18th August 2024

A 35-year-old lady presents with left leg weakness and numbness. She reports that since she woke up this morning

A 35-year-old lady presents with left leg weakness and numbness. She reports that since she woke up this morning she has not been able to move her left leg as normal. She reports she felt well when she went to bed. She has a history of DVT following a long flight. She takes no medication other than an oral contraceptive. On examination, you note her BMI is 32 and she is afebrile. She has MRC grade 3 power in her left leg and has reduced sensation. You also note a blotchy mottled purple rash on her lower legs. Initial blood tests demonstrate platelets of 130 x10⁹ (140-400 x10⁹) and an APTT of 32 secs (23-30 secs). Later testing demonstrates positive anti-beta2-glycoprotein, positive anticardiolipin and positive VDRL test. What medication should the patient be commenced on for long-term secondary prevention?

Select the SINGLE most appropriate option from the list below. Select ONE option only.