#april2020mccqe1
A 75-year-old woman is admitted to the hospital from her home for treatment of community-acquired pneumonia because of extreme weakness and nausea. She has a history of hypertension and compensated heart failure. Medications are metoprolol, lisinopril, and hydrochlorothiazide.
On physical examination, temperature is 38.9°C (102.0°F), blood pressure is 110/74 mm Hg, pulse rate is 100/min, and respiration rate is 20/min. Oxygen saturation by pulse oximetry is 92% on ambient air. Crackles are heard at the left lower lung base. Cardiopulmonary examination is otherwise normal.
Hemoglobin 15 g/dL (150 g/L)
Leukocyte count 18,500/μL (18.5 × 109/L)
Platelet count 150,000/μL (150 × 109/L)
Creatinine 1.2 mg/dL (106.1 mmol/L)
Electrolytes Normal
Which of the following venous thrombosis prophylactic interventions is most appropriate for this patient?
(A) Aspirin
(B) Knee-high compression stockings
(C) Lepirudin
(D) Unfractionated heparin
(E) Prophylaxis not indicated
A 75-year-old woman is admitted to the hospital from her home for treatment of community-acquired pneumonia because of extreme weakness and nausea. She has a history of hypertension and compensated heart failure. Medications are metoprolol, lisinopril, and hydrochlorothiazide.
On physical examination, temperature is 38.9°C (102.0°F), blood pressure is 110/74 mm Hg, pulse rate is 100/min, and respiration rate is 20/min. Oxygen saturation by pulse oximetry is 92% on ambient air. Crackles are heard at the left lower lung base. Cardiopulmonary examination is otherwise normal.
Hemoglobin 15 g/dL (150 g/L)
Leukocyte count 18,500/μL (18.5 × 109/L)
Platelet count 150,000/μL (150 × 109/L)
Creatinine 1.2 mg/dL (106.1 mmol/L)
Electrolytes Normal
Which of the following venous thrombosis prophylactic interventions is most appropriate for this patient?
(A) Aspirin
(B) Knee-high compression stockings
(C) Lepirudin
(D) Unfractionated heparin
(E) Prophylaxis not indicated
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