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Asymptomatic carotid stenosis — USMLE Step 3 MCQ

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HardInternal Medicine (chronic management)Asymptomatic carotid stenosisUSMLE Step 3

A 73-year-old man has a carotid bruit. Duplex ultrasonography shows 45% right internal carotid stenosis. He has no history of stroke or transient ischemic attack. He takes aspirin and high-intensity statin; blood pressure is controlled. 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: C — Continue intensive medical therapy

Mild asymptomatic carotid stenosis is treated with optimal medical therapy rather than revascularization.

Reference: Society for Vascular Surgery carotid disease guidance: https://vascular.org/