Pre-Operative Assessment — ORE Part 1 MCQ

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ModerateOral SurgeryPre-Operative AssessmentORE Part 1

A 22-year-old ASA I patient with no relevant medical history and no regular medication is listed for elective extraction of all four third molars under general anaesthesia. Which pre-operative investigation should be routinely requested?

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Correct answer: E — No routine investigation

The correct answer is E. Pre-operative testing should be directed by the patient’s health, medicines and the nature of surgery, rather than ordered as a routine panel. This healthy ASA I patient has no history or medication suggesting anaemia, bleeding risk, renal impairment or cardiopulmonary disease. NICE NG45 advises that full blood count, haemostasis testing and kidney-function testing are not routinely required for ASA I patients having minor or intermediate elective surgery, and that chest radiographs should not routinely be obtained before surgery. A full blood count may be indicated if anaemia is suspected; a haemostasis screen if there is a bleeding history, liver disease or relevant anticoagulant issue; and kidney-function testing if there is renal risk or risk of acute kidney injury. None applies here.

Reference: National Institute for Health and Care Excellence. Routine preoperative tests for elective surgery (NG45), Recommendations: Tables for minor and intermediate surgery; section 1.8 Chest X-ray. 2016, current guidance page checked July 2026. https://www.nice.org.uk/guidance/ng45/chapter/Recommendations