doubt from uw..... - lacoperon

[ArchivalUser]

35yr old with acute pain and swelling of rt. calf.she denies dysnea and chest pain. BP:120/70, PR: 70, RR:14.
she denies any trauma. she takes OCPs as only medication. nil signif. past history.No fam. history of DVT. non smoker and non alcoholic.
O/E edema, warmth and tenderness of rt. calf . homans sign is positive.what is the most appropriate next step in Mx

1)treatment with warfarin
2)treatment with heparin
3)perform compression sonography
4)perform impedance plethysmography
5)perform contrast venogrphy

[ArchivalUser]

222222

[ArchivalUser]

3?

[ArchivalUser]

the answer is 3.

I answered 2. According to my understanding this pt is most likely to have DVT. so would it not be appropriate to anticoagulate her first before any Ix? correct me if I am wrong.
any opinions please on this one?

[ArchivalUser]

maybe,bcs first confirm dx by sono,then start heparin which has complication.

[ArchivalUser]

well this patient has all the features of DVT and needs treatment to avoid development of PE or other complications of DVT,before establishing any treatment and as far as the patient is not in distress and stable so go on and do us which is easy,reliable and non invasive and will not take a long time to do it and get the results.