Azathioprine Pre-Op — ORE Part 1 MCQ

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ModerateHuman Disease & Dental ManagementAzathioprine Pre-OpORE Part 1

A patient taking long-term azathioprine for Crohn disease requires a dental extraction. Which pre-operative blood test is most important?

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Correct answer: A — Full blood count

**A. Full blood count** is correct. Azathioprine may cause bone-marrow suppression, particularly leucopenia/neutropenia and thrombocytopenia. Before extraction, an FBC is therefore most informative because it identifies cytopenias relevant to postoperative infection risk and bleeding. The UK SmPC advises regular complete blood counts, including platelets, in patients receiving azathioprine. Liver function tests are also routinely monitored because azathioprine can be hepatotoxic, but they do not assess the principal immediate procedural risks tested here. A coagulation screen is not a routine test solely because a patient takes azathioprine; platelet count, rather than clotting-factor testing, is the relevant bleeding assessment. Serum azathioprine concentration is not routine safety monitoring, and blood glucose is unrelated unless there is a separate diabetic indication.

Reference: Electronic Medicines Compendium. Azathioprine 25 mg Film-Coated Tablets: Summary of Product Characteristics, section 4.4 (Monitoring), 2025. https://www.medicines.org.uk/emc/product/11142/smpc