A 60-year-old man is brought to the emergency department with fever, purulent nasal discharge, and epistaxis. The patient has had fever and persistent nasal discharge for the past 5 days. He developed intermittent epistaxis 2 days ago that has been difficult to control. The patient has also had easy bruising for the past 2 months. Medical history is significant for chronic pancreatic insufficiency , and he has not been taking his prescribed medications. Results of coagulation studies are as follows: Which of the following coagulation factors is most likely to be abnormal in this patient?

Question

A 60-year-old man is brought to the emergency department with fever, purulent nasal discharge, and epistaxis.  The patient has had fever and persistent nasal discharge for the past 5 days.  He developed intermittent epistaxis 2 days ago that has been difficult to control.  The patient has also had easy bruising for the past 2 months.  Medical history is significant for chronic pancreatic insufficiency , and he has not been taking his prescribed medications.  Results of coagulation studies are as follows:  Which of the following coagulation factors is most likely to be abnormal in this patient?

Quizplus · Accepted Answer

Eductional Objective: Patients with chronic pancreatic insufficiency are at risk for fat-soluble vitamin (ie, A, D, E, K) deficiency due to fat malabsorption from pancreatic enzyme insufficiency.  Vitamin K is an important cofactor in the activation of coagulation factors II, VII, IX, and X.  Vitamin K deficiency leads to easy bruising, mucosal bleeding, and prolonged PT.

A 60-Year-Old Man Is Brought to the Emergency Department with Fever