Haematology: warfarin reversal: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

General Medicine · Haematology: warfarin reversal

Sample item

A patient on warfarin has an INR of 9 with intracranial haemorrhage. Which is the most appropriate reversal?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Intravenous vitamin K with prothrombin complex concentrate

Life-threatening bleeding on warfarin needs immediate replacement of vitamin K dependent factors with prothrombin complex concentrate, plus intravenous vitamin K for sustained effect. Fresh frozen plasma is an alternative if PCC is unavailable. Observation is only for high INR without bleeding.

Option by option

  • A. Platelet transfusion

    Platelets do not correct the coagulopathy.

  • B. Intravenous vitamin K with prothrombin complex concentrate (correct)

    Correct. PCC works at once and vitamin K sustains the effect.

  • C. Oral vitamin K alone

    Oral vitamin K acts too slowly for major bleeding.

  • D. Stop warfarin and observe

    Observation is unsafe with intracranial haemorrhage.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Intravenous vitamin K with prothrombin complex concentrate. Life-threatening bleeding on warfarin needs immediate replacement of vitamin K dependent factors with prothrombin complex concentrate, plus intravenous vitamin K for sustained effect.

Why is "Platelet transfusion" not the answer?

Platelets do not correct the coagulopathy.

Why is "Oral vitamin K alone" not the answer?

Oral vitamin K acts too slowly for major bleeding.

Why is "Stop warfarin and observe" not the answer?

Observation is unsafe with intracranial haemorrhage.

What concept does this question test?

It tests Haematology: warfarin reversal in General Medicine. Fresh frozen plasma is an alternative if PCC is unavailable. Observation is only for high INR without bleeding.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Haematology: warfarin reversal?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.