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Hematology — ABIM Board MCQ

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HardHematologyABIM Board

A 73-year-old is admitted with decompensated heart failure and has reduced mobility. He has no active bleeding, platelet count is normal, and creatinine clearance is 48 mL/min. Which VTE-prevention strategy is preferred?

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Correct answer: A — Give prophylactic low-molecular-weight heparin during the inpatient stay

For an acutely ill medical inpatient at acceptable bleeding risk, pharmacologic prophylaxis is appropriate and LMWH is preferred over DOACs. Routine extended prophylaxis after discharge and therapeutic dosing add avoidable bleeding risk.

Reference: ASH Guideline: VTE Prophylaxis for Hospitalized Medical Patients: https://ashpublications.org/bloodadvances/article/2/22/3198/16115/American-Society-of-Hematology-2018-guidelines-for