Coagulation Disorders USMLE Step 1 Practice Question
A 45-year-old man with cirrhosis secondary to hepatitis C presents to the emergency department after experiencing prolonged bleeding from a dental extraction 2 days ago. He reports progressive easy bruising over the past week. He denies recent alcohol consumption, melena, or hematemesis. Vital signs are stable. Laboratory studies show: PT 19 seconds (INR 2.3), aPTT 54 seconds, platelet count 92,000/μL, fibrinogen 125 mg/dL, and a normal D-dimer. Which of the following best explains this coagulation abnormality?
Answer choices
- ASelective factor VIII deficiency from hepatic dysfunction
- BDisseminated intravascular coagulation secondary to spontaneous bacterial peritonitis
- CVitamin K malabsorption due to biliary obstruction
- DDecreased hepatic synthesis of multiple coagulation factorsCorrect answer
- EAntithrombin deficiency from urinary losses
- FPrimary hyperfibrinolysis from Portal vein thrombosis
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