A 55-year-old man presents to the emergency department with easy bruising, frequent nosebleeds, and prolonged bleeding after tooth extraction. He has a history of liver cirrhosis due to chronic alcohol use but denies any recent trauma, anticoagulant use, or family history of bleeding disorders. He was vitally stable. Physical Exam show: Multiple ecchymoses on the arms and legs, Mild gingival bleeding, Mild hepatomegaly, no splenomegaly. Laboratory Findings: PT prolonged, aPTT normal, Platelet count normal. Mixing Study was done and no correction of PT. What is most likely the diagnosis?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: B. Vitamin K Deficiency
An isolated prolonged PT (normal aPTT and platelets) means an extrinsic-pathway problem. In the course notes the causes are mild-moderate vitamin K deficiency, which explicitly includes cirrhosis (reduced synthesis of vitamin K-dependent factors), versus congenital factor VII deficiency. Factor VII deficiency is autosomal recessive with a family history, which this patient denies, so in a cirrhotic patient B is intended.
- Factor VIII deficiency prolongs the aPTT.
- Platelet dysfunction gives a normal PT/PTT.
Note: the stem's "no correction on mixing" does not fit any factor deficiency (deficiencies correct; inhibitors don't).
- المصدر
- HEME-06 Coagulopathy [Notes].pdf · p. 3
HEME-06 Coagulopathy [Notes].pdf · p. 7 - المحاضرة
- Inherited Bleeding Disorders · Hematology · Module C
- ظهر في
- MED42 ♂ EOM C