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Medical Student Forums => Problem-Based Learning Center => Topic started by: Muna1 on April 05, 2010, 09:30:26 PM

Title: Case (60)
Post by: Muna1 on April 05, 2010, 09:30:26 PM
A 60-year-old man with recurrent bacterial sepsis is hospitalized in order to receive intravenous antibiotics. He is started on his fourth course of broad-spectrum antibiotics within the past month. Three days into the admission, his nurse notes that his venous access is oozing blood. Laboratory tests reveal a prolonged prothrombin time, a prolonged partial thromboplastin time, and a normal platelet count. Which of the following coagulation cofactors would be deficient first in this patient?

A. Factor II
B. Factor V
C. Factor VII
D. Factor VIII
E. Factor XI
F. Factor XII
Title: Re: Case (60)
Post by: Munim on April 09, 2010, 11:49:40 AM
salamu 3alykum ya jama3tal kher.
jum3a mubarakah.
I think it is Factor 8.
Title: Re: Case (60)
Post by: Guled1 on April 09, 2010, 03:04:42 PM
 salamu 3alykum

 

The correct answer is C.  long-term treatment with  antibiotics can induce a vitamin K deficiency by clearing intestinal flora(where vitamin K is synthesized). Vitamin K is a necessary cofactor for  production of clotting factors II, VII, IX, and X . Factor VII has the shortest half-life of all clotting factors (4-6 hours), which is why the prothrombin time is prolonged first in vitamin K deficiency.
and no more old patient plz lolz
Title: Re: Case (60)
Post by: Muna1 on April 09, 2010, 10:48:28 PM
that is the correct answer Guled1
 The correct answer is C. Vitamin K is synthesized by the intestinal flora; therefore long-term treatment with broad-spectrum antibiotics can induce a vitamin K deficiency by clearing intestinal flora. Vitamin K is a necessary cofactor for hepatic production of clotting factors II, VII, IX, and X and proteins C and S. Factor VII has the shortest half-life of all clotting factors (4-6 hours), which is why the prothrombin time is prolonged first in vitamin K deficiency
bravo Guled1 :D