Coagulation Conundrum: an Exercise in Clinical Reasoning.

For an acquired coagulation disorder, we want to distinguish between a primary coagulation disorder that directly affects coagulation factors vs. a secondary coagulation disorder that is the result of a systemic illness that impacts coagulation. b As a specialist on the hematology consult service, I am concerned at the severity and urgency of a patient presenting with bleeding and profound coagulopathy. A new diagnosis of a congenital bleeding disorder at the age of 72 is rare; however, in patients with mild bleeding disorders who do not seek routine care, diagnostic delays can occur. Coagulopathy due to vitamin K deficiency can be observed within a week of initiating cefazolin.[7] Therefore, vitamin K deficiency should be entertained as a potential diagnosis in patients on antibiotics with coagulopathy. [Extracted from the article]