Chapter 98 Perioperative Therapeutic Management Sample Questions
1. Sandy, a 75 years old female patient, 70 kg is scheduled for cataract removal in a week. Medical conditions include valvular atrial fibrillation, hypertension, type 2 diabetes with history of stroke few years ago. All of which are well controlled by the following medications:
Ramipril 10 mg once daily x 5 years
Hydrochlorothiazide 12.5 mg once daily x 5 years
Metformin 500 mg TID x 10 years
Sitagliptin 50 mg once daily x 8 years
Warfarin 5 mg once daily (recent INR = 2.3)
What would you recommend the doctor to do about Sandy’s Warfarin medication?
- A. Continue warfarin, no interruption of anticoagulation is necessary
- B. Discontinue warfarin 5 days pre-surgery, no bridging required, resumed 1 day post-surgery
- C. Discontinue warfarin 5 days pre-surgery, bridge with LMWH 3 days pre-surgery, warfarin and LMWH continued 12-24 hours post-surgery
- D. Discontinue warfarin 5 days pre-surgery, bridge with LMWH 3 days pre-surgery, only warfarin con-tinued 12-24 hours post-surgery
Ans:
A
Tips: Current Guidelines available at Thrombosiscanada.ca recommend continuation of anticoagulation therapy following a very or low bleeding risk procedure. Cataract, minor dental and dermatological pro-cedures and diagnostic testing are among the procedures with minimal risk of bleeding. For complete list,
Save My Preference