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Atrial fibrillation in older adult — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)Atrial fibrillation in older adultUSMLE Step 3

A 76-year-old man with heart failure, hypertension, and diabetes is admitted after a fall. He has atrial fibrillation and takes no anticoagulant. CT head is normal. CHA2DS2-VASc score is 5. He lives independently and falls about once yearly. 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: A — Discuss starting oral anticoagulation

Fall risk alone rarely outweighs stroke prevention benefit in atrial fibrillation with high thromboembolic risk.

Reference: ACC/AHA/HRS atrial fibrillation guideline