Approach to bleeding disorders (platelet dysfunction) Quiz: Ace Your Exams
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A 75-year-old man presents to the clinic for evaluation of frequent, difficult-to-control nosebleeds over the past two months. He has a history of hypertension, lower gastrointestinal bleeding from angiodysplasia, and aortic stenosis. Temperature is 37°C (98.6°F), blood pressure is 130/80 mmHg, pulse is 88/min, respirations are 18/min, and oxygen saturation is 99% on room air. There is a harsh systolic ejection murmur best heard at the right intercostal space. Laboratory results are shown below. Which of the following tests is most likely to confirm the diagnosis in this patient?
| Laboratory Test | Result | Reference Range |
| Hemoglobin | 9.5 g/dL | 13.5-17.5 g/dL |
| White blood cell count | 7,000 /µL | 4,500-11,000 /µL |
| Platelets | 200,000 /µL | 150,000-400,000 /µL |
| Prothrombin time (PT) | 12 seconds | 11-15 seconds |
| Activated partial thromboplastin time (aPTT) | 34 seconds | 25-40 seconds |
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