Approach to bleeding disorders (coagulopathy) Quiz: Ace Your Exams
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A 19-year-old woman presents to the primary care clinic for evaluation of large bruises on her legs and arms that have developed over the past several weeks without any preceding trauma. She also has been experiencing bulky, oily, foul-smelling stools. She has a history of recurrent upper respiratory infections since childhood. Her current medications include eletriptan for migraines. There is no family history of bleeding disorders. Physical examination reveals a thin woman with multiple large ecchymoses on the bilateral upper and lower extremities. Lung exam is significant for diffuse crackles. Cardiac and abdominal exams are within normal limits. Laboratory results are shown below. What is the most probable cause of this patient's bruising?
| Laboratory value | Result |
| Serum chemistries | |
| Hemoglobin | 11.4 g/dL |
| Platelet count | 240,000/mm3 |
| Serum albumin | 3.6 g/dL |
| Total bilirubin | 0.6 mg/dL |
| Alkaline phosphatase | 52 U/L |
| AST | 24 U/L |
| ALT | 26 U/L |
| Prothrombin time (PT) | 25 seconds |
| Activated Partial thromboplastin time (aPTT) | 28 seconds |
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