A 27-year-old woman is 2 days after an uncomplicated caesarean section. On day 3 she has left leg pain and swelling. No respiratory symptoms, SpO₂ 98%. Doppler shows left femoral vein thrombosis. What is the next step in management?
سؤال مجاني 6 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: C. Start rivaroxaban
A confirmed proximal (femoral) DVT needs anticoagulation now; there are no respiratory symptoms, so CTPA is not indicated and simply repeating the Doppler leaves the clot untreated. DOACs (rivaroxaban/apixaban) are first-line for VTE and rivaroxaban needs no heparin lead-in. Warfarin alone is wrong: it must be started together with heparin/LMWH until the INR is 2–3, otherwise it can be prothrombotic in the first days.
ليش كل خيار صح أو غلط
-
A
ليش غلط
Waiting for a repeat ultrasound is an option only for distal DVT. A proximal (femoral) DVT that is already confirmed is anticoagulated now.
✓ 12• Venous Thromboembolism [Slides].pdf · p. 5 -
B
ليش غلط
Warfarin without LMWH may cause thrombus formation in the first 24 hours; it needs LMWH overlap for at least 5 days, until the INR is 2-3.
✓ Pulmonology 🫁.pdf · p. 27 -
C
ليش صح
A DOAC such as rivaroxaban is a good option for many patients, and it needs no concurrent heparin during initiation because it is effective immediately.
✓ Step Up To Medicine 6th Edition 2024( PE).pdf · p. 10 -
D
ليش غلط
CT pulmonary angiography is the best test for suspected pulmonary embolism. Here DVT is already confirmed and there are no respiratory symptoms; a patient with PE must be checked for DVT, but not the other way around.
✓ Pulmonology 🫁.pdf · p. 26
- المصدر
- Deep venous thrombosis.pdf · p. 12
Step Up To Medicine 6th Edition 2024( PE).pdf · p. 10
Pulmonology 🫁.pdf · p. 27 - المحاضرة
- Venous Thromboembolism · Pulmonology · Module B
- ظهر في
- MED42 ♂ EOM B