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Old 10-24-2012
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Vascular DVT Prevention!

A 38-year-old white woman presents to the physician with a 2-week history of aching pain in her left calf that is made worse by dorsiflexion of her foot. On physical examination, her left calf is found to be erythematous, warm, and swollen. Which of the following measures should she take to decrease similar problems in the future?

A Begin taking a bile acid resin
B Begin taking a statin
C Begin taking low-dose oral contraceptives
D Exercise 30 minutes three times per week
E Quit smoking
F Reduce alcohol consumption to one or two glasses of red wine per week
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Old 10-24-2012
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Default Dd...dvt

EEE..quit smoking?but option D sounds right too
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Old 10-24-2012
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Default My asnwer D

there are 2 options,,,, but If my patient would have DVT, I`d prefer that she quit smoking than make exercise
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Old 10-24-2012
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Default my answer :)

E Quit smoking
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Old 10-25-2012
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My answer is E) Quit smoking
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Old 10-25-2012
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The correct answer is E. This patient presents with deep venous thrombosis (DVT). Erythematous, warm, and tender unilateral calf swelling is classic for DVT. Risk factors for DVT and subsequent pulmonary thromboembolism include Virchow's triad, which consists of stasis (eg., immobility, obesity, congestive heart failure), endothelial injury (e.g., trauma, surgery, previous DVT), and hypercoagulable state (e.g., pregnancy, oral contraceptive use, coagulation disorders, malignancies, smoking). This patient also has a positive Homans' sign (calf pain on forced dorsiflexion), which further supports the diagnosis. Not only should this patient be anticoagulated with heparin or warfarin upon presentation, but she should quit smoking to decrease her clotting tendencies.

Answer A is incorrect. Bile acid resins such as cholestyramine and colestipol decrease serum triglycerides and cholesterol, which may indirectly, although not directly, improve vascular health.

Answer B is incorrect. Statins decrease LDL cholesterol but do not affect the rate of DVT formation.

Answer C is incorrect. Oral contraceptives are associated with hypercoagulable state, so they would make DVT more likely.

Answer D is incorrect. Moderate exercise has been linked to improved cardiovascular health and a decreased incidence of acute coronary syndromes, although it is not specifically linked to DVT. Stasis, however, can make DVT thrombosis more likely.

Answer F is incorrect. Modest alcohol consumption has been associated with improved cardiovascular health, although no specific link to DVT has been proven.
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Thanks for the question bro...

Like goljan always say, " Think cheap for the boards." ...Quit smoking should be the right answer then..lol
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