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Old 06-07-2011
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Blood Pre Endoscopy Prep for an anticoagulated patient

A 72-year-old man undergoes preoperative evaluation 2 weeks prior to colonoscopy and polypectomy for a growth detected during an earlier procedure. Medical history is significant for a mechanical mitral valve. Medications include warfarin, metoprolol, and lisinopril. Physical examination, including vital signs, is normal.

Which of the following is the most appropriate management of this patient?
A) Continue with procedure without stopping warfarin
B) Stop warfarin and begin low-molecular-weight-heparin preoperatively and resume both agents postoperatively
C) Stop warfarin preoperatively and resume postoperatively
D) Stop warfarin preoperatively, use fresh frozen plasma intraoperatively, and resume warfarin postoperatively
E) Stop warfarin preoperatively, use vitamin K intraoperatively, and resume warfarin postoperatively
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Gastroenterology-, Hematology-, Internal-Medicine-, Step-3-Questions

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