Problem: A 35-year-old man comes to the emergency department to evaluate right leg pain and swelling for three days. The symptoms have worsened to the extent that the patient cannot bear weight on her right leg. She does not have shortness of breath, chest pain, or lightheadedness. The patient recently traveled from India to the United States via a 23-hour-long flight. Vital signs are within normal limits. Physical examination shows a swollen, warm, and tender right leg compared to the left leg. Duplex ultrasonography reveals a non-compressible right femoral vein. The patient is provided with a standard dose of warfarin in conjunction with low molecular weight heparin bridging therapy. A physician decides to pursue genetic analysis involving the VKORC1 gene on a subsequent visit. The patient is found to have the homozygous mutation (AA) in the promoter region of the VKORC1 gene, resulting in diminished protein expression. This patient is at risk of which of the following complications following initiation of warfarin therapy? Elimination tool No increased risk when compared to wildtype VKORC1 gene Subtherapeutic INR Supratherapeutic INR Skin necrosis Vascular calcification. Need Professional Help?