Page 1 of 1: risk of developing if heparin is continued for 14 days?

mdali007 · Credits: 5763 My Scrapbook

A 72-year-old female with a painful, swollen right leg, is admitted to the hospital to rule out deep vein thrombosis (DVT). An infusion of heparin is begun with the goal of maintaining the patient's activated partial thromboplastin time (APTT) at 1.5 times the normal value. A diagnosis of DVT is confirmed on the second day and it is decided that the patient should receive long-term anticoagulation therapy with heparin. Which of the following conditions is the patient at an increased risk of developing if heparin therapy is continued for 14 days?

Options:bdg

A. Agranulocytosis.

B. Anaphylactic reaction.

C. Eosinophilia.

D. Protein C deficiency.

E. Thrombocytopenia.

dosha · Credits: 365 My Scrapbook

ans is E thrombocytopenia

mdali007 · Credits: 5763 My Scrapbook

dosha you are right.

The correct answer is E.

Heparin is the most common cause of drug-induced thrombocytopenia, which can occur in up to 30% of all patients receiving heparin therapy. The risk for development of thrombocytopenia (TCP) seems to increase as the duration of therapy increases, especially when heparin is used for more than 10 days. The risk for developing TCP appears to be greater with full-dose therapy, but it has been reported in all dosage ranges. Some patients with heparin-induced TCP may develop antibodies that deposit on vascular endothelial cells, leading to thrombus formation. These thrombotic episodes tend to occur in a small percentage of patients.

Agranulocytosis (choice A) is an acute condition characterized by profound leukopenia with a substantial reduction of polymorphonuclear leukocytes; heparin is not associated with the development of this condition.

Anaphylactic reactions (choice B) can occur in patients taking heparin. However, the appearance of these allergic reactions is typically evident at the onset of therapy, not the end of therapy.

Eosinophilia (choice C) is a condition characterized by an increased number of circulating eosinophils; heparin is not associated with the development of this condition.

Protein C deficiency (choice D) is a condition that can produce a state of hypercoagulability and thrombosis in the cutaneous microvasculature, leading to skin necrosis. Warfarin, a coumarin anticoagulant, is associated with the development of protein C deficiency; heparin is not.

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