In a healthy adult undergoing low-risk surgery, which statement best describes routine preoperative laboratory testing?

• A. Routine laboratory tests are always performed regardless of history.
• B. No testing ever.
• C. No routine labs; tests are indicated by history/physical findings.
• D. Coagulation studies are mandatory for low-risk surgery.

Answer: (C)

In healthy adults undergoing a low-risk procedure, routine preoperative labs do not improve outcomes and can lead to unnecessary follow-up or delays from false positives. The best approach is to forgo routine testing and instead order any labs only when the history or physical exam suggests a potential issue that could change management. For example, if there are signs of anemia, kidney or liver dysfunction, electrolyte disturbances, or a bleeding history, targeted tests become appropriate.

Coagulation studies, in particular, are not mandatory for low-risk surgery unless there is a bleeding history, anticoagulant or antiplatelet therapy, liver disease, or another specific risk factor. So the idea is to tailor testing to what would actually influence perioperative care rather than applying a blanket set of tests to every healthy patient.