07-11-2016, 04:19 PM
A 70-year-old woman is hospitalized for evaluation of a single, transient episode of right-sided weakness. She has type 2 diabetes mellitus controlled with diet. Seven years ago, she underwent lumpectomy and radiation therapy for localized breast cancer and has had no evidence of recurrence. Examination shows a left carotid bruit. Arteriography shows 80%–90% stenosis of the left internal carotid artery in a segment just distal to where it branches from the common carotid artery. On admission, her serum glucose level is 310 mg/dL; after adequate hydration, her serum glucose level decreases to 180 mg/dL. Serum electrolyte levels are within normal limits. Which of the following is the most appropriate recommendation to prevent cerebral infarction in this patient?
A ) Daily aspirin therapy only
B ) Insulin therapy only
C ) Low-dose heparin therapy only
D ) Warfarin therapy only
E ) Endarterectomy and daily aspirin therapy
F ) Endarterectomy and low-dose heparin therapy
G ) Endarterectomy and warfarin therapy
answer according to many posts is E
can someone explain why CHADS2 doest not apply here?