Coagulation Disorders: The Daily PANCE Blueprint
A 30-year-old man presents to the emergency department due to prolonged bleeding after a minor cut on his hand that occurred three hours ago. He reports frequent nosebleeds and easy bruising since childhood. His mother and sister have similar bleeding tendencies. On examination, there is oozing blood from the cut, but no other abnormalities are noted. Blood pressure is 125/80 mm Hg, and pulse is 78/min. Laboratory results are as follows:
Complete blood count:
- Hemoglobin: 12.0 g/dL (13.5-17.5 g/dL)
- Mean corpuscular volume: 84 µm³ (80-100 µm³)
- Platelets: 180,000/mm³ (150,000-450,000/mm³)
Coagulation studies:
- PT: 12 sec (11-15 sec)
- INR: 1 (0.8-1.2)
- Activated PTT: 48 sec (25-35 sec)
Which of the following is the most likely cause of this patient's bleeding problem?
A. Hemophilia A
B. Vitamin K deficiency
C. Disseminated intravascular coagulation
D. Von Willebrand disease
E. Liver disease
Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Hematology ⇒ Coagulation Disorders ⇒ Clotting factor disorders