American Board of Internal Medicine (ABIM) Certification Practice Exam

For patients with ischemic stroke, by which hospital day should DVT prophylaxis be initiated?

1. Day 2

2. Day 1

3. Day 3

4. Day 4

The correct answer is: Day 1

In patients with ischemic stroke who are hospitalized, the initiation of deep vein thrombosis (DVT) prophylaxis is critical to prevent the complications associated with immobility and increased clotting risk that can follow a stroke. Guidelines recommend that DVT prophylaxis should be started on the first hospital day, as this aligns with the goal of minimizing the risk of thromboembolic events early in the patient's hospital stay. Starting prophylaxis on the first day allows for early intervention, which is particularly important because patients with ischemic stroke are often immobilized due to neurological deficits. This risk of DVT is higher in the initial days following the stroke, making prompt prophylactic measures essential. Any delay beyond the first hospital day can increase the risk of developing DVT, which can lead to further complications such as pulmonary embolism. Therefore, starting DVT prophylaxis immediately upon admission or on the first day of hospitalization is the most effective strategy to ensure patient safety and improve outcomes.