What is the most appropriate approach to managing his antithrombotic therapy for the extraction?
Pharmacology questions in the ADC written exam test applied prescribing decisions, not rote recall of drug names. This exam-level vignette tests your ability to work through clinical details and arrive at the correct management.
Mr. David Chen, a 58-year-old man, presents urgently on a Saturday morning with severe pain from a lower right wisdom tooth. He had a coronary artery stent placed 4 months ago and takes warfarin plus aspirin 100 mg daily. His cardiologist has advised he must remain on both medications. He has an INR of 3.0 from Friday's blood test. Clinical examination reveals a partially erupted tooth 48 with pericoronitis and localised swelling but no trismus or systemic signs of infection. After 6 months have passed since the stent placement, the wisdom tooth still requires extraction. The patient remains on warfarin and aspirin. What is the most appropriate approach to managing his antithrombotic therapy for the extraction?
- A. Stop both warfarin and aspirin 5 days before the extraction
- B. Switch warfarin to a DOAC such as rivaroxaban before the extraction, as DOACs have lower bleeding risk
- C. Stop the aspirin but continue warfarin, as warfarin alone provides sufficient thrombotic protection
- D. Continue both medications, consult the patient's cardiologist to evaluate bleeding risk, and consider specialist dental referral
- E. Continue both medications and proceed with extraction in the dental practice with standard local haemostatic measures
The only ADC prep platform where every answer is traced to the guideline source.
No invented explanations. No guesswork content. Every question mapped to Therapeutic Guidelines, Odell's, IADT, and more — so you study what the exam actually tests.
Score high, pay less.
Make your next practice session count. Explore five selected chapters in a 48-hour trial, with an opportunity to earn up to 25% off through the trial challenge. Qualifying steps and deadlines apply.
Try Reviz on WhatsApp.
Explore selected chapters in a 48-hour trial. Account setup is required; continued access needs a paid plan.
Show the answer and cited explanation
According to TG, patients on combination anticoagulant and antiplatelet therapy are at the highest bleeding risk. The patient's medical practitioner must be consulted to evaluate the impact on bleeding risk. Specialist dental referral or management by experienced clinicians should be considered. TG states antithrombotic drugs must not be stopped without consulting the prescribing medical practitioner.
Exam preparation FAQ
Every answer, traced to the source.
Remy — the AI tutor inside Reviz — drills you on 7,000+ ADC-style cited questions with spaced repetition, on WhatsApp and the web.
Explore the Reviz trial