Cerebrovascular Disease USMLE Step 1 Practice Question
A 72-year-old man with hypertension, diabetes, and active smoking presents with acute onset right-sided weakness, right facial droop, and slurred speech. Vital signs show BP 168/94 mmHg, HR 88 bpm, RR 16, temp 37.2°C, and SpO2 98% on room air. Brain MRI demonstrates acute infarction in the left middle cerebral artery territory with diffusion restriction. Serum glucose is 182 mg/dL. No atrial fibrillation is noted on cardiac monitoring. Which mechanism best explains this stroke?
Answer choices
- ACardioembolism from atrial fibrillation
- BSmall vessel lipohyalinosis
- CVasculitis from systemic lupus erythematosus
- DLarge artery atherosclerotic diseaseCorrect answer
- EHypercoagulable state from malignancy
- FArterial dissection of the left internal carotid artery
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