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Heparin-induced thrombocytopenia — RCPSC IM MCQ

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HardHematologyHeparin-induced thrombocytopeniaRCPSC IM

A 62-year-old man develops a 45 percent fall in platelet count 7 days after starting unfractionated heparin for NSTEMI. He has a new painful swollen leg and Doppler confirms femoral vein thrombosis. There is no major bleeding. What is the most appropriate management?

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Correct answer: D — Stop heparin and start a non-heparin anticoagulant

Timing, thrombocytopenia, and new thrombosis are highly suspicious for HIT. Heparin should be stopped and therapeutic non-heparin anticoagulation started while confirmatory testing is pursued.

Reference: Thrombosis Canada HIT clinical guide