American Board of Internal Medicine (ABIM) Certification Practice Exam

Aspirin should only be administered after what specific evaluation in patients with ischemic stroke?

1. A vision assessment

2. A dysphagia evaluation

3. A neurological examination

4. A cardiac evaluation

The correct answer is: A dysphagia evaluation

Aspirin plays a significant role in the management of ischemic stroke by preventing further thromboembolic events. However, it is crucial to assess the patient's swallowing ability prior to its administration, especially in the acute phase of stroke management. In patients who have experienced a stroke, dysphagia, or difficulty swallowing, is a common complication. Administering aspirin (or any oral medication) without an evaluation of swallowing can lead to the risk of aspiration. This is when food or liquid inadvertently enters the airway, which can result in aspiration pneumonia and further worsen the patient's condition. Hence, conducting a thorough dysphagia evaluation ensures that the patient can safely receive oral medications without complications. Assessment of vision, neurological status, or cardiac evaluation, while important in the overall management of a stroke patient, does not specifically address the immediate concerns related to the safe administration of aspirin. Therefore, prioritizing the dysphagia evaluation is essential before proceeding with aspirin treatment.