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Case presentation

A 72-year-old woman is admitted to the surgical ward for an elective open right hemicolectomy. PMH. She was found to have caecal carcinoma eight weeks ago. DH. She completed a short course of preoperative radiotherapy several days ago. She has already been prescribed sufficient pharmacological venous thromboembolism prophylaxis to cover the period up to 24 hours post-operation and has been advised to wear anti-embolism stockings. FH. Her grandfather died of colorectal carcinoma in his 80s. SH. She has a 50-pack-year smoking history but gave up 6 weeks ago.

On examination

Routine observations are normal. She has a body mass index of 21 kg/m2.

Investigations

Hb 125 g/L (115-165), MCV 79 fL (80-96), WCC 6.6 x 109/L (4.0-11.0). Serum biochemistry and liver function tests normal. Contrast enhanced CT of the chest, abdomen and pelvis shows no distal metastasis.

The operation is a success and all solid tumour is resected.

PRESCRIPTION CHART: REGULAR MEDICINES

Time
(hh:mm)
Date
(dd/mm/yy)
Medicine
(Approved Name)
Dose
Units
Route
Enter numbers only.
Frequency
Print Name
Sign Name

Prescribing request

Write a prescription for ONE drug that will help to prevent venous thromboembolism in the period beyond 24 hours post-operation.

TIME REMAINING:

Prepare for the PSA by Finn Catling is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License.