Neurology: high-risk transient ischaemic attack: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Neurology: high-risk transient ischaemic attack

Sample item

A 65-year-old has 20 minutes of transient right hand weakness that has fully resolved, and his ABCD2 score is 5. What is the best antithrombotic management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Aspirin plus clopidogrel for a short period started within 24 hours

High-risk TIA carries a high early stroke risk, so urgent evaluation with brain and vascular imaging is needed. Short-term dual antiplatelet therapy with aspirin and clopidogrel for about 21 days, started early, reduces recurrent stroke in minor stroke and high-risk TIA. Long-term single antiplatelet and statin follow, with anticoagulation if atrial fibrillation is found.

Option by option

  • A. No treatment and routine outpatient review after a month

    Delay leaves the highest-risk period untreated.

  • B. Warfarin loading

    Warfarin is not first-line unless cardioembolic source such as AF is identified.

  • C. Continuous heparin infusion

    Heparin infusion is not shown to improve outcome in TIA.

  • D. Aspirin plus clopidogrel for a short period started within 24 hours (correct)

    Correct. Early short-course dual antiplatelet therapy is recommended.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Aspirin plus clopidogrel for a short period started within 24 hours. High-risk TIA carries a high early stroke risk, so urgent evaluation with brain and vascular imaging is needed.

Why is "No treatment and routine outpatient review after a month" not the answer?

Delay leaves the highest-risk period untreated.

Why is "Warfarin loading" not the answer?

Warfarin is not first-line unless cardioembolic source such as AF is identified.

Why is "Continuous heparin infusion" not the answer?

Heparin infusion is not shown to improve outcome in TIA.

What concept does this question test?

It tests Neurology: high-risk transient ischaemic attack in General Medicine. Short-term dual antiplatelet therapy with aspirin and clopidogrel for about 21 days, started early, reduces recurrent stroke in minor stroke and high-risk TIA. Long-term single antiplatelet and statin follow, with anticoagulation if atrial fibrillation is found.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neurology: high-risk transient ischaemic attack?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.