65-year-old Man in Medicine / Internal Medicine — 65yo Man | Hematology | SMLE Q#11683
SMLE Question #11683
Medicine / Internal Medicine
Hematology
Objective: OBJ-101
Last updated: February 2026
A 65-year-old man underwent open reduction and internal fixation of a left intertrochanteric hip fracture 6 days ago. He has been receiving prophylactic unfractionated heparin since surgery. Today, he develops new swelling and pain in the left calf, and duplex ultrasonography shows an acute DVT in the left popliteal vein. He has no active bleeding but has multiple ecchymoses at injection sites. Heparin-induced thrombocytopenia is strongly suspected, and all heparin products are stopped. Which anticoagulant is most appropriate to start now to treat his DVT?
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