A 30-Year-Old Primigravida at 18 Weeks Gestation Comes to the Office

question 197

Multiple Choice

A 30-year-old primigravida at 18 weeks gestation comes to the office due to left calf pain and swelling that developed after a 4-hour car trip.  The pain is worse with ambulation.  The pregnancy was complicated by first-trimester bleeding.  A recent ultrasound showed an 18-week-sized fetus with normal anatomy and no placenta previa.
Examination shows 1+ pretibial edema with pain elicited on plantar flexion of the left lower extremity.  The remainder of the examination is unremarkable.
A lower extremity compression ultrasound with Doppler shows a thrombosis in the left popliteal vein.
Which of the following is the best treatment strategy for this patient?

• A)Inferior vena cava filter placement
• B)Intravenous recombinant tissue-type plasminogen activator
• C)Oral factor Xa inhibitor
• D)Subcutaneous low-molecular-weight heparin
• E)Subcutaneous unfractionated heparin

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Definitions:

Mutually Exclusive

Situations or events that cannot occur at the same time, requiring a choice to be made.

Straight-Line Depreciation

A template for apportioning the cost of a solid asset throughout its active life in equal yearly parts.

Payback Period

The duration it takes for an investment to return its original cost to the investor.

NPV

Net Present Value (NPV) is a financial metric used to evaluate the profitability of an investment or project by discounting all expected future cash flows back to their present value.