Hepatic Coagulopathy — NDEB AFK MCQ

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ModerateBiomedical SciencesHepatic CoagulopathyNDEB AFK

A patient with severe hepatic cirrhosis is at increased risk for prolonged bleeding after dental extraction primarily due to which mechanism?

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Correct answer: D — Decreased synthesis of clotting factors

The liver synthesises most coagulation factors (I, II, V, VII, IX, X, XI, XII, XIII, fibrinogen, protein C, protein S, antithrombin). Severe hepatic cirrhosis reduces synthesis of these factors, leading to prolonged PT/INR and aPTT and increased bleeding risk. Additionally, cirrhosis causes thrombocytopenia (portal hypertension with splenic sequestration), qualitative platelet defects, and increased fibrinolysis. Pre-operative coagulation screening (PT/INR, aPTT, platelet count) is essential.

Reference: Hoffbrand – Postgraduate Haematology, 7th ed., 2016