Seven Days After Undergoing Bilateral Total Knee Arthroplasty, a 65-Year-Old

Seven days after undergoing bilateral total knee arthroplasty, a 65-year-old man comes to the physician with a dark discoloration and blisters on his abdomen. Current medications include simvastatin, aspirin, and low molecular weight heparin. His vital signs are within normal limits. Examination of the skin shows multiple coalescing blisters with areas of necrosis around the umbilicus. Laboratory studies show a platelet count of 32,000/mm3. Which of the following is the most likely underlying cause of this patient's symptoms?

A) Anti-desmoglein antibody formation
B) Deficiency in ADAMTS13 activity
C) Antibody formation against heparin-PF4 complex
D) Antibody-platelet antigen complex formation
E) Deficiency in vitamin K
F) Decreased production of GpIb

Correct Answer:

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