#april2020mccqe1
A 57-year-old woman is evaluated in the emergency department for a 1-week history of swelling and pain in the left leg. She has had two normal pregnancies and no miscarriages. There is no family or personal history of thromboembolic disease. The patient is otherwise healthy. A proximal deep venous thrombosis is confirmed on ultrasound. Unfractionated heparin is given as an initial bolus followed by a continuous infusion at a dose to prolong the activated partial thromboplastin time to two times the control value. Warfarin, 5 mg/d, is also initiated. Which of the following is the most appropriate duration of heparin therapy for this patient?
(A) Minimum of 3 days
(B) Minimum of 3 days, with one INR measurement of >2
(C) Minimum of 5 days
(D) Minimum of 5 days, with two INR measurements of >2, 24 h apart
A 57-year-old woman is evaluated in the emergency department for a 1-week history of swelling and pain in the left leg. She has had two normal pregnancies and no miscarriages. There is no family or personal history of thromboembolic disease. The patient is otherwise healthy. A proximal deep venous thrombosis is confirmed on ultrasound. Unfractionated heparin is given as an initial bolus followed by a continuous infusion at a dose to prolong the activated partial thromboplastin time to two times the control value. Warfarin, 5 mg/d, is also initiated. Which of the following is the most appropriate duration of heparin therapy for this patient?
(A) Minimum of 3 days
(B) Minimum of 3 days, with one INR measurement of >2
(C) Minimum of 5 days
(D) Minimum of 5 days, with two INR measurements of >2, 24 h apart
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