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Internal Medicine

Public·45 members

A 52-year-old female is admitted to the ICU with a Hunt-Hess 1, modified Fisher 2 subarachnoid hemorrhage. Her past medical history is significant for hypertension, diabetes mellitus, and CKD. She undergoes craniotomy for surgical clipping of an anterior cerebral artery aneurysm, and does not experience any additional complications. Two weeks later, she begins complaining of left calf pain, and a lower extremity sonogram demonstrated a proximal deep venous thrombosis (DVT). The patient weighs 60 kg. Her laboratory values are as follows: sodium 142 mEq/L, potassium 3.4 mEq/L, carbon dioxide 18 mEq/L, blood urea nitrogen (BUN) 70 mg/dL, and serum creatinine 2.5 mg/dL.

What would be the optimal treatment for this patient’s proximal DVT?

A-Unfractionated heparin infusion for at least 5 days concomitantly with warfarin therapy

B-Low molecular weight heparin 60 mg twice a day for at least 5 days concomitantly with warfarin therapy

C-Fondaparinux 7.5 mg daily for 5 days followed by warfarin therapy

D-Apixaban 10 mg twice daily for 7 days followed by 5 mg twice daily

E-Rivaroxaban 15 mg twice daily for 21 days followed by 20 mg once dail

Mazen Kherallah
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