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Chapter 10. Venous Thromboembolism

Student Questions

The following is a recommended risk assessment model for estimating VTE risk specific to general surgical patients:

A. The modified CAPRINI Risk Prediction Score

B. The WELLS Risk Prediction Score

C. The PADUA Risk Prediction Score

D. The PESI Risk Prediction Score

Answer: A

Option A: Correct. The CAPRINI risk prediction score has been validated to predict risk of VTE and general surgical patients and is recommended for use by the American College of Chest Physicians – Guidelines for Antithrombotic Therapy Prophylaxis in these patients.

Option B: Incorrect. The WELLS Criteria is a scoring system to evaluate the Pretest Probability of VTE (DVT or PE).

Option C: Incorrect. The PADUA score is used for VTE risk prediction in hospitalized medical patients.

Option D: Incorrect. PESI is a PE severity index used for risk stratification of pulmonary embolism after the diagnosis has been made.

Which VTE prevention strategy is most appropriate for a 74-year-old female who is undergoing a hip fracture surgery, weighs 84 kg (184 lb), has an estimated creatinine clearance of 58 mL/min (0.97 mL/s), and has no known contraindications to anticoagulant drugs?

A. Warfarin

B. Apixaban

C. Dabigatran

D. Early ambulation combined with graduated compression stockings (GCS)

Answer: A

Option A: Correct. Approved and guideline recommended options for VTE prophylaxis in hip fracture surgery include LMWH, fondaparinux, LDUH, adjusted dose warfarin, and ASA.

Options B and C: Incorrect. Apixaban and Dabigatran have not been evaluated and are not approved for this indication.

Option D: Incorrect. Ambulation with GCS alone (without anticoagulation) is not an effective option.

Which of the following prophylactic strategies is most appropriate for a 65-year-old patient who is admitted to hospital with left-sided paralysis following an acute hemorrhagic stroke?

A. Early ambulation

B. Intermittent pneumatic compression (IPC)

C. Low Molecular Weight Heparin

D. Warfarin

Answer: B

Option A: Incorrect. Early ambulation is not effective in this patient at high risk of VTE.

Option B: Correct.

Options C and D: Incorrect. Anticoagulants are contraindicated given that patient had a ...

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