FRCPath Haem Part 1 MCQs-Transfusion 493

A 72-year-old man with a history of Myelodysplastic syndrome and ischaemic heart disease and previous coronary stent insertion is scheduled for elective cataract surgery. His medications include aspirin 75 mg once daily and clopidogrel 75 mg once daily. His full blood count shows:

Investigation	Result
Haemoglobin	108 g/L
White cell count	4.2 × 10⁹/L
Platelet count	45 × 10⁹/L

His coagulation screen is normal. The ophthalmologist asks whether prophylactic platelet transfusion is required before surgery.

What is the most appropriate management?

A. Transfuse one adult therapeutic dose of platelets before surgery.

B. Transfuse two adult therapeutic doses of platelets and stop both antiplatelet agents.

C. Stop aspirin and clopidogrel for 7 days and transfuse platelets immediately before surgery.

D. Proceed with cataract surgery without platelet transfusion

E. Transfuse platelets to achieve a platelet count above 100 × 10⁹/L.