FRCPath Haem Part 1 MCQs-Haemostasis 496

A 35-year-old man with severe congenital factor XI (FXI) deficiency is scheduled for elective surgery. His FXI activity is 5 IU/dL, and he has a history of excessive bleeding following dental extraction. The haematology team plans to administer FXI concentrate for perioperative haemostatic cover. The surgeon also proposes tranexamic acid (TXA) to reduce surgical blood loss.

Which of the following is the most appropriate management decision?

A. Administer FXI concentrate and TXA together to maximise haemostatic efficacy.

B. Administer TXA before surgery and FXI concentrate immediately after surgery.

C. Avoid combining FXI concentrate with TXA because of the increased risk of thrombosis.

D. Replace FXI concentrate with TXA in all patients with severe FXI deficiency.

E. Administer FXI concentrate with prophylactic therapeutic-dose low-molecular-weight heparin (LMWH) to prevent thrombosis.