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Coagulopathy Cirrhosis Rebalanced Haemostasis — FRCA Final MCQ

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HardGeneral AnaesthesiaCoagulopathy Cirrhosis Rebalanced HaemostasisFRCA Final

A 48-year-old man with hepatitis C cirrhosis (Child-Pugh B) has INR 1.8 and platelets 68. Which statement about his coagulation is most accurate?

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Correct answer: A — INR does not reliably reflect bleeding risk in cirrhosis as both pro- and anticoagulant factors are reduced

In cirrhosis, both procoagulant (II,VII,IX,X) and anticoagulant (protein C, S, antithrombin) factors are reduced. INR only measures procoagulant pathway → overestimates bleeding risk. 'Rebalanced haemostasis' means patients may even be prothrombotic. TEG/ROTEM provides more accurate global assessment.

Reference: BSH – 2021 – Guidelines on management of coagulopathy in cirrhosis