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5338 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?

AV and VIII
BVIII, IX, XI, and XII
CXIII
DII, V, VII, IX, X, and XI
Medicine
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