PAEA Surgery End Of Rotation (EOR) Practice Exam

What therapeutic range should be targeted when overlapping with warfarin in DVT treatment?

1. INR between 1-2

2. INR between 2-3

3. INR between 3-4

4. PTT of 0.3-0.7 U/mL

The correct answer is: INR between 2-3

The therapeutic range that is typically targeted when overlapping warfarin therapy for deep vein thrombosis (DVT) treatment is an International Normalized Ratio (INR) between 2-3. This range is considered optimal for preventing thrombotic events while minimizing the risk of bleeding complications. When initiating warfarin therapy in a patient who is also receiving another anticoagulant, such as unfractionated heparin or low molecular weight heparin, the INR must be monitored closely. The desired INR of 2-3 strikes a balance where anticoagulation is effective enough to prevent the formation of new clots or the extension of existing ones, while not being so high that it increases the risk of hemorrhage. Setting the INR range between 1-2 would not provide sufficient anticoagulation for DVT treatment, and an INR range of 3-4 could lead to a higher risk of bleeding, particularly in patients who may already have a predisposition to hemorrhagic events. Additionally, the use of PTT monitoring is not applicable in the context of warfarin therapy, as warfarin primarily affects the INR, which reflects the extrinsic pathway of coagulation rather than the intrinsic pathway measured by partial thromboplast