Coagulation Disorders USMLE Step 1 Practice Question
A 26-year-old woman is admitted to the labor and delivery unit with placental abruption complicated by massive hemorrhage. Several hours later she develops oozing from venipuncture sites and diffuse petechiae. Laboratory studies show platelets 38,000/mm3, PT prolonged, PTT prolonged, fibrinogen low, and D-dimer markedly elevated. Which of the following best explains this patient's laboratory abnormalities?
Answer choices
- AIsolated inhibition of platelet aggregation due to aspirin use
- BImmune destruction of platelets in the spleen
- CInherited absence of factor VIII
- DExcessive activation of coagulation with secondary consumption of platelets and clotting factorsCorrect answer
- EDefective cleavage of vWF multimers
- FDecreased hepatic synthesis of clotting factors due to acute liver failure
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