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Periprocedural Anticoagulation — MRCP Part 1 MCQ

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ModerateHematologyPeriprocedural AnticoagulationMRCP Part 1

A 78-year-old on warfarin for AF requires an elective colonoscopy with polypectomy. CHADS2-VASc is 3, no prior stroke. Best periprocedural anticoagulation strategy?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Stop warfarin 5 days prior without bridging and resume after

For intermediate thromboembolic risk without recent stroke or mechanical valve, hold warfarin ~5 days preprocedure without bridging. Bridging (A) increases bleeding without benefit. Continuing (C) risks bleeding. Switching to DOAC (D) is not indicated. Empiric vitamin K (E) complicates reanticoagulation.

Reference: CHEST Guideline (2022): Perioperative Management of Antithrombotic Therapy