Case history
Case history #1
A 70-year-old woman‚ known to have osteoporosis and a previous vertebral fracture, presents to the emergency department with a hip fracture after a fall. She has no history of venous thrombosis. On physical exam, her left leg is externally rotated and painful on active and passive motion. The leg is not edematous and there is no calf tenderness on palpation. Her creatinine clearance is 50 mL/minute and her coagulation parameters are normal. Her surgery is delayed. She is at increased risk of VTE due to trauma and immobility and will be at a further risk postoperatively.
Case history #2
A 65-year-old woman with known stage IV ovarian cancer is admitted to the hospital with nausea and vomiting of 5 days' duration. On physical exam, her abdomen is distended and tender, and bowel sounds are diminished. An abdominal x-ray shows small-bowel dilation suggesting small-bowel obstruction. Laboratory values are consistent with acute kidney injury, specifically elevated blood urea nitrogen and creatinine. Coagulation profile and hemoglobin are normal. She is at increased risk of VTE due to malignancy.
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