In what is a patient with the following coagulation test results most likely deficient?
Test Result Reference Range
Prothrombin time (PT) 17 seconds 11-15 seconds
Partial thromboplastin time (PTT) 31 seconds 25-37 seconds
Thrombin time (TT) 16 seconds 15-21 seconds
a. Fibrinogen
b. VII
c. VIII
d. X
ANS: B
Factor VII deficiency shows a prolonged PT with a normal PTT result. A deficiency of fibrinogen ideally should prolong the PT, PTT, and TT. Factor VIII deficiency prolongs the PTT but not the PT and TT, whereas a factor X deficiency should prolong both the PT and PTT but not the TT.
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