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Secondary stroke prevention — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)Secondary stroke preventionUSMLE Step 3

A 69-year-old woman had a noncardioembolic ischemic stroke 3 weeks ago. She has recovered well. ECG monitoring showed no atrial fibrillation. LDL cholesterol is 118 mg/dL, blood pressure is 146/82 mm Hg, and she is not taking a statin. Which of the following is the most appropriate at this time?

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Correct answer: C — Start high-intensity statin and optimize blood pressure control

Secondary prevention after noncardioembolic ischemic stroke includes antiplatelet therapy, high-intensity statin, and blood pressure control.

Reference: AHA/ASA secondary stroke prevention guideline: https://www.stroke.org/