Deep vein trombosis
A 67-yr-old woman presents with pain in her left thigh muscle. Duplex ultrasonography indicates the presence of deep vein thrombosis (DVT) in the affected limb.
Questions and tasks
1. The decision was made to treat this woman with enoxaparin. Relative to unfractionated heparin, enoxaparin:
a) can be used without monitoring the patient`s aPTT
b) has a shorter duration of action
c) is less likely to have a teratogenic effect
d) is more likely to be given intravenously
c) is more likely to cause thrombosis and thrombocytopenia
2. During the next week the patient was started on warfarin and her heparin was discontinued. Two months later, she returned after a severe nosebleed. Laboratory analysis revealed an INR (international normalized ratio) of 7.0. To prevent severe hemorrhage, the warfarin should be discontinued and this patient should be treated immediately with which of the following?
a) aminocaproic acid
b) desmopressin
c) factor VIII
d) protamine
e) vitamin K1
3. A patient develops severe thrombocytopenia in response to treatment with unfractionated heparin and still requires parenteral anticoagulation. The patient is most likely to be treated with which of the following?
a) abciximab
b) cilostazol
c) lepirudin
d) plasminogen
e) vitamin K1