skip to main content

Deep vein thrombosis — PARA MCQ

Instant feedback + full explanation. One question, done properly.

HardGeneral Medicine - HaematologyDeep vein thrombosisPARA

A patient with established triple-positive antiphospholipid syndrome has a confirmed proximal DVT. Renal function is normal and there is no active bleeding. Which anticoagulant strategy does NICE recommend?

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

Reveal the answer and explanation

Correct answer: E — Bridge LMWH to warfarin until INR criteria are met

Explanation lettering: B = shown as A · A = shown as B · E = shown as D · D = shown as E

D is correct. For confirmed proximal DVT or PE with established triple-positive antiphospholipid syndrome, NICE recommends LMWH concurrently with a vitamin K antagonist for at least 5 days and until the INR is at least 2.0 on 2 consecutive readings, followed by the VKA alone. A is inadequate treatment. B does not follow the APS-specific recommendation. C provides no continuing anticoagulation. E is reserved for limited circumstances such as contraindication to anticoagulation, not routine first-line use.

Reference: NICE NG158: venous thromboembolic diseases recommendations: https://www.nice.org.uk/guidance/ng158/chapter/Recommendations GMC: PA registration assessment content map: https://www.gmc-uk.org/education/standards-guidance-and-curricula/standards-and-outcomes/pa-and-aa-prequalification-education-framework/pa-registration-assessment-content-map