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Atrial fibrillation stroke prevention — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareAtrial fibrillation stroke preventionUSMLE Step 3

A 65-year-old man with atrial fibrillation has a CHA2DS2-VASc score of 3 and no contraindication to anticoagulation. He asks whether aspirin is sufficient because he feels well. Kidney function is normal. Which of the following is the most appropriate at this time?

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

Reveal the answer and explanation

Correct answer: E — Start oral anticoagulation

Nonvalvular atrial fibrillation with elevated stroke risk is treated with oral anticoagulation; aspirin is inadequate stroke prevention.

Reference: ACC/AHA/HRS atrial fibrillation guideline