A 54-Year-Old Man Comes to the Emergency Department with Pain

question 13

Multiple Choice

A 54-year-old man comes to the emergency department with pain and swelling of his right leg.  He injured his leg 2 days ago while playing soccer and noticed the swelling the next day.  His medical history is significant for hypertension and chronic kidney disease.  His medications include amlodipine, lisinopril, and clonidine.  He has not been hospitalized previously.
Laboratory results are as follows:

Ultrasound examination shows deep venous thrombosis of the right lower extremity extending to the superficial femoral vein.  The patient is hospitalized and started on heparin infusion and oral warfarin.
On the second day of hospitalization, his platelet count is 130,000/mm³ and International Normalized Ratio is 1.1.  He reports no additional symptoms and the remainder of his laboratory workup is unremarkable.  Leg pain and swelling are decreased.
Which of the following is the best next step in management of this patient?

• A)Continue heparin infusion and check for heparin-PF4 antibodies
• B)Continue heparin infusion and observe
• C)Stop heparin infusion and check for heparin-PF4 antibodies
• D)Stop heparin infusion, check for heparin-PF4 antibodies, and start argatroban

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Definitions:

Direct Labor

The workforce directly involved in manufacturing a product or delivering a service, whose costs are directly attributable to the product.

Variable Manufacturing

Costs in manufacturing that vary with the level of production output, such as raw materials and labor costs.

Factory Overhead

All indirect costs associated with manufacturing, such as utilities, maintenance, and depreciation of equipment, excluding direct materials and direct labor.

Direct Labor

Direct labor refers to the work of employees directly involved in the manufacturing of products.