Professional and Linguistic Assessments Board (PLAB) Practice Exam

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In the CHA2DS2-VASc score, what risk factor contributes the most points?

  1. Age over 75

  2. Hypertension

  3. Diabetes mellitus

  4. Congestive heart failure

The correct answer is: Age over 75

The CHA2DS2-VASc score is a clinical tool used to estimate the risk of stroke in patients with atrial fibrillation. Each component of the score assigns different point values based on the established risk associated with each factor. Among the options provided, being over 75 years of age contributes the most points, specifically two points. This is significant because advancing age is a well-recognized risk factor for stroke, which makes age a critical element in determining the management and therapy of patients with atrial fibrillation. While hypertension, diabetes mellitus, and congestive heart failure are also important risk factors that contribute to the overall stroke risk—each adding one point to the score—they do not have the same weight as age over 75, underscoring the pronounced impact of older age on stroke risk. Therefore, the emphasis on age in assessing the risk is supported by extensive research linking advanced age with a higher incidence of thromboembolic events in atrial fibrillation.