q1042 - sami2004

[ArchivalUser]

. A 61-year-old woman presents to a large tertiary-care facility
complaining of a swollen and painful left calf. This developed
after she had flown from California to Minnesota on a nonstop
flight. On examination, the left calf is warm and slightly
erythematous and there is prominence of the superficial veins
below the knee. Results of the examination are otherwise normal.
Ultrasonography shows an acute-appearing thrombus
within the left superficial femoral vein. What is the most appropriate
next step in the initial management of this patient?
a. Bed rest, leg elevation, heat, and nonsteroidal anti-inflammatory
drug
b. Outpatient therapy with low-molecular-weight heparin
concurrent with warfarin
c. Inpatient intravenous unfractionated heparin
d. Inpatient low-molecular-weight heparin
e. Warfarin 5 mg daily until the international normalized ratio
is 2.0 to 3.

[ArchivalUser]

Good Questions.

I think I will go with B.

[ArchivalUser]

answeris b.. superficial femora vein per se is a deep vein.. patient with DVT should recieve heparin immediately for clot stabilisation and to prevent further episodes add warfarin..

[ArchivalUser]

B....

[ArchivalUser]

I will pick c

[ArchivalUser]

C...

[ArchivalUser]

c.. you need to monitor pt and inr initially.

[ArchivalUser]

B is the correct answer.

Though it says Superficial , a superficial femoral vein is a Deep Vein. DVT should get LMWH + coumadin. Outpatient therapy is the best choice for all compliant patients and INR can be monitored in the clinic . When INR is > 2.0, LMWH will be stopped. (ref: Dr.red hematology
)

If they said anterior tibial vein in leg or basilic vein in arm, these are superficial veins and need not require anticoagulation