A patient on warfarin for mechanical mitral valve replacement is found to have INR = 5.2 but no bleeding. What is the next step?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: B. Omit next warfarin dose and monitor INR
For an INR of 5–9 with no bleeding, skip 1–2 warfarin doses and monitor the INR. Vitamin K is added only for INR >9 or before an urgent procedure.
- IV vitamin K 10 mg (with PCC) is for major bleeding and would over-correct a patient with a mechanical valve.
- Stopping warfarin permanently is wrong: a mechanical mitral valve needs lifelong anticoagulation, with a target INR of 2.5–3.5.
- Continuing the same dose ignores a supratherapeutic INR.
ليش كل خيار صح أو غلط
-
A
ليش غلط
Continuing the same dose ignores a supratherapeutic INR: even with a metallic valve the target INR is 2.5-3.5, and his INR is 5.2.
✓ Hematology🩸.pdf · p. 59 -
B
ليش صح
For INR 5-9 without bleeding, skip 1-2 warfarin doses and monitor the INR; vitamin K is reserved for an urgent procedure.
✓ Hematology🩸.pdf · p. 59 -
C
ليش غلط
Vitamin K is used for INR >9 (hold warfarin, give vitamin K) or an urgent procedure; INR 5.2 with no bleeding only needs skipped doses and monitoring.
✓ Hematology🩸.pdf · p. 59 -
D
ليش غلط
Warfarin is managed by skipping doses and monitoring, not stopping it permanently; this patient's metallic valve has a target INR of 2.5-3.5.
✓ Hematology🩸.pdf · p. 59
- المصدر
- Hematology🩸.pdf · p. 59
- المحاضرة
- Anticoagulation · Hematology · Module C
- ظهر في
- MED43 ♂ Quiz C · MED43 ♀ Compre