Deep vein thrombosis Quiz: Ace Your Exams
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An 81-year-old man is admitted to the hospital for an acute diverticular bleed. He receives IV fluid resuscitation and 2 units of packed red blood cells. Abdominal CT scan is performed, and is indicative of diverticulosis at the splenic flexure. He has another bloody bowel movement on day 3 of his hospital stay, but his hemoglobin and symptoms remain stable. On examination he is noted to have swelling and erythema of the right leg. Temperature is 37.3 °C (99.1 °F), blood pressure is 130/82 mmHg, pulse is 88/min, respiratory rate is 14/min, and oxygen saturation is 98% on room air. On physical examination, there is pitting edema and warmth of the right leg, and pain with passive dorsiflexion of the right foot. An ultrasound shows a non-compressible right popliteal vein. Laboratory studies are shown below. Which of the following is the next best step in management?
| Laboratory value | Result |
| Leukocyte count | 9000/mm3 |
| Hemoglobin | 7.2 g/dL |
| Platelet count | 160,000/mm3 |
| INR | 1.0 |
| D-dimer | 1500 ng/mL |
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