Cirrhosis: The Daily PANCE Blueprint
Which of the following laboratory findings is most characteristic of cirrhosis?
A. Hypernatremia
B. Elevated INR
C. Elevated platelet count
D. Hyperalbuminemia
E. Elevated alkaline phosphatase
Answer and topic summary
The answer is B. Elevated INR
Cirrhosis causes impaired liver synthetic function, including decreased production of clotting factors. As a result, INR (international normalized ratio) becomes elevated, reflecting coagulopathy. This is one of the key markers used in assessing liver function (e.g., MELD score). Additional characteristic findings include thrombocytopenia (due to splenic sequestration from portal hypertension), hypoalbuminemia, and hyponatremia (from impaired water handling and increased ADH). Elevated alkaline phosphatase may occur in cholestatic liver disease but is not specific for cirrhosis.
Incorrect answer explanations:
- Hypernatremia – Cirrhotic patients more commonly have hyponatremia due to dilutional effects and ADH elevation.
- Elevated platelet count – Thrombocytopenia is a hallmark of cirrhosis due to splenic sequestration and bone marrow suppression.
- Hyperalbuminemia – Cirrhosis impairs albumin production, leading to hypoalbuminemia, which contributes to ascites.
- Elevated alkaline phosphatase – Can be elevated in liver disease, but it’s more specific to biliary obstruction or cholestasis, not classic cirrhosis.
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint GI and Nutrition ⇒ ⇒
Also covered as part of the Internal Medicine, Family Medicine, and Emergency Medicine PAEA EOR topic list
