Mechanical Aortic Valve Takes in Medicine / Internal Medicine — 60yo Man | Infectious Diseases | SMLE Q#16797
SMLE Question #16797
Medicine / Internal Medicine
Infectious Diseases
Objective: OBJ-349
Last updated: February 2026
A 60-year-old man with a mechanical aortic valve takes warfarin. He develops 3 weeks of productive cough, night sweats, and progressive shortness of breath. Sputum smear is positive for acid-fast bacilli, and he starts isoniazid, rifampin, pyrazinamide, and ethambutol. Two weeks later, his INR is significantly lower despite adherence to warfarin and no dietary changes. Which medication adjustment is most appropriate?
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