Pre-Quiz: DVT Prophylaxis Orientation

A 62-year-old male patient, Mr. Smith, is admitted to the hospital for elective total hip replacement surgery due to osteoarthritis. He has a medical history of hypertension, type 2 diabetes mellitus, and a prior DVT episode following a long-haul flight five years ago. His current medications include metformin, lisinopril, and atorvastatin. Mr. Smith’s BMI is 32, and he reports being a non-smoker. In the preoperative evaluation, which of the following is the most appropriate DVT prophylaxis strategy for Mr. Smith?

A. Initiate enoxaparin (LMWH) 40 mg subcutaneously once daily starting 12 hours before surgery and continuing for 10 days postoperatively.
B. Administer fondaparinux 2.5 mg subcutaneously once daily starting 6 hours before surgery and continuing for 28 days postoperatively.
C. Begin aspirin 81 mg orally once daily starting 12 hours before surgery and continuing for 35 days postoperatively.
D. Commence mechanical prophylaxis using intermittent pneumatic compression devices (IPC) for the duration of hospitalization and early ambulation postoperatively.

In a patient at high risk for DVT but with a contraindication to pharmacological prophylaxis, which of the following is the best alternative intervention?

Early mobilization
Graduated compression stockings
Vena cava filter placement
Vitamin K antagonist

Which of the following medications is associated with an increased risk of DVT due to its hypercoagulable effect?

Levothyroxine
Oral contraceptives
Metformin
Propranolol

PGY1 Orientation

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