A 49-year-old outpatient has mild calf pain after a 7-hour flight. Ultrasound shows an isolated posterior tibial-vein thrombosis 3 cm long, more than

Question

A 49-year-old outpatient has mild calf pain after a 7-hour flight. Ultrasound shows an isolated posterior tibial-vein thrombosis 3 cm long, more than 5 cm below the popliteal vein. He has no cancer, prior VTE, immobility, severe symptoms, or bleeding risk and can return reliably. Which strategy is most appropriate?

Accepted Answer

Use serial compression ultrasonography for 2 weeks and anticoagulate if extension occurs

Answer

Place an inferior vena cava filter and repeat ultrasonography after 2 weeks

Answer

Begin low-molecular-weight heparin for 6 weeks and repeat ultrasonography after treatment

Answer

Begin apixaban for 3 months and repeat ultrasonography if symptoms progress

Answer

Begin aspirin for 3 months and repeat ultrasonography if symptoms progress

Postoperative proximal DVT — USMLE Step 3 MCQ