MKSAP: 28-year-old man with left calf deep venous thrombosis

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.A 28-year-old man is evaluated 24 hours after a new diagnosis of a left calf deep venous thrombosis. One week ago, he underwent orthopedic surgery. Two weeks ago, he returned from vacationing in Italy on an 8-hour flight. Current medications are enoxaparin, 80 mg subcutaneously twice daily, and warfarin, 5 mg/d.On physical examination, temperature is normal, blood pressure is 145/85 mm Hg, pulse rate is 72/min, and respiration rate is 18/min. BMI is 25. His lungs are clear. His left calf is erythematous and edematous.Duplex ultrasound obtained yesterday confirms a left posterior tibial vein thrombosis. Laboratory results from his emergency department visit reveal factor V Leiden heterozygosity.The patient asks why he developed this blood clot and how long he will have to take warfarin.Which of the following is the most appropriate management of this patient’s venous thromboembolism?A: Low-intensity warfarin (INR, 1.5-2) for at least 3 months B: Standard-intensity warfarin (INR, 2-3) for at least 12 months C: Standard-intensity warfarin (INR, 2-3) for at least 3 months D: Standard-intensity warfarin (INR, 2-3) for lifeContinue reading ... Manage your online reputation: A complete social media guide. Read the book by KevinMD.
Source: Kevin, M.D. - Medical Weblog - Category: Family Physicians Tags: Conditions Medications orthopedics Source Type: blogs