Why is 'bridging' with Heparin often required when starting a patient on Warfarin therapy?
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Correct answer: To prevent skin necrosis from rapid Protein C depletion
Warfarin inhibits Protein C and S (natural anticoagulants) faster than it inhibits Prothrombin. This creates a temporary prothrombotic window that can lead to microvascular thrombosis and skin necrosis if not covered by a rapid-acting anticoagulant.
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