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A 53-Year-Old Woman Arrives at the Hospital with Bleeding into the Back

Question 26

Multiple Choice

A 53-year-old woman arrives at the hospital with bleeding into the back of the throat and has a coagulation screen performed.She has no history of abnormal bleeding before this despite major stress to hemostasis in the past: she was in a major automobile accident at age 37 and has had impacted wisdom teeth extracted.Her coagulation results follow:
 Patient’s  Results  Reference  Range 1:1 Mix with  Normal Plasma  Prothrombin time (PT)  13.1 seconds 1115 seconds  Partial thromboplastin  time (PTT)  87 seconds 2537 seconds 35 Fibrinogen 380200400mg/dLmg/dL\begin{array}{|l|l|l|l|}\hline& \begin{array}{l}\text { Patient's } \\\text { Results }\\\\\end{array} & \begin{array}{l}\text { Reference } \\\text { Range}\\\\\end{array} & \begin{array}{l}\text { 1:1 Mix with } \\\text { Normal Plasma }\\\\\end{array} \\\hline \text { Prothrombin time (PT) } & \begin{array}{l}13.1 \\\text { seconds }\end{array} & \begin{array}{l}11-15 \\\text { seconds }\end{array} \\\hline \begin{array}{l}\text { Partial thromboplastin } \\\text { time (PTT) }\end{array} & \begin{array}{l}87 \\\text { seconds }\end{array} & \begin{array}{l}25-37 \\\text { seconds }\end{array} & \begin{array}{l}35\end{array}\\\hline \text { Fibrinogen } & 380 & 200-400 \\& \mathrm{mg} / \mathrm{dL} & \mathrm{mg} / \mathrm{dL} \\\hline\end{array}
Which of the following is the most likely cause for her bleeding?


A) factor XII deficiency
B) factor IX deficiency
C) factor VIII deficiency
D) factor VIII inhibitor

Correct Answer:

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