What is the best method to prevent warfarin-induced skin necrosis during treatment for thrombosis?

a. Use higher dose of warfarin early in treatment.
b. Give the patient injections of protein C.
c. Stop warfarin at the first sign of necrosis.
d. Use heparin for first 5 days in conjunction with warfarin.

ANS: D
To prevent warfarin-induced skin necrosis, heparin is given along with the warfarin until a therapeutic and stable international normalized ratio (INR) is obtained.