Preventing pulmonary embolism in elderly patients. - triplehelix

[ArchivalUser]

Since the question does not talk about chemo or B.marrow being suppressed i think I would go with A now since she did recieve anti coagulation previously and it was not C.I at that time........tough one TH........A

[ArchivalUser]

a.

[ArchivalUser]

A. recurrent pulmonary TE , not contraindicate for Anti COagulant

[ArchivalUser]

D---if pt with HX of pulm E dx for ant ca or fracture OR PPH

[ArchivalUser]

D---if pt with HX of pulm E dx for any ca ,, fracture ,,PPH

[ArchivalUser]

d....

[ArchivalUser]

it should b D ! now come on man break the suspense.

[ArchivalUser]

D. IVC filter

virtuoso

[ArchivalUser]

correct answer is C.

Patients with acute venous thromboembolism in association with metastatic cancer are at higher risk for recurrent venous thrombosis than those without malignancy. In such patients, it has been demonstrated that chronic low-molecular-weight heparin at therapeutic doses reduces the risk for œon-treatment recurrence by approximately 50% at 6 months when compared with standard-intensity anticoagulant therapy (target INR, 2 to 3). High-intensity warfarin (target INR, 3 to 4) would not be appropriate in this setting because it has not been shown to be more efficacious in preventing recurrent thrombosis than standard-intensity warfarin (target INR, 2 to 3); retrospective studies have also shown that patients with venous thrombosis and active cancer are at increased risk for major bleeding while receiving standard-intensity warfarin.

Placement of an inferior vena cava (IVC) filter in patients with venous thrombosis without anticoagulation is associated with an increased risk for recurrent venous thrombosis; IVC filter placement is generally reserved for patients at high risk for recurrent thrombosis who have sustained major bleeding and cannot undergo anticoagulation.

[ArchivalUser]

Good One TH.......i feel awful......i knew that from MKSAP that LMW heparin is superior to warfarin and i didnt apply that fact here . Anyway, i enjoyed doing the question!