MRCS PART A · PERIOPERATIVE CARE

Perioperative decisions

Balance the risks. Choose a plan. Reassess when the facts change.

Examination practice · 12 fictional adult patients · session-only progress · no patient information

Choose a patient

Patient 1 / 120 completed

A last dose before urgent surgery

A 74-year-old taking apixaban for atrial fibrillation needs urgent surgery for a trapped, compromised hernia. Choose the information needed to balance delay against bleeding.

1. Choose the information you need

Only one answer opens at a time. Questions do not alter the patient's facts. In a real emergency, assessment and escalation run together.

2. Which next action best fits the available evidence?A. Wait a fixed 48 hours regardless of bowel compromiseB. Proceed with spinal anaesthesia because PT is normalC. Stop further apixaban and urgently coordinate surgery, anaesthesia and haematology for a bleeding-risk plan without an unsafe delayD. Give routine therapeutic LMWH bridging nowE. Use vitamin K as reliable apixaban reversal

Sources and scope

Guidance checked. Independent MRCS practice, not official exam material or a bedside protocol. Verify current guidance and local emergency procedures. Doses and techniques not specified here need competent clinical prescribing and assessment.

UKCPA — apixaban perioperative guidance