ABFM KSA CVA Latest Update Questions Answers

ABFM + KSA CVA (Latest Update 2025 / 2026) Questions & Answers | Grade A | 100% Correct (Verified Answers)

Question:

True statements regarding cerebral arterial atherosclerosis include which of the following? (Mark all that are true.)

• Atherosclerosis is rare before the age of 30
• Atherothrombotic stroke is the most common form of stroke
• The majority of embolic strokes result from intracranial embolic sources
• Small cerebral arteries are affected by atherosclerosis more frequently than

medium or large vessels

• Thrombotic occlusion is more common at cerebral artery branch points

Answer:

B AND E

Atherosclerosis is a chronic and slowly progressive disease that begins in childhood. Arterial stenosis precipitated by atherosclerosis, turbulent blood flow, and platelet adherence causes blood clots to form, resulting in a stroke (SOR A). Medium and large vessels are more commonly affected by atherosclerotic plaque formation than small arteries.

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Atherothrombotic stroke is the most common form of stroke. The majority of embolic strokes are due to embolization of intracardiac thrombi in patients with atrial fibrillation. The most common sites of thrombotic occlusion are cerebral artery branch points, particularly in the distribution of the internal carotid artery. Less common causes of thrombosis, particularly in younger individuals, include cervical artery dissection, essential thrombocytosis, polycythemia, sickle cell anemia, fibromuscular dysplasia of the cerebral arteries, and cocaine abuse.

Question:

True statements regarding serum glucose levels and acute ischemic stroke include which of the following? (Mark all that are true.)

• Hypoglycemia in the initial period after stroke may worsen symptoms
• Maintenance of glucose levels below 120 mg/dL in the first hours after

stroke improves long-term outcomes

• Persistent hyperglycemia (glucose >200 mg/dL) is an indicator of poor

prognosis in acute stroke

• Metformin (Glucophage) should be used as the initial agent to control

acutely elevated glucose levels in the acute setting

• Thiazolidinediones have been shown to reduce mortality when given

acutely in the setting of ischemic stroke

Answer:

A AND C

Although tight control of blood glucose levels has been shown to be beneficial in other acutely ill patients, including patients with myocardial infarction and those who have had coronary bypass surgery, there is no evidence of this benefit in acute stroke. An elevated glucose level on admission is associated 2 / 4

with a worse prognosis in stroke patients. Elevated glucose levels have been associated with more severe strokes and have been independently associated with expansion of stroke size and with poor neurologic outcomes (SOR B).While the American Heart Association suggests that it is reasonable to treat hyperglycemia to achieve a blood glucose level in the range of 140-180 mg/dL, there is currently no evidence that maintaining blood glucose below a particular target level improves either primary or secondary outcomes (SOR B). There have been no trials of metformin or thiazolidinediones for acutely lowering blood glucose levels, and their slow onset of action makes them very unlikely to be useful in this setting (SOR C).

Question:

A 68-year-old male presents to your office with a history consistent with a TIA 10 days ago. Information needed to calculate an ABCD2 risk score that would define his risk for a completed stroke in the next 30 days includes which of the following? (Mark all that are true.)

• Age
• Blood pressure
• Cardiac risk factors
• Clinical features
• Diabetes mellitus
• Duration of symptoms

Answer:

A, B, D, E, F,

The ABCD2 score was developed to help predict subsequent short-term stroke risk in patients with clinical TIAs (SOR A). Factors used for determining risk under the ABCD scoring system are Age, Blood pressure, Clinical features, 3 / 4

Duration of symptoms, and Diabetes, with points assigned as shown below.The cumulative point total can be used to determine which patients should be hospitalized for expedited evaluation based on short-term risk. A score of 4 or greater is often used as the decision point for hospitalization, depending on factors such as the availability of neurologic imaging and urgent follow-up by a neurologist.Age ≥60 = 1 pointBlood pressure >140/90 mm Hg or = 1 pointUnilateral weakness = 2 pointsSpeech disturbance without weakness = 1 pointDuration of symptoms ≥60 minutes = 2 pointsDuration of symptoms 10- 59 minutes = 1 pointDiabetes mellitus = 1 point

Question:

Which one of the following measures has been shown to improve long-term function and reduce mortality in the treatment of stroke?

• tPA given in the first 4.5 hours after the onset of symptoms
• Therapeutic doses of intravenous anticoagulants, either unfractionated

heparin or low molecular weight heparin

• Aggressive blood pressure control in the first 48 hours after the stroke
• Aggressive blood glucose control in the first 48 hours after the stroke
• Initial care in a dedicated stroke unit

Answer:

E

Stroke unit care showed approximately 20% reductions in the following

outcomes: death, the combined outcome of death or institutionalized care,

and the combined outcome of death or dependency at 1 year (SOR A).Sensitivity analyses indicated that the observed benefits remained when the analysis was restricted to trials that used formal randomization procedures with blinded outcome assessment. Outcomes were independent of patient

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