A 64-Year-Old Man Undergoes an Emergency Colonic Resection for Extensive

question 65

Multiple Choice

A 64-year-old man undergoes an emergency colonic resection for extensive ischemic colitis.  He lives alone and consumes large amounts of alcohol.  His family history is noncontributory.  The patient is extubated on the 4th postoperative day.  After extubation, he has episodes of confusion and agitation treated with lorazepam and haloperidol.  He is also receiving piperacillin with tazobactam.  The patient has had nothing by mouth since the surgery.  On postoperative day 7, the nurse notices bleeding from a venipuncture site.  His temperature is 36.7 C (98 F) , blood pressure is 121/76 mm Hg, pulse is 80/min, and respirations are 16/min.  Laboratory results are as follows: Which of the following is the most likely cause of this patient's current condition?

• A)Acute disseminated intravascular coagulation
• B)Factor V Leiden
• C)Factor VIII deficiency
• D)Hypersplenism
• E)Lupus anticoagulant
• F)Thrombotic thrombocytopenic purpura
• G)Vitamin K deficiency
• H)von Willebrand disease

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