American Board of Family Medicine (ABFM) Practice Exam

What is a common treatment approach for a patient presenting with DVT while on warfarin therapy?

1. Intravenous heparin

2. Compression stockings

3. Rivaroxaban for 3 months

4. Oral anticoagulants for life

The correct answer is: Rivaroxaban for 3 months

A common treatment approach for a patient presenting with deep vein thrombosis (DVT) while on warfarin therapy is to prescribe rivaroxaban for a duration of 3 months. This is because rivaroxaban is a direct oral anticoagulant that offers effective management of DVT, often without the need for bridging with other anticoagulants when initiated after appropriate initial therapy. In cases where a patient experiences DVT despite being on warfarin, there may be concerns about inadequate anticoagulation or issues with therapeutic levels which rivaroxaban can address through a straightforward dosing regimen. Additionally, switching to rivaroxaban can streamline management and improve adherence, particularly since it does not require monitoring of INR levels like warfarin does. While intravenous heparin can be effective in managing acute thrombotic events, it is typically used in more urgent situations or when immediate anticoagulation is necessary, especially if there is a need to quickly reverse the effects of warfarin. Compression stockings can be beneficial for long-term management and prevention of post-thrombotic syndrome but are not effective treatments for the acute thrombus itself. Long-term oral anticoagulants may be indicated in certain cases but are not universally applied for