skip to main content

Aspirin primary prevention — USMLE Step 3 MCQ

Instant feedback + full explanation. One question, done properly.

HardPreventive Medicine, Epidemiology, BiostatisticsAspirin primary preventionUSMLE Step 3

A 54-year-old without cardiovascular disease has a calculated 10-year CVD risk of 13%. Blood pressure is controlled, and he has no ulcer, bleeding history, anticoagulant use, or aspirin preference yet. What is the best approach to primary-prevention aspirin?

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

Reveal the answer and explanation

Correct answer: B — Use shared decision-making because the expected net benefit is small

The best answer is “Use shared decision-making because the expected net benefit is small”. For adults age 40–59 with at least 10% 10-year CVD risk and no increased bleeding risk, the USPSTF recommends an individual decision; net benefit is small. The recommendation is neither routine initiation nor a blanket prohibition.

Reference: USPSTF: Aspirin Use to Prevent Cardiovascular Disease: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/aspirin-to-prevent-cardiovascular-disease-preventive-medication