The pedigree presents us with Male-to-Male transmission.
There are two modes of inheritance where Male-to-Male transmission is impossible:
1) X-linked recessive
2) Mitochondrial inheritance
Given the diagnosis of AAA, why did he have syncope? I was first thinking it was from rupture, but his blood pressure is not hypotensive, so how could he get syncope from that.
Or maybe the AAA was compressing the inferior vena cava, causing syncope?
The pain in this patient as described in the stem is indistinguishable from testicular torsion as testicular torsion can start in the unilateral abdomen and move to the testes.
Chalk it up to yet another crap NBME question