Medical Emergencies · single question
A patient presents with an INR of 3.5 AND a platelet count of 30,000/μL prior to a dental surgical procedure. What is the PRIMARY concern?
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Correct answer: D. Low platelet count only — this poses the most immediate bleeding risk
- A. While both are concerning, the severely low platelet count is the more urgent issue — platelets provide PRIMARY hemostasis; without adequate platelets, clot formation cannot be initiated.
- B. Both values require treatment modification — proceeding without addressing either would be inappropriate.
- C. An INR of 3.5 is elevated (normal 2.0–3.5 for anticoagulated patients), which does increase bleeding risk — but it is manageable.
- D. A platelet count of 30,000/μL is SEVERELY THROMBOCYTOPENIC (normal >150,000). Spontaneous bleeding occurs below 20,000; surgical bleeding is a major risk below 50,000. This is the more IMMEDIATE and critical problem. Platelet count of 30,000 poses a greater bleeding risk than a moderately elevated INR and requires medical consultation/platelet transfusion before proceeding. ✓
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