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Neurology Flashcards

7 cards from real ABIM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Neurology flashcards as text

  1. A 72-year-old man presents 2 hours after onset of acute ischemic stroke and is otherwise eligible for IV thrombolysis. His BP is 196/108 mm Hg. What BP must be achieved before thrombolysis is given?

    Answer: <185/110 mm Hg

    BP must be lowered to below 185/110 mm Hg before thrombolysis and kept below 180/105 mm Hg for 24 hours afterward.

  2. A 68-year-old woman with left M1 occlusion was last known well 14 hours ago. CT perfusion shows a small infarct core and a large mismatch. What is the most appropriate next step?

    Answer: Mechanical thrombectomy

    DAWN and DEFUSE-3 showed benefit from thrombectomy up to 24 hours in selected large-vessel occlusion patients with favorable imaging.

  3. A 60-year-old man has a minor ischemic stroke (NIHSS 2) with no atrial fibrillation. Which antithrombotic regimen is recommended initially?

    Answer: Aspirin plus clopidogrel for 21 days, then a single antiplatelet

    CHANCE and POINT support short-term dual antiplatelet therapy (about 21 days) after minor stroke or high-risk TIA.

  4. A 66-year-old man had a TIA with right-hand weakness 4 days ago. Carotid duplex shows 80% stenosis of the left internal carotid artery. What is the best management?

    Answer: Carotid endarterectomy within 2 weeks plus medical therapy

    Symptomatic 70-99% stenosis benefits most from endarterectomy done within 2 weeks of the event.

  5. A 42-year-old woman with no vascular risk factors has an embolic-appearing cortical stroke. Workup shows only a PFO with a large right-to-left shunt and an atrial septal aneurysm. What is the best management?

    Answer: Percutaneous PFO closure plus antiplatelet therapy

    In patients aged 60 or younger with PFO-associated cryptogenic stroke and high-risk anatomy, closure plus antiplatelet therapy lowers the risk of recurrence.

  6. A 70-year-old man with a mechanical mitral valve has a cardioembolic stroke. Which long-term anticoagulant is appropriate?

    Answer: Warfarin

    DOACs are contraindicated with mechanical heart valves, so warfarin is required.

  7. A 52-year-old woman with aneurysmal subarachnoid hemorrhage has her aneurysm secured. Which medication improves neurologic outcome?

    Answer: Oral nimodipine for 21 days

    Oral nimodipine reduces poor outcomes from delayed cerebral ischemia after aneurysmal SAH.

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