s asking about aortic aneurysm in general. Also, if you specify it to “Abdominal aortic aneurysm may cause …”, then it should be abdominal and flank pain, not abdominal and back pain.
that’s the thing that makes it not a great card! Lots of different answers for both - saw someone mention they’d diagnosed a dissection purely on the basis of a sudden onset sore throat the other day! Plus back pain would also be correct for AAA. I do see what you mean though.