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FRCPath Haem Part 1 MCQ-Haemostasis 300

A 66yr-old pt has pre surgery assessment. APTT: prolonged. PT: normal. Mixing study: corrects. FXII: 3%. What is advice to surgeons?

  • Refer the patient to tertiary care for surgery

  • Cancel surgery and investigate for lupus anticoagulant

  • Replace Factor XII concentrate pre-operatively

  • Proceed with surgery


 
 
 

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adwaan567
Dec 12, 2025

Correct Answer: Proceed with Surgery


This is Factor XII deficiency, which causes a markedly prolonged APTT but no bleeding tendency.

Key points:

  • APTT prolonged, PT normal

  • Mixing study corrects → factor deficiency

  • FXII = 3% → severe deficiency

  • FXII deficiency does not cause clinical bleeding, even with extremely low levels.

Advice to the surgeons:

✅ Proceed with surgery normally — no bleeding risk and no replacement required. No need for FFP, factor replacement, or delay.

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