#may2020mccqe1
A 27-year-old primigravida at 35 weeks’ gestation presents to her obstetrician because of a long bump on her leg. She denies ever having had a problem like this before. Her pregnancy has been without complication. Prior to her pregnancy she used only barrier protection. Age of menarche was 12 years. She denies any travel history and has been “mainly in bed” since 1 week ago. Her pulse is 78/min, respiratory rate is 10/min, and temperature is 37.2°C (99°F). On physical examination she in no acute distress. Her lungs are clear to auscultation bilaterally, and her extremities are warm and well perfused. Examination of the extremities reveals a long, firm, cord-like mass on the lateral aspect of her left leg. It is subcutaneous, erythematous, and tender. Compression ultrasonography of the lower extremity shows normal compressibility and normal Doppler flow. Which of the following is the most appropriate management?
(A) Advise the patient to take heparin if the mass does not resolve
(B) Advise the patient to take warfarin if the mass does not resolve
(C) Advise the patient to use warm compresses and elevate the affected area
(D) Reassure the patient that ibuprofen is safe in pregnancy
A 27-year-old primigravida at 35 weeks’ gestation presents to her obstetrician because of a long bump on her leg. She denies ever having had a problem like this before. Her pregnancy has been without complication. Prior to her pregnancy she used only barrier protection. Age of menarche was 12 years. She denies any travel history and has been “mainly in bed” since 1 week ago. Her pulse is 78/min, respiratory rate is 10/min, and temperature is 37.2°C (99°F). On physical examination she in no acute distress. Her lungs are clear to auscultation bilaterally, and her extremities are warm and well perfused. Examination of the extremities reveals a long, firm, cord-like mass on the lateral aspect of her left leg. It is subcutaneous, erythematous, and tender. Compression ultrasonography of the lower extremity shows normal compressibility and normal Doppler flow. Which of the following is the most appropriate management?
(A) Advise the patient to take heparin if the mass does not resolve
(B) Advise the patient to take warfarin if the mass does not resolve
(C) Advise the patient to use warm compresses and elevate the affected area
(D) Reassure the patient that ibuprofen is safe in pregnancy
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