A 44-Year-Old Man with a History of Heavy Alcohol Consumption

A 44-year-old man with a history of heavy alcohol consumption comes to the emergency department with a nosebleed after getting into a fight while intoxicated.  Continuous local pressure is applied and his bleeding resolves within 30 minutes.  A detailed physical examination is performed after the bleeding subsides and shows distended paraumbilical veins, ascites, and a flapping hand tremor on wrist extension.  Which of the following laboratory findings would be most indicative of a poor prognosis for this patient?

A) High aspartate aminotransferase
B) High fibrinogen levels
C) High gamma glutamyl transferase
D) Prolonged bleeding time
E) Prolonged prothrombin time

Correct Answer:

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