FRCPath Haem Part 1 MCQs-Haemostasis 485

A 72-year-old man with atrial fibrillation presents with sudden severe headache, vomiting and reduced consciousness. CT brain demonstrates a large intracerebral haemorrhage (ICH) with mass effect.

He takes edoxaban 60 mg once daily for stroke prevention. His last dose was 4 hours ago. Blood tests show:

• Hb 118 g/L

• Platelets 214 × 10⁹/L

• PT 18 s

• APTT 38 s

• Renal function: normal

The neurosurgical team considers the haemorrhage life-threatening and requests urgent reversal of anticoagulation.

Which of the following is the most appropriate reversal strategy?

A. Intravenous immunoglobulin (IVIG)

B. Plasma exchange

C. Haemodialysis

D. Prothrombin complex concentrate (PCC)

E. Andexanet alfa

F. Vitamin K + PCC

G. Vitamin K + andexanet alfa