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Postoperative deep vein thrombosis — USMLE Step 3 MCQ

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ModerateSurgery (post-operative, follow-up)Postoperative deep vein thrombosisUSMLE Step 3

A 67-year-old man is 8 days after total knee arthroplasty and comes to the office with left calf swelling and pain. He has no chest pain or dyspnea. The calf is tender and 4 cm larger than the other side. Duplex ultrasonography shows a proximal femoral vein thrombosis. Creatinine is normal and there is no active bleeding. Which of the following is the most appropriate at this time?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Begin therapeutic anticoagulation

Symptomatic proximal DVT after surgery is treated with therapeutic anticoagulation unless there is a contraindication; IVC filters are reserved for patients who cannot receive anticoagulation.

Reference: CHEST venous thromboembolism guideline