A 65-year-old female presents with acute right-sided weakness and aphasia, diagnosed as an acute ischemic stroke affecting the left middle cerebral artery territory. She receives IV tPA and her symptoms improve significantly. She has a history of hypertension and hyperlipidemia. Carotid ultrasound shows <50% stenosis bilaterally. What is the most appropriate long-term secondary stroke prevention strategy?

The correct answer to the question "A 65-year-old female presents with acute right-sided weakness and aphasia, diagnosed as an acute ischemic stroke affecting the left middle cerebral artery territory. She receives IV tPA and her symptoms improve significantly. She has a history of hypertension and hyperlipidemia. Carotid ultrasound shows <50% stenosis bilaterally. What is the most appropriate long-term secondary stroke prevention strategy?" is Option B: Start high-intensity statin therapy and antiplatelet agent..

The other options — A) Initiate warfarin therapy., C) Schedule carotid endarterectomy., D) Prescribe a loop diuretic for blood pressure control. — are incorrect for this USMLE Exam Prep question. As explained above: For secondary prevention after an acute ischemic stroke not caused by cardioembolism, high-intensity statin therapy and antiplatelet therapy (e.g., aspirin) are cornerstone treatments to reduce the r…