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Medicine
A 56-year-old woman presents with feeling light-headed when standing up and 3 days of passing dark black stools. She has a past history of chronic viral hepatitis B, and has developed cirrhosis.On examination, she is alert, blood pressure is 90/60 mm Hg supine and 76/60 mm Hg standing. Her abdomen is distended with signs of ascites, it is nontender, and there are multiple bruises on the legs. Her hemoglobin is 9.0 g/dL, platelets 90,000/mL, albumin 3 g/dL, bilirubin 1.3 mg/dL, and international normalized ratio (INR) 2.5 (prothrombin time 25 seconds). Which of the following coagulation factors are most likely deficient in this patient?
V and VIII
VIII, IX, XI, and XII
XIII
II, V, VII, IX, X, and XI
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