申論題

二、請閱讀下述案例報告病程描述並回答下列問題：
A 71-year-old woman with paroxysmal atrial fibrillation being treated with warfarin 3.75 mg/day presented at the hospital with a 5-day history of increasing swelling in her neck, sialorrhoea, and difficulty swallowing. One week earlier, she had been started on fluconazole 200 mg once a day because of oral candidiasis. She was afebrile. Physical examination showed a large, soft, dark-red swelling on the floor of her mouth: her tongue was displaced superiorly. She had a sublingual haematoma. Laboratory testing showed a C-reactive protein level of 65 mg/L (reference value <5.0 mg/L), a white cell count of 12.5✕10⁹ per L with 83.3% neutrophils, and an international normalised ratio of more than 9.0 (reference range < 3.0). Coagulation was rapidly corrected with prothrombin complex concentrate and intravenous vitamin K, leading to spontaneous resolution of haematoma over the course of one week while the patient was under close surveillance.