DVT grandpa

Man with DVT

A 60-year-old man presented to the emergency department with a 3-day history of breathlessness and left-sided chest pain.

The chest pain was sharp and was brought on by taking deep breaths. He also coughed up fresh blood.

He has recently been immobile for 6 weeks due to a fracture of the femur. On examination, his blood pressure was 100/62 mmHg, pulse rate 110 beats/minute, temperature 36.7°C, and respiratory rate 24 breaths/minute. His SpO2 was 92% on air.

He was diagnosed to have pulmonary embolism and was started on unfractionated heparin therapy immediately.

Open Ended

Explain the mechanism of action of heparin and the reason for its use in this patient.

[4 marks]

Open Ended

State ONE (1) contraindication to be considered in this patient when starting him on heparin.

[1 mark]

Open Ended

State the specific blood investigation required to monitor heparin therapy in this patient.

[1 mark]

Open Ended

Give THREE (3) reasons why heparin should not be continued for more than 5-7 days.

[3 marks]

Open Ended

State ONE (1) oral anticoagulant that is used to replace heparin that requires monitoring and explain its mechanism of action.

[5 marks]

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