A 50-Year-Old Man with a Long History of Alcohol Use

A 50-year-old man with a long history of alcohol use disorder is admitted to the hospital with difficulty breathing.  Blood pressure is 90/40 mm Hg, pulse is 114/min, respirations are 22/min, and pulse oximetry is 92% on room air.  Physical examination shows bilateral basal crackles, increased jugular venous pressure, hepatomegaly, ascites, and peripheral pitting edema.  Chest x-ray demonstrates cardiomegaly.  Scattered ecchymoses are present across each extremity.  Laboratory results are as follows: The patient is given intramuscular vitamin K.  Two days later, his laboratory results are unchanged.  Which of the following is the most likely cause of this patient's laboratory abnormality?

A) Dietary vitamin K deficiency
B) Factor VII deficiency
C) Factor VIII deficiency
D) Intrinsic platelet dysfunction
E) Von Willebrand factor deficiency

Correct Answer:

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