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Postoperative ileus — USMLE Step 3 MCQ

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HardSurgery (Post-operative / Follow-up)Postoperative ileusUSMLE Step 3

A hospital transfusion committee is defining default restrictive red-cell transfusion thresholds for hemodynamically stable adults while preserving case-by-case clinical judgment. Which subgroup-specific threshold pair is consistent with the 2023 AABB international guideline?

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Correct answer: B — Use 7.5 g/dL for cardiac surgery and 8 g/dL for orthopedic surgery or preexisting cardiovascular disease

The best answer is “Use 7.5 g/dL for cardiac surgery and 8 g/dL for orthopedic surgery or preexisting cardiovascular disease”. AABB recommends a restrictive strategy for stable adults and notes that clinicians may choose a 7.5-g/dL threshold for patients undergoing cardiac surgery and an 8-g/dL threshold for orthopedic surgery or preexisting cardiovascular disease. These are subgroup thresholds rather than universal transfusion mandates; symptoms, comorbidity, bleeding, and patient preferences still inform an individual decision.

Reference: AABB: Updates in Red Blood Cell Transfusion Thresholds: https://www.aabb.org/docs/default-source/default-document-library/resources/updates-in-red-blood-cell-transfusion-thresholds.pdf