Haematology and oncology: anticoagulation in cancer-associated thrombosis: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Haematology and oncology: anticoagulation in cancer-associated thrombosis

Sample item

A 60-year-old woman with metastatic pancreatic cancer develops a proximal deep vein thrombosis. Which anticoagulant approach is preferred for long-term treatment?

AWarfarin alone without heparin overlapBInferior vena cava filter placement aloneCLow-molecular-weight heparin or a DOACDAspirin alone for a period of six months

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Low-molecular-weight heparin or a DOAC

In cancer-associated venous thromboembolism, LMWH or a DOAC is preferred over vitamin K antagonists, which have more recurrence and unstable INR control from poor intake and chemotherapy interactions. A filter is reserved for those who cannot be anticoagulated.

Option by option

A. Warfarin alone without heparin overlap
Warfarin without overlap is unsafe initially and less effective in cancer.
B. Inferior vena cava filter placement alone
A filter alone does not treat the clot and is used when anticoagulation is contraindicated.
C. Low-molecular-weight heparin or a DOAC (correct)
Correct. LMWH or a DOAC gives lower recurrence than warfarin in malignancy.
D. Aspirin alone for a period of six months
Aspirin is not adequate treatment for a proximal DVT.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Low-molecular-weight heparin or a DOAC. In cancer-associated venous thromboembolism, LMWH or a DOAC is preferred over vitamin K antagonists, which have more recurrence and unstable INR control from poor intake and chemotherapy interactions.

Why is "Warfarin alone without heparin overlap" not the answer?

Warfarin without overlap is unsafe initially and less effective in cancer.

Why is "Inferior vena cava filter placement alone" not the answer?

A filter alone does not treat the clot and is used when anticoagulation is contraindicated.

Why is "Aspirin alone for a period of six months" not the answer?

Aspirin is not adequate treatment for a proximal DVT.

What concept does this question test?

It tests Haematology and oncology: anticoagulation in cancer-associated thrombosis in General Medicine. A filter is reserved for those who cannot be anticoagulated.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Haematology and oncology: anticoagulation in cancer-associated thrombosis?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.