10-14-2010, 04:49 PM
A 30-year old woman comes to your office for evaluation of deep venous thrombi. Last year she developed a lower extremity venous clot. She was on oral contraceptives but has subsequently stopped. She was successfully treated with coumadin for six months. Three weeks ago she developed a femoral venous thrombosis, and now she is again treated with coumadin. Her mother died of a pulmonary embolus, and her aunt on her mother's side had a history of venous thrombosis.
All routine laboratory studies are normal, including the complete blood count, prothrombin time, activated thromboplastin time, and liver function tests. She has a test that is positive for the factor V leiden mutation by polymerase chain reaction (PCR).
What will you recommend to the patient?
(A) Coumadin for another three months
(B) Low-molecular-weight heparin for six months
© Intravenous heparin, then coumadin for six months
(D) Lifelong coumadin
(E) Inferior vena cava filter placement
All routine laboratory studies are normal, including the complete blood count, prothrombin time, activated thromboplastin time, and liver function tests. She has a test that is positive for the factor V leiden mutation by polymerase chain reaction (PCR).
What will you recommend to the patient?
(A) Coumadin for another three months
(B) Low-molecular-weight heparin for six months
© Intravenous heparin, then coumadin for six months
(D) Lifelong coumadin
(E) Inferior vena cava filter placement