Preoperative assessment: recent coronary stent and antiplatelets: practice question

A Anaesthesia 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.

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Anaesthesia · Preoperative assessment: recent coronary stent and antiplatelets

Sample item

A 62-year-old man had a drug-eluting coronary stent placed three months ago and takes aspirin and clopidogrel. He now needs an urgent laparotomy for a perforated viscus. What is the most appropriate antiplatelet plan?

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

The answer and the reasoning

A. Continue aspirin and decide on clopidogrel jointly with the cardiologist and surgeon

Stopping antiplatelet therapy early after a drug-eluting stent carries a high risk of stent thrombosis, so aspirin is continued whenever possible. The decision about the P2Y12 inhibitor balances stent thrombosis against surgical bleeding and is made with the cardiologist and surgeon. An urgent operation cannot be postponed.

Option by option

  • A. Continue aspirin and decide on clopidogrel jointly with the cardiologist and surgeon (correct)

    Correct. Aspirin is continued, and the P2Y12 inhibitor is a shared risk-benefit decision.

  • B. Stop aspirin but continue clopidogrel alone through surgery

    Aspirin is the drug that is usually kept, so continuing clopidogrel alone reverses the priority.

  • C. Stop both drugs now and give prophylactic heparin as cover for the stent

    Heparin does not protect a stent from thrombosis, so stopping both agents leaves it unprotected.

  • D. Stop both drugs and delay the operation by a week to restore platelet function

    A perforated viscus needs urgent surgery, and waiting a week would be harmful and unnecessary.

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.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is A, Continue aspirin and decide on clopidogrel jointly with the cardiologist and surgeon. Stopping antiplatelet therapy early after a drug-eluting stent carries a high risk of stent thrombosis, so aspirin is continued whenever possible.

Why is "Stop aspirin but continue clopidogrel alone through surgery" not the answer?

Aspirin is the drug that is usually kept, so continuing clopidogrel alone reverses the priority.

Why is "Stop both drugs now and give prophylactic heparin as cover for the st…" not the answer?

Heparin does not protect a stent from thrombosis, so stopping both agents leaves it unprotected.

Why is "Stop both drugs and delay the operation by a week to restore platelet…" not the answer?

A perforated viscus needs urgent surgery, and waiting a week would be harmful and unnecessary.

What concept does this question test?

It tests Preoperative assessment: recent coronary stent and antiplatelets in Anaesthesia. The decision about the P2Y12 inhibitor balances stent thrombosis against surgical bleeding and is made with the cardiologist and surgeon. An urgent operation cannot be postponed.

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 Preoperative assessment: recent coronary stent and antiplatelets?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia 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.