A 55-year-old man comes to the emergency department with epistaxis (uncontrolled nosebleed). He reports that he has “bleeder’s disease” and has had multiple episodes of inflammatory hemarthroses...

A 55-year-old man comes to the emergency department with epistaxis (uncontrolled nosebleed). He reports that he has “bleeder’s disease” and has had multiple episodes of inflammatory hemarthroses (joint bleeding). Physical examination reveals swollen, immobilized knees; mild jaundice; and an enlarged liver and spleen. CBC results indicate that the patient is anemic and has thrombocytopenia with a platelet count of 74,400/mL (reference interval, 150,000 to 450,000/mL). The PT is 18 seconds (reference interval, 12 to 14 seconds), and the PTT is 43 seconds (reference interval, 25 to 35 seconds).

1. What is the most likely diagnosis? Support your answer.


2. How can the PT result support your diagnosis?


3. Can this be considered a vitamin k deficiency? Why or why not?


4. Provide strong evidence of your diagnosis by creating a table of other possible parameters or test results (coagulation tests) that might be present in this type of condition.