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Basic Science
intermediate
X-Type

Tranexamic Acid Use - Dosing and Contraindications

Blood Management

A 72-year-old woman is scheduled for elective primary total knee arthroplasty for end-stage osteoarthritis. Her medical history includes well-controlled hypertension, type 2 diabetes (HbA1c 7.1%), and a coronary artery drug-eluting stent placed 2 years ago (currently on aspirin 100mg daily). Her preoperative hemoglobin is 128 g/L. The anaesthetic team asks about the use of tranexamic acid (TXA). Regarding the mechanism of action and evidence for TXA in total joint arthroplasty:

Mark each as TRUE or FALSE

A

Tranexamic acid is a synthetic lysine analogue that competitively inhibits plasminogen activation to...

B

Level I evidence from multiple RCTs and meta-analyses demonstrates that TXA reduces blood loss by 30...

C

TXA is a procoagulant that actively promotes clot formation; it significantly increases VTE risk in ...

D

Routes of TXA administration include: intravenous (most studied), topical/intra-articular (applied t...

E

For this patient with a remote history of coronary stent (greater than 1 year ago), stable cardiac d...

Answer the questions to see explanations

Click T (True) or F (False) for each option