70 years old male with atrial brillation started on warfarin after 5 days his inr still sub therapeutic 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.
المصادر مختلفة. ملفات الدفعة فيها إجابتين، وما نرجّح وحدة على الثانية. سبب كل وحدة في الشرح تحت:
- إجابة: C. bridge with parentral heparin until warfarin comes therapeutic
- إجابة ثانية: A. continue warfarin alone
Warfarin takes 4–5 days to start working (it also lowers protein C first). The course anticoagulation lecture teaches that most patients need bridging with a parenteral anticoagulant (heparin/LMWH) until the INR is therapeutic (2–3). Heparin is then stopped and warfarin continued alone, which supports C.
- Stopping warfarin altogether (B) and adding aspirin (D) are wrong.
- However, OnlineMedEd states that AF is the one setting where bridging is NOT needed, unless there is a mechanical valve. That supports simply continuing and adjusting warfarin (A).
ليش كل خيار صح أو غلط
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A
ليش صح
Supported by the stroke notes: in AF warfarin is started without a bridge unless there is another indication such as a mechanical valve. Sources disagree, so this question is disputed.
✓ 1. Stroke.pdf · p. 2 -
B
ليش غلط
Warfarin is not stopped: if heparin is used as a bridge, it is the heparin that is stopped once warfarin is therapeutic, and warfarin is continued alone.
✓ Step Up To Medicine 6th, 2024 (anticoagulation).pdf · p. 3 -
C
ليش صح
Supported by the Year 4 anticoagulants lecture, which says most patients starting warfarin need bridging with a parenteral anticoagulant. Sources disagree for AF, so this question is disputed.
✓ Year4C- Anticoagulants🍓.pdf · p. 14 -
D
ليش غلط
AF needs anticoagulation (warfarin with INR 2-3 or a NOAC); aspirin is the antiplatelet used for secondary stroke prevention, not a way to cover a sub-therapeutic INR.
✓ 1. Stroke.pdf · p. 2
- المصدر
- Year4C- Anticoagulants🍓.pdf · p. 14
Step Up To Medicine 6th, 2024 (anticoagulation).pdf · p. 3
1. Stroke.pdf · p. 2 - المحاضرة
- Anticoagulation · Hematology · Module C
- ظهر في
- MED43 ♀ Quiz C