AF Diagnosis & Risk 5

Question 1

Which condition is classified as a 'clinically relevant non-major risk factor' (formerly CHA2DS2-VASc modifier) for stroke in AF?

Accepted Answer

Female sex

Answer

Female sex is considered a stroke risk modifier rather than an independent risk factor; it increases stroke risk when other risk factors are present but alone does not mandate anticoagulation.

Question 2

A patient with AF develops sudden-onset neurological deficits. The most common embolic source responsible for AF-related stroke is the:

Accepted Answer

Left atrial appendage

Answer

Approximately 90% of thrombi in non-valvular AF originate in the left atrial appendage due to stasis from loss of organized atrial contraction.

Question 3

In AF, which finding on physical examination suggests uncontrolled ventricular rate?

Accepted Answer

Pulse deficit (apical rate greater than radial pulse rate)

Answer

A pulse deficit occurs in rapid AF because some ventricular contractions are too weak to generate a palpable peripheral pulse, causing apical-radial rate discrepancy.

Question 4

Which HAS-BLED score component represents a modifiable bleeding risk factor that should be corrected before initiating anticoagulation?

Accepted Answer

Uncontrolled hypertension (systolic BP >160 mmHg)

Answer

Uncontrolled hypertension is both a stroke risk factor and a modifiable HAS-BLED component; controlling BP can reduce hemorrhagic risk without withholding anticoagulation.

Question 5

Vagally-mediated AF is most likely to occur in which clinical setting?

Accepted Answer

During sleep or after a large meal in a physically fit individual

Answer

Vagally-mediated AF is triggered by increased parasympathetic tone, typically at night, at rest, or postprandially, often in athletic individuals with high vagal tone.

(AF) Atrial Fibrillation Certification Practice Test

(AF) Atrial Fibrillation Certification Practice Test

AF Diagnosis & Risk 5