Gen Surgery Blood

MCQs for MCH entrance exam General  Surgery 2021

Blood, Blood Products , Clotting Problems

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Q1 ) . Restrictive strategy of transfusion in acute GI bleed  all are true except?

A. Should be started at a hemoglobin < 7 g/dl
B. Will not alter the risk of re bleed
C. Child A and B patients had significantly lower risk of gi bleed


Ans b

Restrictive vs Liberal means maintaing HB at 7g%

It alters the risk of rebleed. It was significantly lower in restrictive group

In the subgroup of patients with cirrhosis, the risk of further bleeding was lower with the restrictive transfusion strategy than with the liberal transfusion strategy among patients with Child–Pugh class A or B disease and was similar in the two groups among patients with Child–Pugh class C disease.

Ref :

Q2)  Patient on Clopidogrel has  Intraop bleeding.  Which component will you transfuse to control it

a) Platelets
b) FFP
c) Cryoprecipitate


2) A, platelets

Patients on clopidogrel who are actively bleeding and undergoing major surgery may require almost continuous infusion of platelets during the course of the procedure. Arginine vasopressin or its analogues (DDAVP) have also been used in this patient group

Platelet shelf life is 5 days and stored at temp of -24

Bailey 27th page 

Q3) 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

Answer 3) 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

ref BAiley 27th edition page 220-221

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