In high-risk Factor V Leiden patients, the recommended management is...

In high-risk Factor V Leiden patients, the recommended management is...

• A. No therapy
• B. Indefinite anticoagulation
• C. Aspirin monotherapy
• D. Vitamin K supplementation

Answer: (B)

Factor V Leiden increases the risk of venous thrombosis because it causes resistance to activated protein C, tipping the balance toward clot formation. In patients considered high-risk, especially those with a history of thrombosis or strong thrombophilia, preventing recurrence is the primary goal. Long-term, or indefinite, anticoagulation reduces the chance of another clot by continuously suppressing clot formation, making it the best approach for these individuals. It’s chosen after weighing the bleeding risk against recurrence risk, with options like warfarin (target INR 2–3) or a direct oral anticoagulant often used in modern practice. No therapy would leave the patient exposed to recurrent clots. Aspirin monotherapy doesn’t provide adequate protection against venous thromboembolism in high-risk people. Vitamin K supplementation has no role in preventing thrombosis and could worsen the balance toward clotting if anything, so it isn’t used for this purpose.

Factor V Leiden increases the risk of venous thrombosis because it causes resistance to activated protein C, tipping the balance toward clot formation. In patients considered high-risk, especially those with a history of thrombosis or strong thrombophilia, preventing recurrence is the primary goal. Long-term, or indefinite, anticoagulation reduces the chance of another clot by continuously suppressing clot formation, making it the best approach for these individuals. It’s chosen after weighing the bleeding risk against recurrence risk, with options like warfarin (target INR 2–3) or a direct oral anticoagulant often used in modern practice.

No therapy would leave the patient exposed to recurrent clots. Aspirin monotherapy doesn’t provide adequate protection against venous thromboembolism in high-risk people. Vitamin K supplementation has no role in preventing thrombosis and could worsen the balance toward clotting if anything, so it isn’t used for this purpose.