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Atrial Fibrillation — UKMLA MCQ

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HardCardiologyAtrial FibrillationUKMLAMRCGP AKTPARAMRCEM SBAMRCP Part 1PSA

A 76-year-old with non-valvular atrial fibrillation has CHA₂DS₂-VASc 4, weight 68 kg, serum creatinine 100 micromol/L and no contraindication to anticoagulation. Which principle should guide stroke prevention?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — A licensed-dose DOAC with risk-factor review

The best answer is “A licensed-dose DOAC with risk-factor review”. A DOAC is usually offered for eligible non-valvular AF, using the product-specific dose criteria rather than age alone. Bleeding-risk assessment identifies modifiable hazards and follow-up needs but is not used by itself to deny stroke prevention; aspirin is ineffective for this purpose and a supratherapeutic warfarin target is harmful.

Reference: NICE NG196: Atrial fibrillation diagnosis and management: https://www.nice.org.uk/guidance/ng196/chapter/Recommendations