A patient with cirrhosis of liver has the following coagulation parameters; Platelet count 2,00,000, Prothrombin time 25s/12s, Activated paial thromboplastin time 60s/35s, thrombin time 15s/15s.In this patient:
**Core Concept**
The patient's coagulation parameters indicate a mixed coagulopathy, where both the intrinsic and extrinsic coagulation pathways are affected. This is consistent with cirrhosis of the liver, which can lead to a complex coagulopathy due to impaired synthesis of coagulation factors, platelet dysfunction, and increased fibrinolysis.
**Why the Correct Answer is Right**
The prolonged Prothrombin time (PT) and Activated partial thromboplastin time (aPTT) are indicative of a deficiency in coagulation factors, which are synthesized in the liver. The impaired liver function in cirrhosis leads to decreased production of these factors, resulting in a mixed coagulopathy. The thrombin time (TT) is within normal limits, suggesting that the fibrinogen level is normal. However, the presence of thrombocytopenia (low platelet count) further exacerbates the coagulopathy.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is not provided as the correct answer is given as a single letter.
**Option B:** This option is not provided as the correct answer is given as a single letter.
**Option C:** This option is not provided as the correct answer is given as a single letter.
**Option D:** This option is not provided as the correct answer is given as a single letter.
**Clinical Pearl / High-Yield Fact**
In patients with cirrhosis, a mixed coagulopathy can lead to increased bleeding and thrombosis risks. It is essential to assess coagulation parameters and correct any deficiencies before performing invasive procedures.
**Correct Answer:** D.