ABFM CVA Exam: Questions & Answers: Updated A+ Guide Score Solution

Cardiac conditions that increase the risk of stroke include which of the following? (Mark all that are true.) Endocarditis Mitral stenosis Patent foramen ovale A tissue mitral valve prosthesis 1 year postoperatively A mechanical mitral valve prosthesis 1 year postoperatively (Ans- A, B, C, E Endocarditis may lead to production of emboli (SOR A). Mitral stenosis increases stroke risk because increasing the size of the left atrium, especially if associated with atrial fibrillation, increases the risk of embolism (SOR A). Patent foramen ovale may be a cause of cryptogenic stroke (SOR A). Mechanical mitral valves do not become covered by endothelium, and long-term anticoagulation is necessary to prevent stroke and other complications (SOR A). A tissue prosthesis becomes covered with endothelium within months and does not pose a risk for stroke (SOR A). A 36-year-old female presents to the emergency department with rightsided upper and lower extremity weakness. She denies any history of hypertension, diabetes mellitus, high cholesterol, or smoking.Which of the following would increase the likelihood that a stroke is the cause of her focal weakness? (Mark all that are true.) Cocaine use The presence of lupus anticoagulant antibodyMarfan's syndrome A history of cranial radiation in childhood for CNS lymphoma (Ans- ALL OF THE ABOVE All of the factors listed increase a person's risk for stroke. The presence of lupus anticoagulant antibody has been found to confer an increased risk of stroke, as has Marfan's syndrome. A history of intracranial radiation therapy, such as for CNS lymphoma, also confers an increased risk of ischemic stroke in adulthood. Cocaine use represents a significant cause of stroke, often hemorrhagic, particularly in younger individuals. The increase in relative risk may be as great as 14 times the risk seen in age-matched individuals who do not use cocaine. You see an active 65-year-old male for a routine annual evaluation. He recently received a flyer in the mail advertising screening carotid ultrasonography at his local senior center, and asks whether you think it would be worthwhile.Which one of the following would be appropriate advice? All patients with a 10-year Framingham coronary artery disease risk >10% should be screened for carotid artery stenosis (CAS) The U.S. Preventive Services Task Force recommends against screening for asymptomatic CAS in the healthy adult population Asymptomatic women have been shown to derive a greater benefit from carotid endarterectomy than asymptomatic men Patients over the age of 80 with asymptomatic CAS have been found to benefit more from carotid endarterectomy compared to younger patients (Ans- B