Question

A 68-year-old man presents with a swollen, painful left calf after a long-haul flight. Examination shows unilateral pitting oedema up to the knee and tenderness along the deep veins. His Wells score for deep vein thrombosis (DVT) is high. According to NICE NG158, what is the most appropriate immediate management?

Accepted Answer

Start therapeutic anticoagulation and arrange a proximal leg vein ultrasound scan within 4 hours

Answer

Arrange an outpatient ultrasound within 1 week and advise him to stay mobile

Answer

Give prophylactic low-molecular-weight heparin and review in 48 hours

Answer

Wait for a D-dimer result before deciding on anticoagulation

Answer

Admit for observation without imaging or anticoagulation

Practice question