NEET 2018 General Surgery Questions 11-20

NEET 2018 General Surgery Questions 11-20

 Q1-5      6-10


Q11) In a patient who is on warfarin for mechanical heart valve, prostatectomy is to be done. When will you stop warfarin?

a) 1 day back

b) 2 days back

c) 3 days back

d) 5 days back


Q12 ) Test done before  radial artery harvesting?

a) Allen test

b)  Pratt's test

c) 


Answer 11) d

Recommendations concerning warfarin anticoagulant management
Low-risk procedures
 No adjustment to anticoagulation required
Check INR within the week before procedure

Avoid elective procedures when anticoagulation is above the
therapeutic range

High-risk procedure in a patient with a low-risk condition
 Discontinue warfarin 5 days before the procedure
 Check INR on day of procedure to ensure <1.5
Restart warfarin on evening after procedure if uncomplicated and recheck INR in 1 week

High-risk procedure in a patient with a high-risk condition
Discontinue warfarin 5 days before the procedure
 Start low molecular weight heparin (LMWH) 2 days after
stopping warfarin

 Check INR on day of procedure to ensure <1.5

 Omit LMWH on day of procedure

Warfarin may be resumed the night of the procedure

LMWH should be continued until INR adequate

The decision to administer intravenous heparin should be
individualised

ref BAiley 27th edition page 220-221


12 ) d Allen’s test
● The patient makes a tight fist while the surgeon compresses
both distal and ulnar arteries digitally; this squeezes blood
from the hand
● The hand is then relaxed and compression of the ulnar artery
is released; the speed of returning colour to the hand is
assessed
● If colour returns in 5–7 s, patency and collateral flow from the
ulnar artery is confirmed

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