A 60-year-old man cis brought to the hospital 40 minutes after a sudden loss of vision in his right eye and numbness of his left arm. He was eating dinner with his wife when he abruptly dropped his knife and felt what he describes as "like a curtain falling over my right eye." These symptoms resolved spontaneously 15 minutes later and he says that he feels well now. Medical history is significant for hypertension and a 30-pack-year smoking history. Temperature is 36.9 C (98.4 F), blood pressure is 140/84 mm Hg, pulse is 82/min and regular, and respirations are 14/min. Physical examination shows no extremity weakness or sensory loss. There is a right carotid bruit; the remainder of the examination shows no abnormalities. Noncontrast CT scan of the head is normal. Which of the following pharmacotherapies is most appropriate in management of this patient?

Question

A 60-year-old man cis brought to the hospital 40 minutes after a sudden loss of vision in his right eye and numbness of his left arm. He was eating dinner with his wife when he abruptly dropped his knife and felt what he describes as "like a curtain falling over my right eye." These symptoms resolved spontaneously 15 minutes later and he says that he feels well now. Medical history is significant for hypertension and a 30-pack-year smoking history. Temperature is 36.9 C (98.4 F), blood pressure is 140/84 mm Hg, pulse is 82/min and regular, and respirations are 14/min.  Physical examination shows no extremity weakness or sensory loss.  There is a right carotid bruit; the remainder of the examination shows no abnormalities.  Noncontrast CT scan of the head is normal.  Which of the following pharmacotherapies is most appropriate in management of this patient?

Quizplus · Accepted Answer

Eductional Objective: Transient ischemic attacks (TIAs) are transient episodes of focal neurologic impairment that occur due to local brain ischemia; tissue infarction does not occur, and brain imaging is normal. Patients with TIA are at increased risk of future stroke; secondary prevention includes antiplatelet agents (eg, aspirin, clopidogrel), statins, and lifestyle modifications (eg, tobacco cessation, exercise) to reduce future risk.

A 60-Year-Old Man Cis Brought to the Hospital 40 Minutes