A 34-year-old man is brought to the emergency department because of increasing confusion for the past 6 hours. He drinks large amounts of alcohol daily and occasionally uses illicit drugs. He is lethargic and oriented only to person. Physical examination shows jaundice, hepatomegaly, and scattered petechiae over the trunk and back. Laboratory results are as follows: The patient is given intramuscular vitamin K. Two days later, his laboratory results are unchanged. Which of the following is the most likely cause of this patient's laboratory abnormality?

Question

A 34-year-old man is brought to the emergency department because of increasing confusion for the past 6 hours. He drinks large amounts of alcohol daily and occasionally uses illicit drugs. He is lethargic and oriented only to person. Physical examination shows jaundice, hepatomegaly, and scattered petechiae over the trunk and back. Laboratory results are as follows:  The patient is given intramuscular vitamin K.  Two days later, his laboratory results are unchanged.  Which of the following is the most likely cause of this patient's laboratory abnormality?

Quizplus · Accepted Answer

Eductional Objective: Vitamin K-dependent coagulation factors (II, VII, IX, and X) are synthesized in the liver.  Factor VII has the shortest half-life of the coagulation factors.  Failure of the prothrombin time to correct with vitamin K supplementation indicates factor VII deficiency, which is often due to underlying liver disease

A 34-Year-Old Man Is Brought to the Emergency Department Because