USMLE DOACs on CCS

[AnalisCanalis]

I'm currently doing the Uworld CCS cases and I've just come across two cases in which DVT/PE is treated with warfarin and heparin bridging. Now where I practice, uncomplicated DVT/PE is just treated with apixaban/rivaroxaban/whichever right off the bat, sometimes with prior LMWH/UFH if there is any uncertainty as to the degree of hemodynamic stability. Warfarin would not receive consideration unless specifically indicated. Are the cases and recommendations in Uworld outdated or is this the standard of care in the US? Any americans care to chime in?

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[steveme]

@AnalisCanalis - Yes, I agree that UWorld CCS is outdated with CCS guidelines and even with regard to turn around times of tests on the software. When USMLE updated their order times and case flows 2 years ago, UW ccs software did not automatically update those turn around times so there are some discrepancies. There are several issues with consults in UWorld. The exact software is at www.usmle.org and I would definitely practice on that several times. If you are looking for exact CCS software being used to demonstrate large number of CCS cases with guidelines, ********** cases videos are excellent and up to date with guidelines and they demonstrate on the exact exam software.

With regard to your question regarding DOACs, even the official exam software from usmle.org is not uptodate with all the newer anticoagulants. But it helps to know that they have updated their list with Xarelto or Rivaroxaban and this can be used instead of Warfarin. They expect us to do that because warfarin is no longer preferred choice for a reason . There is no option for Apixiban or Dabigatran. I obtained this info from ********** and I tested it myself on the official exam software and found that this info is correct.
Similar to how Archer demonstrates high-yield cases on original exam software, the best way is to download the USMLE step3 CCS software from usmle.org and put in these orders to test yourself. This is the best way to practice rather than just doing UWorld