The Real-World Boards: Question #35

These are the Real-World Boards. As in the real world, there may be no single “right” answer, and you are only competing against yourself. Upgrade to the Lifelong Learner level for full access to all the questions and unlimited CME credits with an included Learner+ account. An 81-year-old man arrives in the emergency department after experiencing dark stools for a week. He takes warfarin for a mechanical mitral valve, and also for atrial fibrillation and a history of massive pulmonary embolism treated with thrombolytics six months ago. His blood pressure is 110/55; his pulse is 110/min. Hemoglobin is 6.3 g/dL. INR is 3.4. Vitamin K and packed red blood cells are ordered. Both fresh frozen plasma and 4-factor prothrombin complex concentrate are available.